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Lopes MMGD, Sousa IM, Queiroz SA, Bezerra MRO, Gonzalez MC, Fayh APT. Bioelectrical impedance vector analysis is different according to the comorbidity burden in post-acute myocardial infarction. Nutr Clin Pract 2024; 39:450-458. [PMID: 37740504 DOI: 10.1002/ncp.11074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/01/2023] [Accepted: 08/20/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND The prevalence of a high comorbidity burden in patients who suffered an acute myocardial infarction (AMI) is increasing with the aging population, and the nutrition status also may be a predictor of clinical outcomes for these patients. This study aimed to investigate the relationship between the comorbidity burden and the characteristics of the bioelectrical impedance vector analysis (BIVA) in patients post-AMI. METHODS This prospective observational cohort study was conducted with adult patients who were hospitalized with AMI. Pre-existing comorbidities were assessed by the Charlson comorbidity index (CCI) adjusted by age, and anthropometric and BIVA characteristics were evaluated after the hemodynamic stabilization. All patients were followed-up until hospital discharge, and their length of stay was observed. RESULTS A total of 184 patients (75% were males; mean age, 60.2 ± 12.3 years) were included. The most common comorbidities were dyslipidemia (73.9%), hypertension (62%), and type 2 diabetes (34.2%). A higher CCI (≥3) was associated with sex (P = 0.008) and age (P < 0.001). Regarding BIVA, statistically significant differences were detected between sex (P < 0.001), age (P < 0.001), and CCI (P = 0.003), with longer vectors in female, older adults, and those with CCI ≥ 3. CONCLUSION Finding a relationship between BIVA and CCI suggests the first identified coherent differences, potentially correlated with diseases, representing a first contribution to support this type of assessment. Therefore, with BIVA, healthcare professionals may monitor abnormalities and adopt preventive nutrition care measures on patients post-AMI to improve their clinical status.
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Affiliation(s)
- Marcia M G D Lopes
- Department of Nutrition, Center for Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Applied Sciences to Women's Health, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Iasmin M Sousa
- Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Sandra Azevedo Queiroz
- Department of Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Mara R O Bezerra
- Department of Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Maria Cristina Gonzalez
- Department of Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Ana Paula Trussardi Fayh
- Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Department of Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Correia MIT, da Silva BR, Gonzalez MC, Kiss N, Francisco EMP, Prado CM. Reply to GP Ayers and W Johnson. Am J Clin Nutr 2024; 119:1089-1090. [PMID: 38569778 DOI: 10.1016/j.ajcnut.2024.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 04/05/2024] Open
Affiliation(s)
- Maria Isabel Td Correia
- Department of Surgery, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
| | - Bruna R da Silva
- Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Maria Cristina Gonzalez
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, Pelotas, State of Rio Grande do Sul, Brazil
| | - Nicole Kiss
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Eliza Mei Perez Francisco
- Nutrition Support Team and Weight Management Center, Mary Mediatrix Medical Center, Lipa City, Batangas, Philippines
| | - Carla M Prado
- Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, AB, Canada.
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de Sousa IM, Fayh APT, Gonzalez MC, Silva FM. Prevalence of low calf circumference in hospitalized patients classified by raw or body mass index-adjusted values. Nutr Clin Pract 2024. [PMID: 38443160 DOI: 10.1002/ncp.11138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/02/2024] [Accepted: 01/20/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Adiposity can influence the estimation of muscle mass using calf circumference (CC) and underestimate the frequency of low CC. An adjustment for CC using body mass index (BMI) was proposed to reduce this effect. We aimed to compare the low CC frequency in hospitalized patients when considering raw and BMI-adjusted values and explore data by sex, age, and race (white and non-white). METHODS Secondary analysis from two cohort studies conducted with adult hospitalized patients using BMI and CC data collected in the first 72 h after hospital admission. We classified low CC by two approaches: (1) raw CC; (2) BMI-adjusted CC for patients with BMI ≥ 25. Cutoff values for low CC were ≤34 cm (men) and ≤33 cm (women). RESULTS Among 1272 patients (54.1 ± 15.3 years old; 51.7% women; 82.1% White race), low CC frequency was 30.6% and low BMI-adjusted CC was 68.9%. For all elevated BMI categories, the low CC frequency was higher when considering BMI-adjusted values (P < 0.001). Low CC was more frequent (P < 0.001) in older adults (38.7% by raw; 79.1% by BMI-adjusted value) than in younger adults (27.6% by raw; 65.2% by BMI-adjusted value) and it was not associated with race. Low CC by raw values was more frequent in men than in women (35.0% versus 26.4%; P = 0.001), but did not differ between sexes when classified by BMI-adjusted values (70.7% versus 67.1%; P = 0.184). CONCLUSION Low CC BMI adjusted was 2.2 times more frequent in comparison with raw CC values, and it was identified in >60% of patients with BMI ≥ 25.
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Affiliation(s)
- Iasmin M de Sousa
- Postgraduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ana Paula Trussardi Fayh
- Postgraduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Postgraduate Program in Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Maria Cristina Gonzalez
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, Rio Grande do Sul, Brazil
| | - Flávia M Silva
- Nutrition Science Postgraduation Program of Federal University of Health Science of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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Dos Santos ALS, Santos BC, Frazão LN, Miranda AL, Fayh APT, Silva FM, Gonzalez MC, Correia MITD, Souza NC, Anastácio LR, Maurício SF. Validity of the GLIM criteria for the diagnosis of malnutrition in patients with colorectal cancer: A multicenter study on the diagnostic performance of different indicators of reduced muscle mass and disease severity. Nutrition 2024; 119:112324. [PMID: 38215671 DOI: 10.1016/j.nut.2023.112324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/27/2023] [Accepted: 12/03/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVES To assess the concurrent and predictive validity of different combinations of Global Leadership Initiative on Malnutrition (GLIM) criteria in patients with colorectal cancer considering different indicators of reduced muscle mass (MM) and the effects of the disease. METHODS A secondary analysis with patients with colorectal cancer. The reduced MM was assessed by arm muscle area, arm muscle circumference, calf circumference, fat-free mass index, skeletal muscle index (SMI) and skeletal muscle. Cancer diagnosis or disease staging (TNM) was considered for the etiologic criterion referred to as the effect of the disease. The other phenotypic and etiologic criteria were also evaluated, and we analyzed 13 GLIM combinations. Concurrent validity between GLIM criteria and Patient-Generated Subjective Global Assessment was evaluated. Logistic and Cox regression were used in the predictive validation. RESULTS For concurrent validity (n = 208), most GLIM combinations (n = 6; 54.5%) presented a moderate agreement with Patient-Generated Subjective Global Assessment and none showed satisfactory sensitivity and specificity (>80%). Reduced MM evaluated by SMI and SMI were present in the GLIM combinations associated with postoperative complications (odds ratio, ≥2.0), independent of other phenotypic and etiologic criteria. The combinations with reduced MM considering any method and fixed phenotypic criteria and TNM were associated with mortality (hazard ratio, ≥2.0). CONCLUSIONS Satisfactory concurrent validity was not verified. The GLIM diagnosis of malnutrition was associated with postoperative complications and mortality.
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Affiliation(s)
| | - Bárbara Chaves Santos
- Universidade Federal de Minas Gerais, Postgraduate Program in Food Science, Belo Horizonte, Brazil
| | | | - Ana Lúcia Miranda
- Universidade Federal do Rio Grande do Norte, Postgraduate Program in Health Sciences, Health Sciences Center, Natal, Brazil
| | - Ana Paula Trussardi Fayh
- Universidade Federal do Rio Grande do Norte, Postgraduate Program in Health Sciences, Health Sciences Center, Natal, Brazil
| | - Flávia Moraes Silva
- Universidade Federal de Ciências da Saúde de Porto Alegre, Department of Nutrition, Porto Alegre, Brazil
| | - Maria Cristina Gonzalez
- Postgraduate Program in Food and Nutrition, Federal University of Pelotas, Rio Grande do Sul, Pelotas, Brazil
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Cattem MVDO, Orsso CE, Gonzalez MC, Koury JC. One-Year Changes in Bioelectrical Impedance Data in Adolescent Athletes. Nutrients 2024; 16:701. [PMID: 38474828 DOI: 10.3390/nu16050701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 02/25/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
Raw bioelectrical impedance (BI) data and vector analysis (BIVA) have been used to evaluate fat-free mass (FFM) cross-sectionally in adolescent athletes; however, there have been no longitudinal studies about it. This study aimed to assess the magnitude of changes in raw BI data (resistance [R], reactance [Xc], and phase angle [PhA]), BIVA, and FFM in adolescent athletes (n = 137, 40% female). BI data were collected using a single-frequency device at baseline and after one year of sports practice. Baseline chronological age categorized the participants (11, 12, or 13 years [y]). In females, Xc/H increased (13 to 14 y, p = 0.04) while R/H decreased in all age groups (p = 0.001). PhA (11 to 12 y, p = 0.048) and FFM (11 to 12 y and 12 to 13 y groups p = 0.001) increased and showed the lowest magnitude of changes in the 13 to 14 y group (p = 0.05). In males, Xc/H decreased (11 to 12 and 12 to 13 y groups, p = 0.001) with a higher magnitude of changes in the 13 to 14 y group (p = 0.004); R/H decreased (p = 0.001); FFM increased in all groups (p = 0.001); however, no magnitude of changes was observed. PhA increased in the 13 to 14 y group (p = 0.004). BIVA showed no differences among ellipse distances in females. In males, a high distance was observed in the 11 to 12 y group. "Time interval" influenced PhA and Xc/H in the female group and R/H and Xc/H in the male group. "Initial age" and "time interval" influenced the increase in PhA in the male group. Raw BI data and BIVA patterns can detect the magnitude of the changes in a sex-dependent manner.
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Affiliation(s)
| | - Camila E Orsso
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2P5, Canada
| | - Maria Cristina Gonzalez
- Post-Graduate Program in Nutrition and Foods, Federal University of Pelotas, Pelotas 96010-610, Brazil
| | - Josely Correa Koury
- Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro 20550-013, Brazil
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Alves VA, Fayh APT, Queiroz SA, Gonzalez MC, de Sousa IM. Muscle mass evaluation in hospitalized patients: Comparison between doubly indirect methods. Clin Nutr ESPEN 2024; 59:188-193. [PMID: 38220375 DOI: 10.1016/j.clnesp.2023.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND Loss of muscle mass (MM) in hospitalized patients has been associated with negative outcomes, thus, evaluating this biomarker is important to stratify risk. Although studies have been showing that calf circumference (CC) and bioelectrical impedance analysis (BIA) are valid for estimating MM in hospitalized patients, we do not know if they are associated. The aim of this study was to evaluate the associations between CC and BIA in hospitalized patients. METHODS A cross-sectional study, in hospitalized patients' post-acute cardiac event. We collected sociodemographic, clinical, and anthropometric data. CC measurement was adjusted according to the BMI. Spearman's correlations and associations between the methods were performed for the total sample, according to sex and stage of life (older adults or not). RESULTS We included 177 patients, mean age of 60.5 ± 12.4 years old, the majority males (75 %). Median BMI was 26.2 kg/m2 (23.8-29.2 kg/m2), most of them overweight (41.8 %). The median of CC was lower in females and older adults, and majority of the patients had low CC (87.6 %). Higher values of fat-free mass (FFM) by BIA were observed in males and younger adults, and 5.6 % presented low FFMI. We found a positive and moderate correlation between fat-free mass index (FFMI) and CC (rho = 0.532). Males had higher correlations (rho = 0.481). An increase of 1 kg in the FFM represented an increase of 1.16 cm (crude analysis) to 1.59 cm (adjusted analysis) in CC (p < 0.001). FFM explained 37 % in the variability of CC, and together with BMI, sex and age, explained 60 % in the variability. CONCLUSIONS Raw values of FFM obtained by BIA and CC presented a weak to moderate correlation in cardiac patients. Changes in one measure impact on the other one.
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Affiliation(s)
- Viviane Andrade Alves
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ana Paula Trussardi Fayh
- Postgraduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil; Postgraduate Program in Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil.
| | - Sandra Azevedo Queiroz
- Postgraduate Program in Nutrition, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | | | - Iasmin Matias de Sousa
- Postgraduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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7
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Correia MITD, da Silva BR, Ayesh W, Ballesteros-Pomar MD, Cardenas D, de van der Schueren MAE, Gonzalez MC, Kiss N, Perez Francisco EM, Prado CM. Sex disparities in parenteral and enteral nutrition societies' leadership worldwide: a 20-year retrospective analysis. Am J Clin Nutr 2024; 119:196-205. [PMID: 37956721 DOI: 10.1016/j.ajcnut.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Despite advancements in the global dialog surrounding sex and gender equity, an important gap persists with women markedly underrepresented in major roles within health care leadership. OBJECTIVES We examined the extent of women's representation in prominent positions within parenteral and enteral nutrition (PEN) societies worldwide over a span of 2 decades. DESIGN This retrospective analysis explored the sex distribution of society chairs, conference presidents, and editor-in-chief positions across 64 PEN societies between 2003 and 2022. Additionally, data on the first and last authors of endorsed clinical guidelines were collected from the 2 leading societies. RESULTS Over the past 20 y, women held society chair positions in 34.4% of cases. The representation shifted from 30% during the decade from 2003 to 2012 to 40.5% from 2013 to 2022. Throughout these years, the numbers consistently ranged from 0 to 10; however, the median shifted upward from 1 during the first decade to 4 in the subsequent decade (P = 0.04). Of 420 congress presidencies, ∼30% were women. In endorsed guidelines, women were the first authors in 27.1% of cases (P < 0.001) and the last in 28.9% (P < 0.001) compared with men. Of the 123 journal editor-in-chief positions, women occupied 23 (18.7%). CONCLUSION Over the last 2 decades, women have been consistently underrepresented in prominent leadership roles in PEN societies globally. Although there has been a noticeable shift toward more women in chair positions, true sex equality remains elusive. Moreover, sex disparities are even more pronounced in positions, such as conference presidents, authors of major guidelines, and editors-in-chief of society-affiliated journals. These data underscore the pressing need to enhance efforts toward sex equality across these domains.
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Affiliation(s)
- Maria Isabel T D Correia
- Department of Surgery, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
| | - Bruna R da Silva
- Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Canada
| | - Wafaa Ayesh
- Nutrition Department Altadawi Hospital and Medical Centres, Dubai, United Arab Emirates
| | - Maria D Ballesteros-Pomar
- Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, Gerencia Regional de Salud de Castilla y León (SACYL), Altos de Nava, León, Spain
| | - Diana Cardenas
- Nutrition Unit, Gustave Roussy Cancer Campus, Villejuif, France
| | - Marian A E de van der Schueren
- Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, Nijmegen, The Netherlands; Department of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | | | - Nicole Kiss
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia; Allied Health Department, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Eliza Mei Perez Francisco
- Nutrition Support Team and Weight Management Center, Mary Mediatrix Medical Center, Lipa City, Batangas, Philippines
| | - Carla M Prado
- Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Canada.
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Lima J, Foletto E, Cardoso RCB, Garbelotto C, Frenzel AP, Carneiro JU, Carpes LS, Barbosa-Silva TG, Gonzalez MC, Silva FM. Ultrasound for measurement of skeletal muscle mass quantity and muscle composition/architecture in critically ill patients: A scoping review on studies' aims, methods, and findings. Clin Nutr 2024; 43:95-110. [PMID: 38016244 DOI: 10.1016/j.clnu.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 10/24/2023] [Accepted: 11/06/2023] [Indexed: 11/30/2023]
Abstract
AIMS This scoping review aimed to identify, explore, and map the objectives, methodological aspects, and results of studies that used ultrasound (US) to assess skeletal muscle (SM) in critically ill patients. METHODS A scoping review was conducted according to the Joanna Briggs Institute's methodology. All studies that evaluated SM parameters from the US in patients admitted to the intensive care unit (ICU) were considered eligible. We categorized muscle thickness and cross-sectional area as parameters for assessing SM quantity, while echogenicity, fascicle length, and pennation angle analysis were used to evaluate muscle "quality" (composition/architecture). A literature search was conducted using four databases for articles published until December 2022. Independent reviewers selected the studies and extracted data. Descriptive statistics were calculated to present the results. RESULTS A total of 107 studies were included, the majority of which were prospective cohort studies (59.8 %) conducted in general ICUs (49.5 %). The most frequent objective of the studies was to evaluate SM quantity depletion during the ICU stay (25.2 %), followed by determining whether a specific intervention would modify SM (21.5 %). Most studies performed serial SM evaluations (76.1 %). The rectus femoris muscle thickness was evaluated in most studies (67.9 %), followed by the rectus femoris cross-sectional area (54.3 %) and the vastus intermedius muscle thickness (40.2 %). The studies demonstrated the feasibility and reproducibility of US for SM evaluation, especially related to quantitative parameters. Most studies (70.3 %) reported significant SM quantity depletion during hospitalization. However, the accuracy of the US in measuring SM varied across the studies. CONCLUSIONS The lack of detailed description and standardization in the protocols adopted by the studies included in this scoping review precludes the translation of the evidence related to US for SM assessment into clinical practice.
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Affiliation(s)
- Júlia Lima
- Nutrition Science Graduate Program, Federal University of Health Sciences of Porto Alegre, Porto Alegre Brazil
| | - Estéfani Foletto
- Nutrition Course, Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre Brazil
| | - Rafaella C B Cardoso
- Nutrition Course, Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre Brazil
| | - Charlles Garbelotto
- Nutrition Course, Department, Federal University of Health Sciences of Porto Alegre, Porto Alegre Brazil
| | - Aline P Frenzel
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas Brazil
| | - Juliana U Carneiro
- Multiprofessional Residency Program: Intensive Care. Federal University of Health Sciences of Porto Alegre, Porto Alegre Brazil
| | - Larissa S Carpes
- Santa Casa de Misericórdia de Porto Alegre Hospital, Porto Alegre Brazil
| | - Thiago G Barbosa-Silva
- Department of General Surgery, Faculty of Medicine, Federal University of Pelotas, Pelotas Brazil
| | | | - Flávia M Silva
- Nutrition Department and Nutrition Science Graduate Program. Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre Brazil.
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Silva AM, Campa F, Stagi S, Gobbo LA, Buffa R, Toselli S, Silva DAS, Gonçalves EM, Langer RD, Guerra-Júnior G, Machado DRL, Kondo E, Sagayama H, Omi N, Yamada Y, Yoshida T, Fukuda W, Gonzalez MC, Orlandi SP, Koury JC, Moro T, Paoli A, Kruger S, Schutte AE, Andreolli A, Earthman CP, Fuchs-Tarlovsky V, Irurtia A, Castizo-Olier J, Mascherini G, Petri C, Busert LK, Cortina-Borja M, Bailey J, Tausanovitch Z, Lelijveld N, Ghazzawi HA, Amawi AT, Tinsley G, Kangas ST, Salpéteur C, Vázquez-Vázquez A, Fewtrell M, Ceolin C, Sergi G, Ward LC, Heitmann BL, da Costa RF, Vicente-Rodriguez G, Cremasco MM, Moroni A, Shepherd J, Moon J, Knaan T, Müller MJ, Braun W, García-Almeida JM, Palmeira AL, Santos I, Larsen SC, Zhang X, Speakman JR, Plank LD, Swinburn BA, Ssensamba JT, Shiose K, Cyrino ES, Bosy-Westphal A, Heymsfield SB, Lukaski H, Sardinha LB, Wells JC, Marini E. The bioelectrical impedance analysis (BIA) international database: aims, scope, and call for data. Eur J Clin Nutr 2023; 77:1143-1150. [PMID: 37532867 DOI: 10.1038/s41430-023-01310-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Bioelectrical impedance analysis (BIA) is a technique widely used for estimating body composition and health-related parameters. The technology is relatively simple, quick, and non-invasive, and is currently used globally in diverse settings, including private clinicians' offices, sports and health clubs, and hospitals, and across a spectrum of age, body weight, and disease states. BIA parameters can be used to estimate body composition (fat, fat-free mass, total-body water and its compartments). Moreover, raw measurements including resistance, reactance, phase angle, and impedance vector length can also be used to track health-related markers, including hydration and malnutrition, and disease-prognostic, athletic and general health status. Body composition shows profound variability in association with age, sex, race and ethnicity, geographic ancestry, lifestyle, and health status. To advance understanding of this variability, we propose to develop a large and diverse multi-country dataset of BIA raw measures and derived body components. The aim of this paper is to describe the 'BIA International Database' project and encourage researchers to join the consortium. METHODS The Exercise and Health Laboratory of the Faculty of Human Kinetics, University of Lisbon has agreed to host the database using an online portal. At present, the database contains 277,922 measures from individuals ranging from 11 months to 102 years, along with additional data on these participants. CONCLUSION The BIA International Database represents a key resource for research on body composition.
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Affiliation(s)
- Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002, Lisbon, Portugal.
| | - Francesco Campa
- Department of Biomedical Science, University of Padova, 35100, Padova, Italy
| | - Silvia Stagi
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042, Cagliari, Italy
| | - Luís A Gobbo
- Skeletal Muscle Assessment Laboratory, Physical Education Department, School of Technology and Science, São Paulo State University, Presidente Prudente, 19060-900, Brazil
| | - Roberto Buffa
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042, Cagliari, Italy
| | - Stefania Toselli
- Department for Life Quality Studies, University of Bologna, 47921, Rimini, Italy
| | - Diego Augusto Santos Silva
- Research Center of Kinanthropometry and Human Performance, Sports Center, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Ezequiel M Gonçalves
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, 13083-887, Brazil
| | - Raquel D Langer
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, 13083-887, Brazil
| | - Gil Guerra-Júnior
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, 13083-887, Brazil
| | - Dalmo R L Machado
- Laboratory of Kinanthropometry and Human Performance, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, 05508-030, São Paulo, Brazil
| | - Emi Kondo
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, 305-8574, Japan
| | - Hiroyuki Sagayama
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, 305-8574, Japan
| | - Naomi Omi
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, 305-8574, Japan
| | - Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, 566-0002, Japan
| | - Tsukasa Yoshida
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, 566-0002, Japan
| | - Wataru Fukuda
- Yokohama Sports Medical Center, Yokohama Sport Association, Kanagawa, 222-0036, Japan
| | - Maria Cristina Gonzalez
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, 96010-610 Pelotas, Brazil
| | - Silvana P Orlandi
- Nutrition Department, Federal University of Pelotas, 96010-610, Pelotas, Brazil
| | - Josely C Koury
- Nutrition Institute, State University of Rio de Janeiro, 20550-013, Rio de Janeiro, Brazil
| | - Tatiana Moro
- Department of Biomedical Science, University of Padova, 35100, Padova, Italy
| | - Antonio Paoli
- Department of Biomedical Science, University of Padova, 35100, Padova, Italy
| | - Salome Kruger
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, 2520, South Africa
| | - Aletta E Schutte
- School of Population Health, University of New South Wales, The George Institute for Global Health, Sydney, NSW, Australia
| | | | | | | | - Alfredo Irurtia
- National Institute of Physical Education of Catalonia (INEFC), University of Barcelona (UB), Barcelona, Spain
| | - Jorge Castizo-Olier
- School of Health Sciences, TecnoCampus, Pompeu Fabra University, Barcelona, Spain
| | - Gabriele Mascherini
- Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - Cristian Petri
- Department of Sports and Computer Science, Section of Physical Education and Sports, Universidad Pablo de Olavide, Seville, Spain
| | - Laura K Busert
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Mario Cortina-Borja
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | | | | | | | - Hadeel Ali Ghazzawi
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Adam Tawfiq Amawi
- Department of Physical and Health Education, Faculty of Educational Sciences, Al-Ahliyya Amman University, Al-Salt, Jordan
| | - Grant Tinsley
- Energy Balance & Body Composition Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, 79409, USA
| | - Suvi T Kangas
- International Rescue Committee, New York, NY, 10168, USA
| | - Cécile Salpéteur
- Department of Expertise and Advocacy, Action contre la Faim, 93358, Montreuil, France
| | - Adriana Vázquez-Vázquez
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Mary Fewtrell
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Chiara Ceolin
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, 35128, Italy
| | - Giuseppe Sergi
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, 35128, Italy
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Berit L Heitmann
- Research Unit for Dietary Studies, The Parker Institute, Frederiksberg and Bispebjerg Hospital, Copenhagen, Denmark
- Section for general Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Roberto Fernandes da Costa
- Department of Physical Education, Research Group in Physical Activity and Health, Federal University of Rio Grande do Norte, Natal, Brazil
| | - German Vicente-Rodriguez
- Faculty of Health and Sport Science FCSD, Department of Physiatry and Nursing, University of Zaragoza, 50009, Zaragoza, Spain
| | - Margherita Micheletti Cremasco
- Laboratory of Anthropology, Anthropometry and Ergonomics, Department of Life Sciences and Systems Biology, University of Torino, 10123, Torino, Italy
| | - Alessia Moroni
- Laboratory of Anthropology, Anthropometry and Ergonomics, Department of Life Sciences and Systems Biology, University of Torino, 10123, Torino, Italy
| | - John Shepherd
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Jordan Moon
- United States Sports Academy, Daphne, AL, 36526, USA
| | - Tzachi Knaan
- Weight Management, Metabolism & Sports Nutrition Clinic, Metabolic Lab, Tel-Aviv, Tel Aviv-Yafo, Israel
| | - Manfred J Müller
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, 24105, Kiel, Germany
| | - Wiebke Braun
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, 24105, Kiel, Germany
| | - José M García-Almeida
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Malaga University, 29010, Malaga, Spain
| | | | - Inês Santos
- Laboratório de Nutrição, Faculdade de Medicina, Centro Académico de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal
| | - Sofus C Larsen
- Research Unit for Dietary Studies at the Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, Frederiksberg, Denmark
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Xueying Zhang
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - John R Speakman
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- School of Biological Sciences, University of Aberdeen, Aberdeen, UK
| | - Lindsay D Plank
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Boyd A Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Jude Thaddeus Ssensamba
- Center for Innovations in Health Africa (CIHA Uganda), Kampala, Uganda
- Makerere University Walter Reed Project, Kampala, Uganda
| | - Keisuke Shiose
- Faculty of Education, University of Miyazaki, Miyazaki, Japan
| | - Edilson S Cyrino
- Metabolism, Nutrition, and Exercise Laboratory. Physical Education and Sport Center, State University of Londrina, Rod. Celso Garcia Cid, Km 380, 86057-970, Londrina-PR, Brazil
| | - Anja Bosy-Westphal
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, 24105, Kiel, Germany
| | | | - Henry Lukaski
- Department of Kinesiology and Public Health Education, Hyslop Sports Center, University of North Dakota Grand Forks, Grand Forks, ND, 58202, USA
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002, Lisbon, Portugal
| | - Jonathan C Wells
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Elisabetta Marini
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042, Cagliari, Italy
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Araujo CF, Schuch HS, Cademartori MG, Bielemann RM, Bertoldi AD, Tomasi E, Gonzalez MC, Demarco FF. Functional dentition and edentulism associated with mortality: A cohort study of older adults in Southern Brazil. Community Dent Oral Epidemiol 2023; 51:1209-1215. [PMID: 37186382 DOI: 10.1111/cdoe.12862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/11/2023] [Accepted: 03/30/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the association between the lack of a functional dentition and edentulism with mortality in a cohort of older adults in a Southern Brazilian city. MATERIALS AND METHODS This is a longitudinal study carried out with community-dwelling older adults (≥60 years old) from Pelotas, Brazil, using data from the baseline (2014) and the first follow-up (2017). Main exposures were functional dentition (20+ teeth present) and edentulism (absence of all teeth), derived from self-reported number of teeth. All-causes mortality was evaluated according to the city's Epidemiological Surveillance Department. Potential confounders were age, sex, socioeconomic position, smoking, diabetes, hypertension, and body mass index (BMI). To test the association between functional dentition and edentulism with mortality, Poisson regression models with robust variance were used, to estimate Relative Risks and 95% confidence intervals. RESULTS A total of 1289 older adults had information on all variables of interest and comprise the analytical sample (from 1451 at baseline). When analysing the presence of functional dentition, only 222 individuals (17.2%) had 20 or more teeth in their mouth, while 490 older adults were edentulous (38.0%). Crude analysis showed an association between tooth loss indicators and mortality. Models adjusted for sociodemographic variables and health conditions and behaviours revelled no association between the exposures and mortality. CONCLUSIONS With the findings of this study, we did not identify an association between edentulism and functional dentition with mortality, after considering important shared risk factors.
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Affiliation(s)
- Cinthia Fonseca Araujo
- Undergraduate student, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | | | | | - Renata Moraes Bielemann
- Postgraduate Program in Nutrition and Foods, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | - Elaine Tomasi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Maria Cristina Gonzalez
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - Flávio Fernando Demarco
- Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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11
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Heymsfield SB, Prado CM, Gonzalez MC. Skeletal muscle-focused guideline development: hierarchical model incorporating muscle form, function, and clinical outcomes. Appl Physiol Nutr Metab 2023; 48:751-756. [PMID: 37473448 DOI: 10.1139/apnm-2023-0176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Sarcopenia, sarcopenic obesity, malnutrition, and cachexia clinical guidelines were created by expert consensus over the past decade. These pathological states all share in common deficits in skeletal muscle mass, and in some cases muscle function, which adversely impact patient outcomes. Early identification is key as some detrimental outcomes are potentially preventable with available treatments. The four guidelines share common design features: patients suspected of having the condition are first screened with a focused clinical history; if positive, the next step is evaluation with either a measure of body "form" (e.g., mass, shape, and composition) or function (e.g., mechanical, endurance, and metabolic); combined form and functional criteria are also recognized. The form and functional "gateway" nodes establish whether or not to proceed with further evaluations and treatments. Intensive discussions among experts focus on selection of these gateway nodes and the final choice is made when consensus is reached. Form and functional measures are often treated as equivalent alternatives when framed in the context of "outcomes" for which they are intended to predict. Here we adapt a classic biological concept stating that "function follows form" to show that pathophysiological links are present between these two different muscle qualities and clinical outcomes. We argue that a hierarchy exists such that outcomes closely follow functions that, in turn, follow form…the OFF rule. The OFF rule explains why functional measures often show stronger associations with outcomes than those quantifying form, helps to frame debates on how to structure the gateway nodes used to identify patients for further evaluation and treatment, and sets out a pathophysiological structure for developing future outcome prediction models.
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Affiliation(s)
- Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Carla M Prado
- Department of Agricultural, Food & Nutritional Science, Human Nutrition Research Unit, University of Alberta, Edmonton, AB, Canada
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12
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Conde Frio C, Härter J, Santos LP, Orlandi SP, Gonzalez MC. Phase angle, physical quality of life and functionality in cancer patients undergoing chemotherapy. Clin Nutr ESPEN 2023; 57:331-336. [PMID: 37739676 DOI: 10.1016/j.clnesp.2023.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/14/2023] [Accepted: 07/11/2023] [Indexed: 09/24/2023]
Abstract
INTRODUCTION Nutritional deficiency, especially malnutrition, is frequent in cancer patients and is associated with changes in body composition, such as low muscle mass. Phase angle (PhA) has been used as a prognostic indicator and may be related to nutritional status, functionality, and quality of life in these patients. The objectives of this study were to assess the effect of chemotherapy treatment on PhA values, comparing the PhA variation before and after treatment, and to evaluate the PhA correlation, as a muscle mass surrogate, with the physical domain of quality of life, functionality, and nutritional risk in a sample of patients with cancer. METHODS A longitudinal study was conducted in patients with cancer undergoing chemotherapy for the first time. All patients aged 18 years or older, newly diagnosed, and undergoing chemotherapy for the first time were included. To analyze the difference in the PhA means according to the different classification variables, the t-test - or ANOVA - was used. The variation of the final and initial PhA was evaluated through the linear regression test. RESULTS A total of 175 patients were analyzed, of which 66.3% were female. The mean PhA of the initial assessment was significantly higher when compared to the final assessment of the patients PhA (p = 0.018). In both the initial and final assessments, PhA was correlated with the physical domain (r = 0.29; p < 0.001 and r = 0.19; p = 0.021) and with the functionality score (r = - 0.32; p < 0.001 and r = - 0.30; p < 0.001) and total PG-SGA (r = - 0.31; p < 0.001 and r = - 0.23; p = 0.006). CONCLUSION PhA can be considered a predictor of physical quality of life and functionality in cancer patients receiving chemotherapy treatment.
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Affiliation(s)
- Camila Conde Frio
- Post-Graduate Program in Nutrition and Food, Universidade Federal de Pelotas, Pelotas, RS, Brazil.
| | - Jéssica Härter
- Medical Sciences of Universidade Federal do Rio Grande Do Sul, Brazil.
| | | | | | - Maria Cristina Gonzalez
- Post-Graduate Program in Nutrition and Food, Universidade Federal de Pelotas, Pelotas, RS, Brazil.
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Figueira RS, Xavier MO, Tomasi E, Demarco FF, Gonzalez MC, Bielemann RM. Validation of dysphagia perception to predict the risk for dysphagia in non-institutionalized older adults. Clin Nutr ESPEN 2023; 57:358-363. [PMID: 37739679 DOI: 10.1016/j.clnesp.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 05/08/2023] [Accepted: 07/11/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND AND AIMS Dysphagia is a swallowing disorder that affects mainly the older adults and can compromise quality of life, and increase the risk for malnutrition and aspiration. Early diagnosis is, therefore, essential to prevent adversities. We aimed to evaluate the validity of self-perceived dysphagia in community-dwelling older adults (60 years or older) from Pelotas, Brazil, participants in the "COMO VAI?" STUDY METHODS The Eating Assessment Tool (EAT-10) was used as the reference tool to identify the risk for dysphagia and the self-perception of dysphagia was assessed using the following question: "Do you have swallowing difficulties?" (Yes/No). The parameters of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were described with 95% confidence intervals (95% CI) and according to independent variables (sex, age, economic level, and education). RESULTS The prevalence of dysphagia risk according to EAT-10 and self-perception was 12.9% (95% CI 10.2-16.1) and 8.8% (95% CI 6.6-11.6), respectively. Sensitivity was 34.8% (95% CI 23.5-47.6) and the highest values were observed in women and the older individuals (80 years or older). Specificity was 95.1% (95% CI 92.6-96.9). PPV was 51.1% (95% CI 35.8-66.3), NPV 90.8% (95% CI 87.8-93.2) and accuracy 87.3%. CONCLUSIONS Considering the low sensitivity and PPV, the self-perception of dysphagia analyzed with a single question should be used with caution, as an individual at risk for dysphagia may not realize their condition.
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Affiliation(s)
| | - Mariana Otero Xavier
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
| | - Elaine Tomasi
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
| | - Flávio Fernando Demarco
- Post-Graduate Program in Epidemiology and Post-Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.
| | - Maria Cristina Gonzalez
- Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil.
| | - Renata Moraes Bielemann
- Nutrition College and Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
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Felipe de Oliveira Guedes F, Matias de Sousa I, Cunha de Medeiros GO, Gonzalez MC, Trussardi Fayh AP. Is there a difference in the parameters of the bioelectrical impedance obtained from devices from different manufacturers? A cross-sectional study in hospitalized cancer patients. Clin Nutr ESPEN 2023; 56:120-126. [PMID: 37344060 DOI: 10.1016/j.clnesp.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 05/02/2023] [Accepted: 05/15/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Cancer is a disease with high and increasing incidence rates in the world and its course tends to harm the body composition. Monitoring these body changes is very important. Therefore, it is essential to have reliable, accessible, and practical methods for evaluating body compartments. This study aims to evaluate the correlation and agreement of results for the bioelectrical impedance analysis (BIA) obtained from devices from different manufacturers. METHODS This is a single-center cross-sectional study including hospitalized patients with cancer. Two devices from different brands used for obtaining the BIA were used; both with a tetrapolar model and a single frequency (50 kHz). The results were evaluated for resistance (R) and reactance (Xc) and used to calculate the phase angle (PhA) and fat-free mass (FFM) indicators. Pearson and Spearman correlation tests and Bland-Altman plots were performed, with results expressed as bias and limits of agreement at 95% confidence intervals (95%CI). RESULTS We have included 116 patients, with a mean age of 60.8 ± 14.8, 51.7% were women. We have found very strong correlations between the measurements of R (rho = 0.971) and FFM (r = 0.979), and strong correlations for Xc (rho = 0.784) and PhA (rho = 0.768). However, the measurements did not agree between the methods. CONCLUSIONS Commercial brands of devices used for the BIA influence the results generated, a factor that must be considered when choosing the most appropriate method for this analysis.
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Affiliation(s)
| | - Iasmin Matias de Sousa
- Postgraduate Program in Health Sciences, Federal University of Rio Grande Do Norte, Natal, RN, Brazil
| | | | | | - Ana Paula Trussardi Fayh
- Postgraduate Program in Health Sciences, Federal University of Rio Grande Do Norte, Natal, RN, Brazil; PesqClin Lab, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH), Federal University of Rio Grande Do Norte, Natal, Brazil; Postgraduate Program in Nutrition, Health Sciences Center, Federal University of Rio Grande Do Norte, Natal, RN, Brazil.
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Souza CCD, Fernandes MP, Bertoldi AD, Demarco FF, Gonzalez MC, Bielemann RM. [Prevalence of water intake among non-institutionalized elderly individuals in Southern Brazil]. Cien Saude Colet 2023; 28:1903-1914. [PMID: 37436305 DOI: 10.1590/1413-81232023287.14692022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 12/21/2022] [Indexed: 07/13/2023] Open
Abstract
The scope of this study was to determine the percentage of elderly individuals receiving an adequate water intake and associated factors among non-institutionalized elderly individuals in the urban area of Pelotas, Rio Grande do Sul. It involved a cross-sectional, population-based study carried out in 2014 with elderly participants (≥ 60 years) of the "COMO VAI?" survey. The amount of water ingested per day of the interviewees was investigated, considering the intake of at least eight glasses per day to be adequate. The independent variables were sociodemographic, behavioral, and health characteristics, and Poisson Regression was used to investigate associations. A total of 1,451 elderly people were interviewed, with only 12.6% (95%CI 10.8; 14.7) drinking a sufficient amount. A higher percentage of the elderly with adequate water consumption was observed in younger elderly individuals, those overweight, those with five or more diseases, and those who were more impaired. A low percentage of the elderly with an adequate water intake was observed among the elderly adults in the study. The decreasing trend of water intake in relation to age highlights the importance of developing actions for the higher risk population to stress adequate water intake and the possible consequences of the lack of adequate consumption.
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Affiliation(s)
- Carolina Corrêa de Souza
- Faculdade de Nutrição, Universidade Federal de Pelotas. R. Gomes Carneiro 1, 2º andar, Prédio 1. 96010-610 Pelotas RS Brasil.
| | - Mayra Pacheco Fernandes
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. Pelotas RS Brasil
| | - Andréa Dâmaso Bertoldi
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. Pelotas RS Brasil
| | - Flávio Fernando Demarco
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. Pelotas RS Brasil
- Programa de Pós-Graduação em Odontologia, Universidade Federal de Pelotas. Pelotas RS Brasil
| | - Maria Cristina Gonzalez
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas. Pelotas RS Brasil
| | - Renata Moraes Bielemann
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. Pelotas RS Brasil
- Programa de Pós-Graduação em Nutrição e Alimentos, Universidade Federal de Pelotas. Pelotas RS Brasil
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Gortan Cappellari G, Guillet C, Poggiogalle E, Ballesteros Pomar MD, Batsis JA, Boirie Y, Breton I, Frara S, Genton L, Gepner Y, Gonzalez MC, Heymsfield SB, Kiesswetter E, Laviano A, Prado CM, Santini F, Serlie MJ, Siervo M, Villareal DT, Volkert D, Voortman T, Weijs PJ, Zamboni M, Bischoff SC, Busetto L, Cederholm T, Barazzoni R, Donini LM. Sarcopenic obesity research perspectives outlined by the sarcopenic obesity global leadership initiative (SOGLI) - Proceedings from the SOGLI consortium meeting in rome November 2022. Clin Nutr 2023; 42:687-699. [PMID: 36947988 DOI: 10.1016/j.clnu.2023.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 02/17/2023] [Indexed: 02/26/2023]
Abstract
The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched the Sarcopenic Obesity Global Leadership Initiative (SOGLI) to reach expert consensus on a definition and diagnostic criteria for Sarcopenic Obesity (SO). The present paper describes the proceeding of the Sarcopenic Obesity Global Leadership Initiative (SOGLI) meeting that was held on November 25th and 26th, 2022 in Rome, Italy. This consortium involved the participation of 50 researchers from different geographic regions and countries. The document outlines an agenda advocated by the SOGLI expert panel regarding the pathophysiology, screening, diagnosis, staging and treatment of SO that needs to be prioritized for future research in the field.
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Affiliation(s)
| | - Christelle Guillet
- University of Clermont Auvergne, INRA, CRNH, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | | | - John A Batsis
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yves Boirie
- University of Clermont Auvergne, INRA, CRNH, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Irene Breton
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Stefano Frara
- Università Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | | | | | | | - Eva Kiesswetter
- Institute for Evidence in Medicine, Medical Center & Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | | | | | | | | | | | - Dorothee Volkert
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Trudy Voortman
- Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Peter Jm Weijs
- Amsterdam University Medical Centers, Amsterdam, the Netherlands; Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | | | | | | | - Tommy Cederholm
- Uppsala University and Karolinska University Hospital, Stockholm, Sweden
| | - Rocco Barazzoni
- Department of Medical Sciences, University of Trieste, Trieste, Italy
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Gomes DRDP, Santos LP, Gonzalez MC, Vieira ER, Bielemann RM. Changes in Physical Performance among Community-Dwelling Older Adults in Six Years. Int J Environ Res Public Health 2023; 20:ijerph20085579. [PMID: 37107860 PMCID: PMC10138314 DOI: 10.3390/ijerph20085579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 05/11/2023]
Abstract
Changes in physical performance (PP) occur with aging, and understanding the magnitude of these changes over time is important. This study evaluated changes in Gait Speed (GS) and Timed Up and Go (TUG) performance and their association with related factors among community-dwelling older adults over a period of five to six years. A cohort study of 476 older adults with baseline assessment conducted in 2014 and reassessment in 2019-2020 was carried out. Associations between PP changes over time and sociodemographic, behavioral, and health variables were evaluated using mixed linear models. Approximately 68% of the participants declined PP; 20% had no relevant change in GS and 9% in TUG time (sustained PP); 12% increased GS, and 23% decreased TUG time (improved PP). Being male (p = 0.023), living without a partner/separated (p = 0.035), higher education (p = 0.019), and alcohol consumption in the prior month (p = 0.045) were associated with decreased GS, while older age (p < 0.001), having lower socioeconomic status (p < 0.004), physical inactivity (p = 0.017), and being overweight (p = 0.007) were associated with increased TUG time. PP declined for most participants. Factors most strongly associated with PP decline are non-modifiable. The high prevalence of PP decline over time signals the importance of including physical tests in yearly health assessments.
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Affiliation(s)
- Darlise Rodrigues dos Passos Gomes
- Post-Graduate Program in Food and Nutrition, Federal University of Pelotas, Pelotas 96075-630, Brazil; (M.C.G.); (R.M.B.)
- Correspondence:
| | | | - Maria Cristina Gonzalez
- Post-Graduate Program in Food and Nutrition, Federal University of Pelotas, Pelotas 96075-630, Brazil; (M.C.G.); (R.M.B.)
| | - Edgar Ramos Vieira
- Department of Physical Therapy, Florida International University, Miami, FL 33199, USA;
| | - Renata Moraes Bielemann
- Post-Graduate Program in Food and Nutrition, Federal University of Pelotas, Pelotas 96075-630, Brazil; (M.C.G.); (R.M.B.)
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas 96020-220, Brazil
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Silva MZC, Cederholm T, Gonzalez MC, Lindholm B, Avesani CM. GLIM in chronic kidney disease: What do we need to know? Clin Nutr 2023; 42:937-943. [PMID: 37099985 DOI: 10.1016/j.clnu.2023.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/27/2023] [Accepted: 04/13/2023] [Indexed: 04/28/2023]
Abstract
The lack of consensus on diagnostic criteria for malnutrition has hampered developments in research and clinical practice pertaining to nutrition. This opinion paper describes the applicability and other aspects of using the Global Leadership Initiative on Malnutrition (GLIM) criteria for diagnosing malnutrition in patients with chronic kidney disease (CKD). We examine the purpose of GLIM, the particularities of CKD that can affect the nutritional and metabolic status and the diagnosis of malnutrition. In addition, we make an appraisal of previous studies that used GLIM in the context of CKD and discuss the value and relevance of using the GLIM criteria in patients with CKD.
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Affiliation(s)
- Maryanne Zilli Canedo Silva
- Department of Internal Medicine, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, Brazil.
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden.
| | | | - Bengt Lindholm
- Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Technology and Intervention, Karolinska Institute, Stockholm, Sweden.
| | - Carla Maria Avesani
- Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Technology and Intervention, Karolinska Institute, Stockholm, Sweden.
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19
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Montes-Ibarra M, Orsso CE, Limon-Miro AT, Gonzalez MC, Marzetti E, Landi F, Heymsfield SB, Barazonni R, Prado CM. Prevalence and clinical implications of abnormal body composition phenotypes in patients with COVID-19: a systematic review. Am J Clin Nutr 2023:S0002-9165(23)46332-0. [PMID: 37037395 PMCID: PMC10082471 DOI: 10.1016/j.ajcnut.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 03/01/2023] [Accepted: 04/03/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND The impact of body composition (BC) abnormalities on coronavirus disease 2019 (COVID-19) outcomes remains to be determined. OBJECTIVE We summarized the evidence on BC abnormalities and their relationship with adverse clinical outcomes in patients with COVID-19. METHODS A systematic search was conducted up until September 26, 2022 for observational studies using BC techniques to quantify skeletal muscle mass (or related compartments), muscle radiodensity or echo intensity, adipose tissue (AT, or related compartments), and phase angle (PhA) in adults with COVID-19. Methodological quality of studies was assessed using the Newcastle-Ottawa Scale. A synthesis without meta-analysis was conducted to summarize the prevalence of BC abnormalities and their significant associations with clinical outcomes. RESULTS We included 62 studies (69.4% low risk of bias) with 12 to 1,138 participants, except three with up to 490,301 participants. Using computed tomography and different cut-offs, prevalence ranged approximately from 22-90% for low muscle mass, 12-85% for low muscle radiodensity, 16-70% for high visceral AT. Using bioelectrical impedance analysis (BIA), prevalence of high fat mass was 51% and low PhA was 22-88%. Mortality was inversely related to PhA (3/4 studies) and positively related to intramuscular AT (4/5 studies), muscle echo intensity (2/2 studies), and BIA-estimated fat mass (2/2 studies). Intensive care unit admission was positively related to visceral AT (6/7 studies) and total AT (2/3 studies). Disease severity and hospitalization outcomes were positively related to intramuscular AT (2/2 studies). Inconsistent associations were found for the rest of BC measures and hospitalization outcomes. CONCLUSIONS Abnormalities in BC were prevalent in patients with COVID-19. Although conflicting associations were observed among certain BC abnormalities and clinical outcomes, higher muscle echo intensity (reflective of myosteatosis) and lower PhA were more consistently associated with greater mortality risk. Likewise, high IMAT and VAT were associated with mortality and ICU admission, respectively.
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Affiliation(s)
- Montserrat Montes-Ibarra
- Human Nutrition Research Unit, Department of Agricultural, Food, & Nutritional Science, University of Alberta, Edmonton, Alberta, Canada. (MMI, CEO, ATLM and CMP)
| | - Camila E Orsso
- Human Nutrition Research Unit, Department of Agricultural, Food, & Nutritional Science, University of Alberta, Edmonton, Alberta, Canada. (MMI, CEO, ATLM and CMP)
| | - Ana Teresa Limon-Miro
- Human Nutrition Research Unit, Department of Agricultural, Food, & Nutritional Science, University of Alberta, Edmonton, Alberta, Canada. (MMI, CEO, ATLM and CMP); Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. (ATLM)
| | - Maria Cristina Gonzalez
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil. (MCG)
| | - Emanuele Marzetti
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy. (EM and FL); Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy. (EM and FL)
| | - Francesco Landi
- Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy. (EM and FL); Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy. (EM and FL)
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, United States. (SBH)
| | - Rocco Barazonni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Italy; Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Cattinara Hospital, Trieste, Italy. (RB)
| | - Carla M Prado
- Human Nutrition Research Unit, Department of Agricultural, Food, & Nutritional Science, University of Alberta, Edmonton, Alberta, Canada. (MMI, CEO, ATLM and CMP).
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20
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Godinho-Mota JCM, Vaz-Gonçalves L, Dias Custódio ID, Schroeder de Souza J, Mota JF, Gonzalez MC, Rodrigues Vilella P, Anusca Martins K, Paiva Maia YCD, Verde SMML, Frenzel AP, Di Pietro PF, Costa Marinho ED, Freitas-Junior R. Impact of Chemotherapy Regimens on Body Composition of Breast Cancer Women: A Multicenter Study across Four Brazilian Regions. Nutrients 2023; 15:nu15071689. [PMID: 37049529 PMCID: PMC10097367 DOI: 10.3390/nu15071689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 03/15/2023] [Accepted: 03/20/2023] [Indexed: 04/03/2023] Open
Abstract
This study aimed to investigate the effect of chemotherapy (CT) and its different types of regimens on the anthropometry and body composition of women with breast cancer. Three-hundred-and-four women with breast cancer were enrolled in this multicenter study. The participants were evaluated before the infusion of the first cycle of CT (pre-CT), and until two weeks after CT completion (post-CT), regarding body weight, body mass index (BMI); waist circumference (WC); waist-to-height ratio (WHtR); conicity index (C-index); fat mass index (FMI); and fat-free mass index (FFMI). CT regimens were classified as anthracycline-based (AC—doxorubicin or epirubicin); anthracyclines and taxane (ACT); cyclophosphamide, methotrexate, and 5-fluorouracil (CMF); or isolated taxanes (paclitaxel or docetaxel). Women significantly increased BMI and FMI post-CT (p < 0.001 and p = 0.007, respectively). The ACT regimen increased FMI (p < 0.001), while FFMI increased after AC (p = 0.007). It is concluded that the CT negatively impacted body composition and the type of regime had a strong influence. The ACT regimen promoted an increase in FMI compared to other regimens, and the AC increased FFMI. These findings reinforce the importance of nutritional monitoring of breast cancer patients throughout the entire CT treatment.
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21
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da Silva Couto A, Gonzalez MC, Martucci RB, Feijó PM, Rodrigues VD, de Pinho NB, Souza NC. Predictive validity of GLIM malnutrition diagnosis in patients with colorectal cancer. JPEN J Parenter Enteral Nutr 2023; 47:420-428. [PMID: 36645343 DOI: 10.1002/jpen.2475] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 12/23/2022] [Accepted: 01/11/2023] [Indexed: 01/17/2023]
Abstract
BACKGROUND Considering that the validation of the Global Leadership Initiative on Malnutrition (GLIM) remains unclear in patients with colorectal cancer, the present study aimed to assess the agreement, accuracy, sensitivity, specificity, and prognostic effect of the GLIM on survival when compared with the Patient-Generated Subjective Global Assessment (PG-SGA). METHODS Patients with colorectal cancer who were scheduled to undergo a routine abdominal computed tomography (CT) scan were recruited. Using the GLIM two-step approach, the patients were first screened for malnutrition by using the PG-SGA Short Form (score ≥3). The malnutrition diagnosis was based on the etiologic (disease burden [cancer] or reduced food intake) and phenotypic GLIM criteria, including weight loss, body mass index, and skeletal muscle index at the third lumbar vertebra when using the CT scans. The food intake was assessed by the PG-SGA. RESULTS This study included 191 patients (age, 60.5 ± 11.3 years; 57% men), and 23% and 32% were malnourished according to the GLIM and the PG-SGA, respectively. The GLIM revealed fair sensitivity (64%), good agreement (kappa = 0.65), specificity (96%), and diagnostic accuracy for detecting malnutrition (area under the receiver operating characteristic curve = 0.80; 95% CI, 0.72-0.88) when compared with the PG-SGA. The malnutrition value according to the GLIM and the PG-SGA was associated with short-term survival. However, only the PG-SGA was associated with long-term survival. CONCLUSIONS Although showing fair sensitivity, the GLIM had good agreement, specificity, and diagnostic accuracy for malnutrition detection and was an independent predictor of short-term survival in patients with colorectal cancer.
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Affiliation(s)
- Andresa da Silva Couto
- Nutrition and Dietetic Service, Cancer Hospital Unit I, National Cancer Institute José Alencar Gomes da Silva, Rio de Janeiro, Brazil
| | - Maria Cristina Gonzalez
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - Renata Brum Martucci
- Nutrition and Dietetic Service, Cancer Hospital Unit I, National Cancer Institute José Alencar Gomes da Silva, Rio de Janeiro, Brazil.,Department of Applied Nutrition, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Patrícia Moreira Feijó
- Nutrition and Dietetic Service, Cancer Hospital Unit I, National Cancer Institute José Alencar Gomes da Silva, Rio de Janeiro, Brazil.,Postgraduate Program in Food, Nutrition, and Health, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Viviane Dias Rodrigues
- Nutrition and Dietetic Service, Cancer Hospital Unit I, National Cancer Institute José Alencar Gomes da Silva, Rio de Janeiro, Brazil.,Postgraduate Program in Medical Science, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | | | - Nilian Carla Souza
- Nutrition and Dietetic Service, Cancer Hospital Unit I, National Cancer Institute José Alencar Gomes da Silva, Rio de Janeiro, Brazil
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22
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Zambrano DN, Xiao J, Soares JLS, Prado CM, Gonzalez MC. Muscle abnormalities in patients with liver cirrhosis and its effect on muscle function. Nutrition 2023; 110:112001. [PMID: 36940626 DOI: 10.1016/j.nut.2023.112001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 01/19/2023] [Accepted: 02/04/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVES The progression of chronic liver disease is associated with metabolic alterations that compromise the patient's body composition and physical function. Muscle wasting often occurs with pathologic fat accumulation in the muscle (myosteatosis). Unfavorable changes in body composition frequently arise in conjunction with a decrease in muscle strength. These conditions are associated with worse prognoses. The aim of this study was to explore the associations between computed tomography (CT)-derived measures of muscle mass and muscle radiodensity (myosteatosis) and its correlation with muscle strength in patients with advanced chronic liver disease. METHODS This cross-sectional study was conducted between July 2016 and July 2017. CT images at the third lumbar vertebra level (L3) were analyzed, and skeletal muscle index (SMI) and skeletal muscle radiodensity (SMD) were defined. Handgrip strength (HGS) was assessed by dynamometry. Correlations between CT-assessed body composition and HGS were tested. Multivariable linear regression was used to determine the factors associated with HGS. RESULTS We evaluated 118 patients with cirrhosis, of whom 64.4% were men. Of those evaluated, the mean age was 57.5 ± 8.5 y. Both SMI and SMD showed a positive correlation with muscle strength (r = 0.46 and 0.25, respectively); and age and Model for End-Stage Liver Disease (MELD)score showed the highest negative correlations (r = -0.37 and -0.34, respectively). In multivariable analyses, the presence of comorbidities (≥1), MELD score, and SMI were significantly associated with HGS. CONCLUSIONS Low muscle mass and clinical characteristics of disease severity may adversely affect muscle strength in patients with liver cirrhosis.
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Affiliation(s)
- Daniela N Zambrano
- Postgraduate Program in Health in Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Jingjie Xiao
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada; Covenant Health Palliative Institute, Edmonton, Alberta, Canada
| | - Jorge L S Soares
- Radiology Service of Medical School of Federal University of Pelotas, Pelotas, RS, Brazil
| | - Carla M Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Canada
| | - Maria Cristina Gonzalez
- Postgraduate Program in Health in Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil.
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23
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Sousa IM, Fayh APT, Lima J, Gonzalez MC, Prado CM, Silva FM. Low calf circumference adjusted for body mass index is associated with prolonged hospital stay. Am J Clin Nutr 2023; 117:402-407. [PMID: 36863830 DOI: 10.1016/j.ajcnut.2022.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/07/2022] [Accepted: 11/03/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Calf circumference (CC) is of emerging importance because of its practicality, high correlation with skeletal muscle, and potential predictive value for adverse outcomes. However, the accuracy of CC is influenced by adiposity. CC adjusted for BMI (BMI-adjusted CC) has been proposed to counteract this problem. However, its accuracy to predict outcomes is unknown. OBJECTIVES To evaluate the predictive validity of BMI-adjusted CC in hospital settings. METHODS A secondary analysis of a prospective cohort study in hospitalized adult patients was conducted. The CC was adjusted for BMI by reducing 3, 7, or 12 cm for BMI (in kg/m2) of 25-29.9, 30-39.9, and ≥40, respectively. Low CC was defined as ≤34 cm for males and ≤33 cm for females. Primary outcomes included length of hospital stay (LOS) and in-hospital death, and secondary outcomes were hospital readmissions and mortality within 6 mo after discharge. RESULTS We included 554 patients (55.2 ± 14.9 y, 52.9% men). Among them, 25.3% presented with low CC, whereas 60.6% had BMI-adjusted low CC. In-hospital death occurred in 13 patients (2.3%), and median LOS was 10.0 (5.0-18.0) d. Within 6 mo from discharge, 43 patients (8.2%) died, and 178 (34.0%) were readmitted to the hospital. BMI-adjusted low CC was an independent predictor of LOS ≥ 10 d (odds ratio = 1.70; 95% confidence interval: 1.18, 2.43], but it was not associated with the other outcomes. CONCLUSIONS BMI-adjusted low CC was identified in more than 60% of hospitalized patients and was an independent predictor of longer LOS.
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Affiliation(s)
- Iasmin M Sousa
- Graduate Program in Nutrition and Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil; Graduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Ana Paula T Fayh
- Graduate Program in Nutrition and Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil; Graduate Program in Health Sciences, Health Sciences Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Júlia Lima
- Nutrition Science Graduate Program of Federal University of Health Science of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Maria Cristina Gonzalez
- Graduate Program in Health and Behavior, Catholic University of Pelotas, Rio Grande do Sul, Brazil
| | - Carla M Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Flávia M Silva
- Nutrition Science Graduate Program of Federal University of Health Science of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil; Department of Nutrition, Nutrition Science Graduate Program, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
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24
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Díaz G, T D Correia MI, Gonzalez MC, Reyes M. The global leadership initiative on malnutrition criteria for the diagnosis of malnutrition in patients admitted to the intensive care unit: A systematic review and meta-analysis. Clin Nutr 2023; 42:182-189. [PMID: 36599273 DOI: 10.1016/j.clnu.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/03/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Malnutrition is associated with a high risk of morbidity and mortality in patients with critical illness. The nutrition status of patients in the intensive care unit (ICU) is challenging to assess. The Global Leadership Initiative on Malnutrition (GLIM) is a novel framework used for the diagnosis of malnutrition. However, its efficacy in patients with critical illness in the ICU has not been validated. AIM To investigate the use and validity of the GLIM criteria in adult patients admitted to the ICU. METHODS A systematic review and meta-analysis were performed, and seven databases were searched for relevant studies. The selection criteria included studies that used the GLIM in adult patients admitted to the ICU. Quality assessment was performed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. RESULTS Five studies were included in the analysis. Approximately 15%-68% of patients were diagnosed with malnutrition using the GLIM criteria. Meanwhile, 48%-75% of patients with malnutrition were identified with the Subjective Global Assessment (SGA). The inflammation criterion was easily adjudicated due to critical status, and three studies compared the GLIM and the SGA. According to the QUADAS-2 tool, the nutritional assessment process was not explicit in the studies. The meta-analysis had an overall sensitivity of 65.3% (95% CI: 34.9%-86.9%) and an overall specificity of 88.8% (95% CI: 58.1%-97.8%). In the prospective validation, malnutrition assessed by the GLIM criteria, and the SGA was associated with mortality. However, the association between length of hospital stay and mechanical ventilation was unclear. CONCLUSIONS The use and validity of the GLIM criteria among patients admitted to the ICU is still limited. Moreover, some concurrent and predictive validation studies have methodological limitations. Further studies must be performed to validate the use of the GLIM criteria in the ICU.
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Affiliation(s)
- Gustavo Díaz
- Research Institute on Nutrition, Genetics, and Metabolism, School of Medicine, Universidad El Bosque, Bogota, Colombia; Research in Colombia Foundation. Bogota, Colombia.
| | - Maria Isabel T D Correia
- Department of Surgery, School of Medicine, Universidad de Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Maria Cristina Gonzalez
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.
| | - Mariana Reyes
- Research Institute on Nutrition, Genetics, and Metabolism, School of Medicine, Universidad El Bosque, Bogota, Colombia.
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25
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Frenzel AP, Bielemann RM, Barbosa-Silva TG, Gonzalez MC. Applicability of the SARC-F questionnaire by remote interview. Nutrition 2023; 105:111871. [PMID: 36413820 DOI: 10.1016/j.nut.2022.111871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/10/2022] [Accepted: 10/08/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The aim of this study was to assess the applicability of the strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F) questionnaire by telephone to identify sarcopenia risk (SR; SARC-F ≥6) and low muscle function risk (LMFR; SARC-F ≥ 4) and their associated risk factors in a cohort of community-dwelling older adults in southern Brazil. METHODS A longitudinal study was carried out with community-dwelling older individuals from COMO VAI? STUDY Sociodemographic, behavioral, and health-related information were collected at baseline, and, in the second assessment, the SARC-F questionnaire was applied by phone or in-person interviews. Older adults identified with sarcopenia at the baseline assessment were excluded. Adjusted analysis by Poisson regression according to hierarchical levels was performed. RESULTS Of the 1451 participants interviewed at baseline, only 951 participated in the second assessment. During the second assessment, 732 adults (77%) were interviewed by phone and 219 (23%) in person. There was no statistically significant difference for the SR (9.1 versus 9.7%, P = 0.802) and LMFR (22.4 versus 20.0%, P = 0.435) prevalence when the SARC-F questionnaire was administered in person or by phone, respectively. Age ≥80 y, presence of depressive symptoms, multimorbidity, dependence to perform one or more daily activities, and polypharmacy were factors associated with a higher risk for poor outcomes in older adults interviewed by phone. CONCLUSIONS The similar prevalence between in-person and remote assessments suggests the feasibility of using the SARC-F questionnaire by phone interview as a reliable alternative for sarcopenia and low muscle function risk assessment without the requirement of face-to-face evaluations.
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Affiliation(s)
- Aline P Frenzel
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Pelotas, Brazil
| | - Renata M Bielemann
- Postgraduate Program in Nutrition and Foods, Federal University of Pelotas (UFPel), Pelotas, Brazil
| | | | - Maria Cristina Gonzalez
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Pelotas, Brazil; Postgraduate Program in Nutrition and Foods, Federal University of Pelotas (UFPel), Pelotas, Brazil.
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26
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Guttier MC, Silveira MPT, Tavares NUL, Krause MC, Bielemann RM, Gonzalez MC, Tomasi E, Demarco FF, Bertoldi AD. Difficulties in the use of medications by elderly people followed up in a cohort study in Southern Brazil. Rev Bras Epidemiol 2023; 26:e230020. [PMID: 36921128 PMCID: PMC10000017 DOI: 10.1590/1980-549720230020.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/18/2022] [Indexed: 03/15/2023] Open
Abstract
OBJECTIVE This study aimed to assess the need for help by elderly people to take their medications, the difficulties related to this activity, the frequency of forgotten doses, and factors associated. METHODS Cross-sectional study conducted with a cohort of elderly people (60 years and over - "COMO VAI?" [How do you do?] study), where the need for help to properly take medication and the difficulties faced in using them were evaluated. The Poisson regression model was used to estimate the crude and adjusted prevalence ratios (PR) of the outcomes and respective 95% confidence intervals according to the characteristics of the sample. RESULTS In total, 1,161 elderly people were followed up. The prevalence of participants who reported requiring help with medication was 15.5% (95%CI 13.5-17.8), and the oldest subjects, with lower educational levels, in worse economic situations, on four or more medications and in bad self-rated health were the ones who needed help the most. Continuous use of medication was reported by 83.0% (95%CI 80.7-85.1) of the sample and most participants (74.9%; 95%CI 72.0-77.5) never forgot to take their medications. CONCLUSION The need for help to use medications was shown to be influenced by social and economic determinants. Studies assessing the difficulties in medication use by the elderly are important to support policies and practices to improve adherence to treatment and the rational use of medications.
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Affiliation(s)
- Marília Cruz Guttier
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia -Pelotas (RS), Brasil
| | - Marysabel Pinto Telis Silveira
- Universidade Federal de Pelotas, Instituto de Biologia, Departamento de Fisiologia e Farmacologia, Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas - Pelotas (RS), Brasil
| | | | | | - Renata Moraes Bielemann
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Nutrição e Alimentos - Pelotas (RS), Brasil
| | - Maria Cristina Gonzalez
- Universidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento - Pelotas (RS), Brasil
| | - Elaine Tomasi
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia -Pelotas (RS), Brasil
| | - Flavio Fernando Demarco
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia -Pelotas (RS), Brasil
| | - Andréa Dâmaso Bertoldi
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia -Pelotas (RS), Brasil
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27
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Rosenfeld RS, Gonzalez MC, Freire SM, Lourenço RA. Low phase angle in critically ill older patients is associated with late mortality: A prospective study. Nutrition 2023; 105:111852. [PMID: 36335872 DOI: 10.1016/j.nut.2022.111852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/18/2022] [Accepted: 09/16/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVES The aim of this study was to ascertain the accuracy of phase angle (PhA) as a predictor of mortality during intensive care unit (ICU) stay (MICU) and at 28 (M28) and 60 d (M60) after ICU admission among patients aged >60 y. METHODS Patients aged >60 y who were under mechanical ventilation (MV) ≥48 h were included once they were hemodynamically stable. PhA was measured by single-frequency bioelectrical impedance analysis up to 48 h after admission. ICU prognostic scores, functional scale, and nutritional assessments were performed in the first 24 h. Patients were followed for 60 d after ICU admission. RESULTS We enrolled 102 patients into the present study. PhA was significantly higher (P < 0.001) in survivors at MICU, M28, and M60. Areas under the receiving operator characteristic curves for MICU, M28, and M60 were 0.77 (95% confidence interval [CI], 0.67-0.86), 0.71 (95% CI, 0.60-0.82), and 0.71 (95% CI, 0.60-0.81), respectively. The PhA cutoff to predict mortality was 3.29° for males at MICU, M28, and M60 and lower for females at M28 (2.63°) and M60 (3.01°). PhA better discriminated M60 than conventional prognostic scores. Logistic regression showed that even after controlling for other factors, PhA was a protective factor against late mortality. Survival analysis at 60 d revealed that low PhA was associated with lower median survival (18 versus 58 d; log-rank P < 0.001). CONCLUSIONS Low PhA values are associated with higher late mortality and a short survival time at 60 d in critically ill older adults. Low PhA values can be considered a useful ICU prognostic score in similar populations.
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Affiliation(s)
- Ricardo Schilling Rosenfeld
- Nutrition Support Team, Casa de Saude Sao Jose - Rede Santa Catarina, Rio de Janeiro, Brazil; Postgraduate Program in Medical Science - Rio de Janeiro State University, Rio de Janeiro, Brazil.
| | - Maria Cristina Gonzalez
- Postgraduate Program in Health and Behavior - Catholic University of Pelotas, Pelotas, Brazil
| | - Sergio Miranda Freire
- Department of Information, Technology and Health Education - Rio de Janeiro State University, Rio de Janeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Roberto Alves Lourenço
- Postgraduate Program in Medical Science - Rio de Janeiro State University, Rio de Janeiro, Brazil
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Guttier MC, Silveira MPT, Tavares NUL, Krause MC, Bielemann RM, Gonzalez MC, Tomasi E, Demarco FF, Bertoldi AD. Difficulties in the use of medications by elderly people followed up in a cohort study in Southern Brazil. Rev Bras Epidemiol 2023; 26:e230020. [PMCID: PMC10000017 DOI: 10.1590/1980-549720230020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
Objective: This study aimed to assess the need for help by elderly people to take their medications, the difficulties related to this activity, the frequency of forgotten doses, and factors associated. Methods: Cross-sectional study conducted with a cohort of elderly people (60 years and over — “COMO VAI?” [How do you do?] study), where the need for help to properly take medication and the difficulties faced in using them were evaluated. The Poisson regression model was used to estimate the crude and adjusted prevalence ratios (PR) of the outcomes and respective 95% confidence intervals according to the characteristics of the sample. Results: In total, 1,161 elderly people were followed up. The prevalence of participants who reported requiring help with medication was 15.5% (95%CI 13.5–17.8), and the oldest subjects, with lower educational levels, in worse economic situations, on four or more medications and in bad self-rated health were the ones who needed help the most. Continuous use of medication was reported by 83.0% (95%CI 80.7–85.1) of the sample and most participants (74.9%; 95%CI 72.0–77.5) never forgot to take their medications. Conclusion: The need for help to use medications was shown to be influenced by social and economic determinants. Studies assessing the difficulties in medication use by the elderly are important to support policies and practices to improve adherence to treatment and the rational use of medications.
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Affiliation(s)
- Marília Cruz Guttier
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia –Pelotas (RS), Brasil
| | - Marysabel Pinto Telis Silveira
- Universidade Federal de Pelotas, Instituto de Biologia, Departamento de Fisiologia e Farmacologia, Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas – Pelotas (RS), Brasil
| | | | | | - Renata Moraes Bielemann
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Nutrição e Alimentos – Pelotas (RS), Brasil
| | - Maria Cristina Gonzalez
- Universidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento – Pelotas (RS), Brasil
| | - Elaine Tomasi
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia –Pelotas (RS), Brasil
| | - Flavio Fernando Demarco
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia –Pelotas (RS), Brasil
| | - Andréa Dâmaso Bertoldi
- Universidade Federal de Pelotas, Programa de Pós-Graduação em Epidemiologia –Pelotas (RS), Brasil
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Vargas PM, Schneider BC, Costa CS, César JA, Bertoldi AD, Tomasi E, Demarco FF, Gonzalez MC, Bielemann RM. Age is the most important factor for change in body mass index and waist circumference in older people in southern Brazil. Nutrition 2022; 109:111956. [PMID: 36863112 DOI: 10.1016/j.nut.2022.111956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 12/05/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVES The aim of this study is to assess the changes in body mass index and waist circumference (WC) and their associations with sociodemographic, behavioral, and health characteristics in non-institutionalized older people in southern Brazil over a period of ≤6 y. METHODS This is a prospective study, with interviews conducted in 2014 and in 2019 to 2020. Of the 1451 individuals from Pelotas, Brazil, aged >60 y and interviewed in 2014, 537 were reevaluated in 2019 to 2020. An increase or decrease was defined as a variation of ≥5% in body mass index and WC in the second visit compared with the first. The association with changes in outcomes was assessed according to sociodemographic, behavioral, and health characteristics using multinomial logistic regression. RESULTS Approximately 29% of the older participants lost body mass. Regarding WC, there was an increase in 25.6% in the older participants. The older participants ages ≥80 y had greater odds of losing body mass (odds ratio [OR] = 4.73; 95% confidence interval [CI], 2.29-9.76) and of reducing WC (OR = 2.84; 95% CI, 1.59-6.94). Former smokers had, on average, 41% and 64% lower odds of losing and gaining body mass (95% CI, 0.37-0.95 and 95% CI, 0.19-0.68, respectively), and those who were on ≥5 medications had greater odds of gaining body mass (OR = 1.92; 95% CI, 1.12-3.28) and WC (OR = 1.79; 95% CI, 1.18-2.74). CONCLUSIONS Despite the high proportion of older people who kept their body mass index and WC stable during this period, many of them lost body mass and gained WC. The findings also highlighted the importance of age in the nutritional changes observed in the population.
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Affiliation(s)
- Priscila M Vargas
- Nutrititon and Food Graduate Program, Federal University of Pelotas, Pelotas, Brazil.
| | - Bruna C Schneider
- Epidemiology Graduate Program, Federal University of Pelotas, Pelotas, Brazil
| | - Caroline S Costa
- Epidemiology Graduate Program, Federal University of Pelotas, Pelotas, Brazil
| | - Juraci Almeida César
- Public Health Graduate Program, Federal University of Rio Grande, Pelotas, Brazil
| | - Andréa D Bertoldi
- Epidemiology Graduate Program, Federal University of Pelotas, Pelotas, Brazil
| | - Elaine Tomasi
- Epidemiology Graduate Program, Federal University of Pelotas, Pelotas, Brazil
| | - Flávio F Demarco
- Epidemiology Graduate Program, Federal University of Pelotas, Pelotas, Brazil; Dentistry Graduate Program, Federal University of Pelotas, Pelotas, Brazil
| | - Maria Cristina Gonzalez
- Epidemiology Graduate Program, Federal University of Pelotas, Pelotas, Brazil; Health and Behavior Graduate Program, Catholic University of Pelotas, Pelotas, Brazil
| | - Renata M Bielemann
- Nutrititon and Food Graduate Program, Federal University of Pelotas, Pelotas, Brazil
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da Silva BR, Orsso CE, Gonzalez MC, Sicchieri JMF, Mialich MS, Jordao AA, Prado CM. Phase angle and cellular health: inflammation and oxidative damage. Rev Endocr Metab Disord 2022; 24:543-562. [PMID: 36474107 PMCID: PMC9735064 DOI: 10.1007/s11154-022-09775-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
Phase angle is a composite measure that combines two raw bioelectrical impedance analysis measures: resistance and reactance. Phase angle has been considered an indicator of cellular health, integrity, and hydration. As inflammation and oxidative stress can damage cellular structures, phase angle has potential utility in early detecting inflammatory and oxidative status. Herein, we aimed to critically review the current understanding on the determinants of phase angle and its relationship with markers of inflammation and oxidative stress. We also discussed the potential role of phase angle in detecting chronic inflammation and related adverse outcomes. Several factors have been identified as predictors of phase angle, including age, sex, extracellular to intracellular water ratio, and fat-free mass. In addition to these factors, body mass index (BMI) also seems to influence phase angle. Available data also show that lower phase angle values are correlated (negligible to high correlation coefficients) with higher c-reactive protein, tumour necrosis factor-α, interleukin-6, and interleukin-10 in studies involving the general and aging populations, as well as patients with chronic conditions. Although fewer studies have evaluated the relationship between phase angle and markers of oxidative stress, available data also suggest that phase angle has potential to be used as an indicator (for screening) of oxidative damage. Future studies including diverse populations and bioelectrical impedance devices are required to confirm the validity and accuracy of phase angle as a marker of inflammation and oxidative stress for clinical use.
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Affiliation(s)
- Bruna Ramos da Silva
- Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Canada
| | - Camila E Orsso
- Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Canada
| | - Maria Cristina Gonzalez
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Juliana Maria Faccioli Sicchieri
- Department of Health Sciences, Division of Nutrition and Metabolism, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Mirele Savegnago Mialich
- Department of Health Sciences, Division of Nutrition and Metabolism, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Alceu A Jordao
- Department of Health Sciences, Division of Nutrition and Metabolism, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Carla M Prado
- Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Canada.
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Lima J, Eckert I, Gonzalez MC, Silva FM. Prognostic value of phase angle and bioelectrical impedance vector in critically ill patients: A systematic review and meta-analysis of observational studies. Clin Nutr 2022; 41:2801-2816. [PMID: 36395589 DOI: 10.1016/j.clnu.2022.10.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 09/21/2022] [Accepted: 10/14/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND AIMS Assessment of the raw parameters derived from bioelectrical impedance analysis (BIA) has gained emphasis in critically ill patients. The phase angle (PhA) reflects the integrity of the cell membrane, and bioelectrical impedance vector analysis (BIVA) is indicative of patients' hydration status. The aim of this study was to investigate whether these parameters are associated with clinical outcomes in the intensive care unit (ICU) setting. METHODS We conducted a systematic review with meta-analysis. We searched PubMed, Embase, Scopus and Web of Science for all published observational studies without language restrictions up to April 2022. Two reviewers independently performed study selection and data extraction. We judged the risk of bias by the Newcastle-Ottawa Scale and the certainty of evidence by the GRADE approach. Mortality was the primary outcome. Secondary outcomes included ICU length of stay, hospital length of stay, duration of mechanical ventilation, nutritional risk, and malnutrition. A meta-analysis with a random-effect model was performed to combine data on R version 3.6.2. RESULTS Twenty-seven studies were included in the systematic review (4872 participants). Pooled analysis revealed that patients with low PhA had a higher risk of death (14 studies; RR = 1.82, 95% CI 1.46 to 2.26; I2 = 42%) and spent more days in ICU (6 studies; MD = 1.79, 95% CI 0.33 to 3.24, I2 = 69%) in comparison to patients with normal PhA. The pooled analysis also showed higher PhA values in survivors compared to non-survivor patients (12 studies; MD = 0.75°, 95% CI 0.60° to 0.91°, I2 = 31%). Overhydration defined by BIVA was not a predictor of mortality (4 studies; RR = 1.01, 95% CI 0.70 to 1.46; I2 = 0%). More than 40% of primary studies were classified with a high risk of bias, and the quality of evidence ranged from low to very low. CONCLUSIONS This meta-analysis revealed, with limited evidence, that low PhA was associated with higher mortality and ICU length of stay, while overhydration identified by BIVA was not a predictor of death in critically ill patients.
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Affiliation(s)
- Júlia Lima
- Master Student at Nutrition Science Graduate Program Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil
| | | | - Maria Cristina Gonzalez
- Professor at Graduate Program in Health and Behavior, Catholic University of Pelotas, Rio Grande do Sul, Brazil
| | - Flávia Moraes Silva
- Professor at Nutrition Department and Nutrition Science Graduate Program of Federal University of Health Science of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.
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Bielemann RM, Oliveira R, Bertoldi AD, Tomasi E, Demarco FF, Gonzalez MC, Bohm AW, Brage S, Ekelund U. Objective and Self-Reported Physical Activity and Risk of Falling Among Community-Dwelling Older Adults From Southern Brazil. J Aging Phys Act 2022; 30:972-979. [PMID: 35240575 PMCID: PMC7613917 DOI: 10.1123/japa.2021-0148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 12/16/2022]
Abstract
This study evaluated prospective associations between self-reported and objectively measured physical activity (PA) and risk of falls among older adults. A cohort study started in 2014 with 1,451 community-dwelling older adults living in Pelotas, Brazil. Leisure-time PA was obtained by the International Physical Activity Questionnaire and 7-day raw accelerometer data evaluated for total, light PA, and moderate to vigorous PA. In 2016-2017, participants recorded their falls in the previous 12 months. Around 23% of the 1,161 participants followed-up in 2016-2017 experienced a fall in the last 12 months. Participants who did not spend any time in self-reported leisure-time PA at baseline had on average 34% higher risk of falls, and individuals in the lowest tertile for moderate to vigorous PA had on average 51% higher risk of falls compared to those in the highest tertile. Low levels of self-reported and objectively measured moderate to vigorous PA were related to higher risk of falling among Brazilian older adults.
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Affiliation(s)
- Renata M Bielemann
- Post-Graduate Program in Nutrition and Foods, Federal University of Pelotas, Pelotas, RS,Brazil
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Ricardo Oliveira
- Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN,Brazil
| | - Andréa Dâmaso Bertoldi
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Elaine Tomasi
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Flávio Fernando Demarco
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS,Brazil
- Post-Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Maria Cristina Gonzalez
- Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS,Brazil
| | - Andrea Wendt Bohm
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge,United Kingdom
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo,Norway
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo,Norway
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Gonzalez MC, Barbosa-Silva TG. Letter to Editor: Association of SARC-F and dissociation of SARC-F + calf circumference with comorbidities in older hospitalized cancer patients and its corrigendum. Exp Gerontol 2022; 169:111979. [PMID: 36241005 DOI: 10.1016/j.exger.2022.111979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 10/06/2022] [Indexed: 12/15/2022]
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Santos CMDL, Brito MD, Castro PASVD, Vries TPD, Viana NL, Coelho MPP, Malheiro OB, Bering T, Gonzalez MC, Teixeira R, Cambraia RD, Rocha GA, Silva LD. Metabolic-associated fatty liver disease is associated with low muscle mass and strength in patients with chronic hepatitis B. World J Hepatol 2022; 14:1652-1666. [PMID: 36157867 PMCID: PMC9453457 DOI: 10.4254/wjh.v14.i8.1652] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/04/2022] [Accepted: 08/16/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Although the prognostic relevance of sarcopenia has been increasingly recognised in the context of liver disease, there is a paucity of data evaluating body composition in patients with chronic hepatitis B (CHB). Beyond virus-related factors, nutritional and metabolic aspects can be associated with skeletal muscle abnormalities in these patients and should not be disregarded.
AIM To evaluate the association between components of sarcopenia and demographic, clinical, lifestyle, nutritional, and biochemical variables in CHB patients.
METHODS Dual-energy X-ray absorptiometry (DXA) was used to assess muscle mass by quantifying appendicular lean mass (ALM) adjusted for body mass index (ALMBMI). Muscle function was evaluated by hand grip strength (HGS) and the timed up and go test. Metabolic-associated fatty liver disease (MAFLD) was defined according to the criteria proposed by an international expert panel. A body shape index and the International Physical Activity Questionnaire were used to assess central obesity and physical activity level, respectively.
RESULTS This cross-sectional study included 105 CHB outpatients followed at the tertiary care ambulatory centre (mean age, 48.5 ± 12.0 years; 58.1% males; 76.2% without cirrhosis; 23.8% with compensated cirrhosis). The DXA-derived fat mass percentage was inversely correlated with the ALMBMI (r = - 0.87) and HGS (r = - 0.63). In the multivariable analysis, MAFLD, sedentarism and central obesity were positively and independently associated with low ALMBMI. MAFLD and central obesity were independently associated with low HGS.
CONCLUSION MAFLD and central obesity were associated with low muscle mass and strength in patients with chronic hepatitis B, independent of the liver disease stage.
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Affiliation(s)
- Cecy Maria de Lima Santos
- Sciences Applied to Adult Health Care Post-Graduate Programme Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
- Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
| | - Matheus Duarte Brito
- Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
| | - Pedro Alves Soares Vaz de Castro
- Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
| | - Thais Pontello de Vries
- Sciences Applied to Adult Health Care Post-Graduate Programme Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
- Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
| | - Nataly Lopes Viana
- Sciences Applied to Adult Health Care Post-Graduate Programme Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
- Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
| | - Marta Paula Pereira Coelho
- Sciences Applied to Adult Health Care Post-Graduate Programme Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
| | - Olívio Brito Malheiro
- Department of Locomotor System, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
| | - Tatiana Bering
- Department of Food and Nutrition, Universidade Federal de Mato Grosso, Cuiabá 78060-900, Mato Grosso, Brazil
| | - Maria Cristina Gonzalez
- Postgraduate Program in Health and Behaviour, Catholic University of Pelotas, Pelotas 96015-560, Rio Grande do Sul, Brazil
| | - Rosângela Teixeira
- Sciences Applied to Adult Health Care Post-Graduate Programme Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
- Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
| | - Rodrigo Dias Cambraia
- Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
| | - Gifone Aguiar Rocha
- Laboratory of Research in Bacteriology, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
| | - Luciana Diniz Silva
- Sciences Applied to Adult Health Care Post-Graduate Programme Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
- Outpatient Clinic of Viral Hepatitis, Instituto Alfa de Gastroenterologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
- Department of Internal Medicine, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
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Lima J, Brizola Dias AJ, Burgel CF, Bernardes S, Gonzalez MC, Silva FM. Complementarity of nutritional screening tools to GLIM criteria on malnutrition diagnosis in hospitalised patients: A secondary analysis of a longitudinal study. Clin Nutr 2022; 41:2325-2332. [DOI: 10.1016/j.clnu.2022.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/10/2022] [Accepted: 08/20/2022] [Indexed: 11/16/2022]
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Compher C, Cederholm T, Correia MITD, Gonzalez MC, Higashiguch T, Shi HP, Bischoff SC, Boirie Y, Carrasco F, Cruz-Jentoft A, Fuchs-Tarlovsky V, Fukushima R, Heymsfield SB, Mourtzakis M, Muscaritoli M, Norman K, Nyulasi I, Pisprasert V, Prado CM, de van der Schuren M, Yoshida S, Yu J, Jensen G, Barazzoni R. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition diagnosis of malnutrition. JPEN J Parenter Enteral Nutr 2022; 46:1232-1242. [PMID: 35437785 DOI: 10.1002/jpen.2366] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/21/2022] [Accepted: 03/06/2022] [Indexed: 02/06/2023]
Abstract
The Global Leadership Initiative on Malnutrition (GLIM) provides consensus criteria for the diagnosis of malnutrition that can be widely applied. The GLIM approach is based on the assessment of three phenotypic (weight loss, low body mass index, and low skeletal muscle mass) and two etiologic (low food intake and presence of disease with systemic inflammation) criteria, with diagnosis confirmed by any combination of one phenotypic and one etiologic criterion fulfilled. Assessment of muscle mass is less commonly performed than other phenotypic malnutrition criteria, and its interpretation may be less straightforward, particularly in settings that lack access to skilled clinical nutrition practitioners and/or to body composition methodologies. In order to promote the widespread assessment of skeletal muscle mass as an integral part of the GLIM diagnosis of malnutrition, the GLIM consortium appointed a working group to provide consensus-based guidance on assessment of skeletal muscle mass. When such methods and skills are available, quantitative assessment of muscle mass should be measured or estimated using dual-energy x-ray absorptiometry, computerized tomography, or bioelectrical impedance analysis. For settings where these resources are not available, then the use of anthropometric measures and physical examination are also endorsed. Validated ethnic- and sex-specific cutoff values for each measurement and tool are recommended when available. Measurement of skeletal muscle function is not advised as surrogate measurement of muscle mass. However, once malnutrition is diagnosed, skeletal muscle function should be investigated as a relevant component of sarcopenia and for complete nutrition assessment of persons with malnutrition.
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Affiliation(s)
- Charlene Compher
- Department of Biobehavioral Health Science, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Tommy Cederholm
- Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Theme Inflammation & Ageing, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Isabel T D Correia
- Department of Surgery, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maria Cristina Gonzalez
- Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | | | - Han Ping Shi
- Key Laboratory of Cancer FSMP for State Market Regulation, Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Stephan C Bischoff
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Yves Boirie
- Unité de Nutrition Humaine, Clinical Nutrition Department, INRAE, CHU Clermont-Ferrand, CRNH Auvergne, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Fernando Carrasco
- Department of Nutrition, Faculty of Medicine, Nutrition and Bariatric Surgery Center, University of Chile, and Clínica Las Condes, Santiago, Chile
| | - Alfonso Cruz-Jentoft
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
| | | | - Ryoji Fukushima
- Department of Surgery, Teikyo University School of Medicine/Health and Dietetics Teikyo Heisei University, Tokyo, Japan
| | - Steven B Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Marina Mourtzakis
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Maurizio Muscaritoli
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Kristina Norman
- Department of Geriatrics and Medical Gerontology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Ibolya Nyulasi
- Nutrition Department, The Alfred Hospital, Melbourne, Victoria, Australia
- Department of Dietetics, Nutrition and Sport, LaTrobe University, Bundoora, Victoria, Australia
- Department of Medicine, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Veeradej Pisprasert
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Carla M Prado
- Human Nutrition Research Unit, Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Marian de van der Schuren
- Department of Nutrition, Dietetics and Lifestyle, School of Allied Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Wageningen University & Research, Human Nutrition and Health, Wageningen, The Netherlands
| | - Sadao Yoshida
- Department of Rehabilitation, Chuzan Hospital, Okinawa-city, Okinawa Prefecture, Japan
| | - Jianchun Yu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Gordon Jensen
- Dean's Office, Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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Prado CM, Landi F, Chew STH, Atherton PJ, Molinger J, Ruck T, Gonzalez MC. Advances in Muscle Health and Nutrition: A Toolkit for Healthcare Professionals. Clin Nutr 2022; 41:2244-2263. [DOI: 10.1016/j.clnu.2022.07.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 07/03/2022] [Accepted: 07/31/2022] [Indexed: 11/03/2022]
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Queiroz SA, Gonzalez MC, da Silva AMB, Costa JKDA, de Oliveira CDR, de Sousa IM, Fayh APT. Is the standardized phase angle a predictor of short and long-term adverse cardiovascular events in acute myocardial infarction patients? A cohort study. Nutrition 2022; 103-104:111774. [DOI: 10.1016/j.nut.2022.111774] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 05/27/2022] [Accepted: 06/06/2022] [Indexed: 11/25/2022]
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Orsso CE, Gonzalez MC, Maisch MJ, Haqq AM, Prado CM. Using bioelectrical impedance analysis in children and adolescents: Pressing issues. Eur J Clin Nutr 2022; 76:659-665. [PMID: 34620999 DOI: 10.1038/s41430-021-01018-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/06/2021] [Accepted: 09/21/2021] [Indexed: 11/08/2022]
Abstract
Single- and multifrequency bioelectrical impedance analysis (BIA) has gained popularity as a tool to assess body composition and health status of children and adolescents, but many questions and misconceptions remain. This review addresses pressing issues researchers and health care providers may encounter when using BIA in the young population. The importance of choosing population-specific and device-specific equations to estimate body composition as well as the use of BIA in longitudinal analyses are discussed. When specific equations are not available, raw bioimpedance values (i.e., resistance, reactance, and impedance) can be used to compute bioimpedance parameters, such as phase angle, impedance ratio, and bioelectrical impedance vector analysis. As interpreting these parameters is challenging, suggestions are provided on the use of reference data, cut-off points, and adjustment factors. Furthermore, unsolved technical and analytical issues are listed. Based on existing issues and potential for future development, a greater interaction between industry and academic researchers to improve the validity of BIA measurements among children and adolescents across their developmental stages is encouraged.
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Affiliation(s)
- Camila E Orsso
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, 4-002 Li Ka Shing Centre for Health Innovation, Edmonton, AB, T6G 2E1, Canada.
| | - Maria Cristina Gonzalez
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, R. Gonçalves Chaves 377, Pelotas, RS, 96010280, Brazil
- Pennington Biomedical Research Center, LSU System, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | | | - Andrea M Haqq
- Department of Pediatrics & Department of Agricultural, Food and Nutritional Science, University of Alberta, 1C4 Walter C. Mackenzie Health Sciences Center, Edmonton, AB, T6G 2B7, Canada
| | - Carla M Prado
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, 4-002 Li Ka Shing Centre for Health Innovation, Edmonton, AB, T6G 2E1, Canada
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Barazzoni R, Jensen GL, Correia MITD, Gonzalez MC, Higashiguchi T, Shi HP, Bischoff SC, Boirie Y, Carrasco F, Cruz-Jentoft A, Fuchs-Tarlovsky V, Fukushima R, Heymsfield S, Mourtzakis M, Muscaritoli M, Norman K, Nyulasi I, Pisprasert V, Prado C, de van der Schuren M, Yoshida S, Yu Y, Cederholm T, Compher C. Guidance for assessment of the muscle mass phenotypic criterion for the Global Leadership Initiative on Malnutrition (GLIM) diagnosis of malnutrition. Clin Nutr 2022; 41:1425-1433. [PMID: 35450768 DOI: 10.1016/j.clnu.2022.02.001] [Citation(s) in RCA: 94] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/02/2022] [Indexed: 01/02/2023]
Abstract
The Global Leadership Initiative on Malnutrition (GLIM) provides consensus criteria for the diagnosis of malnutrition that can be widely applied. The GLIM approach is based on the assessment of three phenotypic (weight loss, low body mass index, and low skeletal muscle mass) and two etiologic (low food intake and presence of disease with systemic inflammation) criteria, with diagnosis confirmed by any combination of one phenotypic and one etiologic criterion fulfilled. Assessment of muscle mass is less commonly performed than other phenotypic malnutrition criteria, and its interpretation may be less straightforward, particularly in settings that lack access to skilled clinical nutrition practitioners and/or to body composition methodologies. In order to promote the widespread assessment of skeletal muscle mass as an integral part of the GLIM diagnosis of malnutrition, the GLIM consortium appointed a working group to provide consensus-based guidance on assessment of skeletal muscle mass. When such methods and skills are available, quantitative assessment of muscle mass should be measured or estimated using dual-energy x-ray absorptiometry, computerized tomography, or bioelectrical impedance analysis. For settings where these resources are not available, then the use of anthropometric measures and physical examination are also endorsed. Validated ethnic- and sex-specific cutoff values for each measurement and tool are recommended when available. Measurement of skeletal muscle function is not advised as surrogate measurement of muscle mass. However, once malnutrition is diagnosed, skeletal muscle function should be investigated as a relevant component of sarcopenia and for complete nutrition assessment of persons with malnutrition.
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Affiliation(s)
- Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
| | - Gordon L Jensen
- Dean's Office, Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - Maria Isabel T D Correia
- Department of Surgery, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maria Cristina Gonzalez
- Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | | | - Han Ping Shi
- Key Laboratory of Cancer FSMP for State Market Regulation, Department of Gastrointestinal Surgery and Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Stephan C Bischoff
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Yves Boirie
- Unité de Nutrition Humaine, Clinical Nutrition Department, INRAE, CHU Clermont-Ferrand, CRNH Auvergne, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Fernando Carrasco
- Department of Nutrition, Faculty of Medicine, Nutrition and Bariatric Surgery Center, University of Chile, Clínica Las Condes, Santiago, Chile
| | - Alfonso Cruz-Jentoft
- Servicio de Geriatría, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
| | | | - Ryoji Fukushima
- Department of Surgery Teikyo University School of Medicine/Health and Dietetics Teikyo Heisei University, Tokyo, Japan
| | - Steve Heymsfield
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Marina Mourtzakis
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Maurizio Muscaritoli
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Kristina Norman
- Department of Geriatrics and Medical Gerontology, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany; Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Ibolya Nyulasi
- Nutrition Department, The Alfred Hospital, Melbourne, Victoria, Australia; Department of Dietetics, Nutrition and Sport, LaTrobe University, Bundoora, Victoria, Australia; Department of Medicine, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Veeradej Pisprasert
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Carla Prado
- Human Nutrition Research Unit, Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Marian de van der Schuren
- Department of Nutrition, Dietetics and Lifestyle, School of Allied Health, HAN University of Applied Sciences, Nijmegen, the Netherlands; Wageningen University & Research, Human Nutrition and Health, Wageningen, the Netherlands
| | - Sadao Yoshida
- Department of Rehabilitation, Chuzan Hospital, Okinawa-city, Okinawa Prefecture, Japan
| | - Yanchun Yu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Tommy Cederholm
- Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; Theme Inflammation & Ageing, Karolinska University Hospital, Stockholm, Sweden
| | - Charlene Compher
- Department of Biobehavioral Health Science, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
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Heymsfield SB, Smith B, Chung EA, Watts KL, Gonzalez MC, Yang S, Heo M, Thomas DM, Turner D, Bosy-Westphal A, Müller MJ. Phenotypic differences between people varying in muscularity. J Cachexia Sarcopenia Muscle 2022; 13:1100-1112. [PMID: 35170220 PMCID: PMC8978029 DOI: 10.1002/jcsm.12959] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/20/2022] [Accepted: 02/01/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Body mass is the primary metabolic compartment related to a vast number of clinical indices and predictions. The extent to which skeletal muscle (SM), a major body mass component, varies between people of the same sex, weight, height, and age is largely unknown. The current study aimed to explore the magnitude of muscularity variation present in adults and to examine if variation in muscularity associates with other body composition and metabolic measures. METHODS Muscularity was defined as the difference (residual) between a person's actual and model-predicted SM mass after controlling for their weight, height, and age. SM prediction models were developed using data from a convenience sample of 492 healthy non-Hispanic (NH) White adults (ages 18-80 years) who had total body SM and SM surrogate, appendicular lean soft tissue (ALST), measured with magnetic resonance imaging and dual-energy X-ray absorptiometry, respectively; residual SM (SMR ) and ALST were expressed in kilograms and kilograms per square meter. ALST mass was also evaluated in a population sample of 8623 NH-White adults in the 1999-2006 National Health and Nutrition Examination Survey. Associations between muscularity and variation in the residual mass of other major organs and tissues and resting energy expenditure were evaluated in the convenience sample. RESULTS The SM, on average, constituted the largest fraction of body weight in men and women up to respective BMIs of 35 and 25 kg/m2 . SM in the convenience sample varied widely with a median of 31.2 kg and an SMR inter-quartile range/min/max of 3.35 kg/-10.1 kg/9.0 kg in men and 21.1 kg and 2.59 kg/-7.2 kg/7.5 kg in women; per cent of body weight as SM at 25th and 75th percentiles for men were 33.1% and 39.6%; corresponding values in women were 24.2% and 30.8%; results were similar for SMR indices and for ALST measures in the convenience and population samples. Greater muscularity in the convenience sample was accompanied by a smaller waist circumference (men/women: P < 0.001/=0.085) and visceral adipose tissue (P = 0.014/0.599), larger liver (P = 0.065/<0.001), kidneys (P = 0.051/<0.009), and bone mineral (P < 0.001/<0.001), and larger magnitude resting energy expenditure (P < 0.001/<0.001) than predicted for the same sex, age, weight, and height. CONCLUSIONS Muscle mass is the largest body compartment in most adults without obesity and is widely variable in mass across people of similar body size and age; and high muscularity is accompanied by distinct body composition and metabolic characteristics. This previously unrecognized heterogeneity in muscularity in the general population has important clinical and research implications.
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Affiliation(s)
| | - Brooke Smith
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA, USA
| | - Elizabeth A Chung
- Department of Mathematical Sciences, United States Military Academy West Point, West Point, NY, USA
| | - Krista L Watts
- Department of Mathematical Sciences, United States Military Academy West Point, West Point, NY, USA
| | - Maria Cristina Gonzalez
- Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Shengping Yang
- Pennington Biomedical Research Center, LSU System, Baton Rouge, LA, USA
| | - Moonseong Heo
- Department of Public Health Sciences, Clemson University, Clemson, SC, USA
| | - Diana M Thomas
- Department of Mathematical Sciences, United States Military Academy West Point, West Point, NY, USA
| | | | - Anja Bosy-Westphal
- Department of Human Nutrition and Food Science, Christian-Albrecht's-University of Kiel, Kiel, Germany
| | - Manfred J Müller
- Department of Human Nutrition and Food Science, Christian-Albrecht's-University of Kiel, Kiel, Germany
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Maeda SS, Albergaria BH, Szejnfeld VL, Lazaretti-Castro M, Arantes HP, Ushida M, Domiciano DS, Pereira RMR, Marin-Mio RV, de Oliveira ML, de Mendonça LMC, do Prado M, de Souza GC, Palchetti CZ, Sarni ROS, Terreri MT, de Castro LCG, Artoni SMB, Amoroso L, Karcher DE, Prado CM, Gonzalez MC, de Medeiros Pinheiro M. Official Position of the Brazilian Association of Bone Assessment and Metabolism (ABRASSO) on the evaluation of body composition by densitometry-part II (clinical aspects): interpretation, reporting, and special situations. Adv Rheumatol 2022; 62:11. [PMID: 35365246 DOI: 10.1186/s42358-022-00240-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 03/04/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To present an updated and evidence-based guideline for the use of dual-energy x-ray absorptiometry (DXA) to assess body composition in clinical practice. MATERIALS AND METHODS This Official Position was developed by the Scientific Committee of the Brazilian Association of Bone Assessment and Metabolism (Associação Brasileira de Avaliação Óssea e Osteometabolismo, ABRASSO) and experts in the field who were invited to contribute to the preparation of this document. The authors searched current databases for relevant publications in the area of body composition assessment. In this second part of the Official Position, the authors discuss the interpretation and reporting of body composition parameters assessed by DXA and the use of DXA for body composition evaluation in special situations, including evaluation of children, persons with HIV, and animals. CONCLUSION This document offers recommendations for the use of DXA in body composition evaluation, including indications, interpretation, and applications, to serve as a guiding tool in clinical practice and research for health care professionals in Brazil.
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Affiliation(s)
- Sergio Setsuo Maeda
- Discipline of Endocrinology, Department of Medicine, Universidade Federal de São Paulo (UNIFESP), Rua Estado de Israel, 639, São Paulo, SP, CEP: 04022-001, Brazil.
| | - Ben-Hur Albergaria
- Department of Epidemiology, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil
| | - Vera Lúcia Szejnfeld
- Discipline of Rheumatology, Department of Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Marise Lazaretti-Castro
- Discipline of Endocrinology, Department of Medicine, Universidade Federal de São Paulo (UNIFESP), Rua Estado de Israel, 639, São Paulo, SP, CEP: 04022-001, Brazil
| | - Henrique Pierotti Arantes
- School of Medicine, Instituto Master de Ensino Presidente Antônio Carlos (IMEPAC), Uberlândia, MG, Brazil
| | - Marcela Ushida
- Discipline of Rheumatology, Department of Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Diogo Souza Domiciano
- Discipline of Rheumatology, Department of Medicine, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | | | - Rosângela Villa Marin-Mio
- Discipline of Endocrinology, Department of Medicine, Universidade Federal de São Paulo (UNIFESP), Rua Estado de Israel, 639, São Paulo, SP, CEP: 04022-001, Brazil
| | - Mônica Longo de Oliveira
- Discipline of Endocrinology, Department of Medicine, Universidade Federal de São Paulo (UNIFESP), Rua Estado de Israel, 639, São Paulo, SP, CEP: 04022-001, Brazil
| | | | | | | | - Cecília Zanin Palchetti
- Department of Nutrition, School of Public Health, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Roseli Oselka Saccardo Sarni
- Discipline of Allergy, Clinical Immunology, and Rheumatology, Department of Pediatrics, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Maria Teresa Terreri
- Section of Pediatric Rheumatology, Department of Pediatrics, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | | | | | - Lizandra Amoroso
- School of Agricultural and Veterinary Sciences, Universidade Estadual de São Paulo (UNESP), Jaboticabal, SP, Brazil
| | - Débora Emy Karcher
- School of Agricultural and Veterinary Sciences, Universidade Estadual de São Paulo (UNESP), Jaboticabal, SP, Brazil
| | - Carla M Prado
- Department of Agricultural, Food and Nutritional Science, Division of Human Nutrition, University of Alberta, Edmonton, Canada
| | - Maria Cristina Gonzalez
- Postgraduate Program in Health and Behavior, Universidade Católica de Pelotas (UCPel), Pelotas, RS, Brazil.,Postgraduate Program in Nutrition and Food, Universidade Federal de Pelotas (UFPel), Pelotas, RS, Brazil
| | - Marcelo de Medeiros Pinheiro
- Discipline of Rheumatology, Department of Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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Maeda SS, Peters BSE, Martini LA, Antunes HKM, Gonzalez MC, Arantes HP, Prado CM, Pinto CL, de Araújo IM, de Paula FJA, Borges JLC, Albergaria BH, Ushida M, de Souza GC, de Mendonça LMC, do Prado M, de Medeiros Pinheiro M. Official position of the Brazilian Association of Bone Assessment and Metabolism (ABRASSO) on the evaluation of body composition by densitometry: part I (technical aspects)—general concepts, indications, acquisition, and analysis. Adv Rheumatol 2022; 62:7. [DOI: 10.1186/s42358-022-00241-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 03/04/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Objective
To review the technical aspects of body composition assessment by dual-energy X-ray absorptiometry (DXA) and other methods based on the most recent scientific evidence.
Materials and methods
This Official Position is a result of efforts by the Scientific Committee of the Brazilian Association of Bone Assessment and Metabolism (Associação Brasileira de Avaliação Óssea e Osteometabolismo, ABRASSO) and health care professionals with expertise in body composition assessment who were invited to contribute to the preparation of this document. The authors searched current databases for relevant publications. In this first part of the Official Position, the authors discuss the different methods and parameters used for body composition assessment, general principles of DXA, and aspects of the acquisition and analysis of DXA scans.
Conclusion
Considering aspects of accuracy, precision, cost, duration, and ability to evaluate all three compartments, DXA is considered the gold-standard method for body composition assessment, particularly for the evaluation of fat mass. In order to ensure reliable, adequate, and reproducible DXA reports, great attention is required regarding quality control procedures, preparation, removal of external artifacts, imaging acquisition, and data analysis and interpretation.
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Miranda VIA, Silveira MPT, Lutz BH, Pirolli F, Zambiasi L, Bielemann RM, Gonzalez MC, Bertoldi AD. [Use of anticholinergic drugs among the elderly and a comparison between risk scales: a population-based study]. Cien Saude Colet 2022; 27:1087-1095. [PMID: 35293446 DOI: 10.1590/1413-81232022273.42002020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 01/05/2021] [Indexed: 11/22/2022] Open
Abstract
The pattern of morbidity and mortality has changed in recent years due to the increase in chronic noncommunicable diseases, leading to multiple comorbidities and the use of several medications. The scope of the study was to evaluate the anticholinergic drugs used by elderly people, according to risk scales. It involved a population-based cross-sectional study with elderly people. Socioeconomic factors, health problems, and medication use were investigated in the previous 15 days. The Anticholinergic Drug Scale (ADS), the Anticholinergic Risk Scale (ARS) and the Anticholinergic Cognitive Burden Scale (ACB) were used for risk classification according to anticholinergic activity of the drugs. A total of 1451 elderly people were interviewed and 1305 used medications, 60.7% of which with anticholinergic action, especially among the 80-year-old age bracket and the less educated. In total, 5703 drugs were used, 1282 (22.5%) of which with anticholinergic action. Kappa agreement of 0.63 was observed when assessing the ACB and ADS risk scales. The prevalence of the use of drugs with anticholinergic action was high, and attention should be paid to the consequences related to their use, with a view to more rational decision-making in clinical practice.
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Affiliation(s)
- Vanessa Iribarrem Avena Miranda
- Programa de Pós-Graduação em Saúde Coletiva, Universidade do Extremo Sul Catarinense. Av. Universitária 1105 Bloco S Sala 115, Bairro Universitário 88806-000. Criciúma SC Brasil.
| | | | | | - Flávia Pirolli
- Faculdade de Medicina, Universidade Federal de Pelotas. Pelotas RS Brasil
| | - Lucas Zambiasi
- Faculdade de Medicina, Universidade Federal de Pelotas. Pelotas RS Brasil
| | - Renata M Bielemann
- Programa de Pós-Graduação em Nutrição e Alimentos, Universidade Federal de Pelotas. Pelotas RS Brasil
| | - Maria Cristina Gonzalez
- Programa de Pós-Graduação em Nutrição e Alimentos, Universidade Federal de Pelotas. Pelotas RS Brasil.,Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas. Pelotas RS Brasil
| | - Andréa Dâmaso Bertoldi
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. Pelotas RS Brasil
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Donini LM, Busetto L, Bischoff SC, Cederholm T, Ballesteros-Pomar MD, Batsis JA, Bauer JM, Boirie Y, Cruz-Jentoft AJ, Dicker D, Frara S, Frühbeck G, Genton L, Gepner Y, Giustina A, Gonzalez MC, Han HS, Heymsfield SB, Higashiguchi T, Laviano A, Lenzi A, Nyulasi I, Parrinello E, Poggiogalle E, Prado CM, Salvador J, Rolland Y, Santini F, Serlie MJ, Shi H, Sieber CC, Siervo M, Vettor R, Villareal DT, Volkert D, Yu J, Zamboni M, Barazzoni R. Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement. Clin Nutr 2022; 41:990-1000. [DOI: 10.1016/j.clnu.2021.11.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 11/16/2021] [Indexed: 02/08/2023]
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46
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Donini LM, Busetto L, Bischoff SC, Cederholm T, Ballesteros-Pomar MD, Batsis JA, Bauer JM, Boirie Y, Cruz-Jentoft AJ, Dicker D, Frara S, Frühbeck G, Genton L, Gepner Y, Giustina A, Gonzalez MC, Han HS, Heymsfield SB, Higashiguchi T, Laviano A, Lenzi A, Nyulasi I, Parrinello E, Poggiogalle E, Prado CM, Salvador J, Rolland Y, Santini F, Serlie MJ, Shi H, Sieber CC, Siervo M, Vettor R, Villareal DT, Volkert D, Yu J, Zamboni M, Barazzoni R. Definition and Diagnostic Criteria for Sarcopenic Obesity: ESPEN and EASO Consensus Statement. Obes Facts 2022; 15:321-335. [PMID: 35196654 PMCID: PMC9210010 DOI: 10.1159/000521241] [Citation(s) in RCA: 173] [Impact Index Per Article: 86.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 11/26/2021] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Loss of skeletal muscle mass and function (sarcopenia) is common in individuals with obesity due to metabolic changes associated with a sedentary lifestyle, adipose tissue derangements, comorbidities (acute and chronic diseases) and during the ageing process. Co-existence of excess adiposity and low muscle mass/function is referred to as sarcopenic obesity (SO), a condition increasingly recognized for its clinical and functional features that negatively influence important patient-centred outcomes. Effective prevention and treatment strategies for SO are urgently needed, but efforts are hampered by the lack of a universally established SO definition and diagnostic criteria. Resulting inconsistencies in the literature also negatively affect the ability to define prevalence as well as clinical relevance of SO for negative health outcomes. AIMS AND METHODS The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched an initiative to reach expert consensus on a definition and diagnostic criteria for SO. The jointly appointed international expert panel proposes that SO is defined as the co-existence of excess adiposity and low muscle mass/function. The diagnosis of SO should be considered in at-risk individuals who screen positive for a co-occurring elevated body mass index or waist circumference, and markers of low skeletal muscle mass and function (risk factors, clinical symptoms, or validated questionnaires). Diagnostic procedures should initially include assessment of skeletal muscle function, followed by assessment of body composition where presence of excess adiposity and low skeletal muscle mass or related body compartments confirm the diagnosis of SO. Individuals with SO should be further stratified into stage I in the absence of clinical complications or stage II if cases are associated with complications linked to altered body composition or skeletal muscle dysfunction. CONCLUSIONS ESPEN and EASO, as well as the expert international panel, advocate that the proposed SO definition and diagnostic criteria be implemented into routine clinical practice. The panel also encourages prospective studies in addition to secondary analysis of existing data sets, to study the predictive value, treatment efficacy and clinical impact of this SO definition.
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Affiliation(s)
| | | | | | | | | | - John A. Batsis
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Yves Boirie
- University of Clermont Auvergne, INRA, CRNH, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Dror Dicker
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Stefano Frara
- San Raffaele, Vita-Salute University and IRCCS Hospital, Milan, Italy
| | - Gema Frühbeck
- Clínica Universidad de Navarra, CIBEROBN, IdiSNA, Pamplona, Spain
| | | | | | - Andrea Giustina
- San Raffaele, Vita-Salute University and IRCCS Hospital, Milan, Italy
| | | | - Ho-Seong Han
- Seoul National University Bundang Hospital (SNUBH), Seoul, Republic of Korea
| | | | | | | | | | | | | | | | | | | | - Yves Rolland
- Gerontopole of Toulouse, INSERM 1027, Toulouse University Hospital, Toulouse, France
| | | | | | - Hanping Shi
- Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Cornel C. Sieber
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Mario Siervo
- University of Nottingham, Nottingham, United Kingdom
| | | | | | - Dorothee Volkert
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Jianchun Yu
- Peking Union Medical College Hospital, Beijing, China
| | | | - Rocco Barazzoni
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
- **Rocco Barazzoni,
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Ferreira MF, Böhlke M, Pauletto MB, Frühauf IR, Gonzalez MC. Sarcopenia diagnosis using different criteria as a predictor of early mortality in patients undergoing hemodialysis. Nutrition 2021; 95:111542. [PMID: 35026482 DOI: 10.1016/j.nut.2021.111542] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 10/13/2021] [Accepted: 11/08/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Chronic kidney disease (CKD) is a public health problem, causing secondary sarcopenia. The aim of this study was to evaluate sarcopenia using the definitions proposed by European Working Group on Sarcopenia in Older People in 2010 (EWGSOP2010) and 2019 (EWGSOP2019) as an independent prognostic factor for worse survival in patients with CKD undergoing hemodialysis. METHODS Muscle mass, muscle strength, and physical performance were assessed in a cohort of patients with CKD on hemodialysis. The sample consisted of 127 patients (40% >60 y of age) and 36 patients (28.3%) died after a median follow-up length of 23.5 mo (interquartile range= 14.9 - 29). The EWGSOP2010 and EWGSOP2019 definitions were used for diagnosing sarcopenia. Sarcopenia association with mortality by both definitions was investigated using Kaplan-Meier curves and Cox proportional hazard models. The area under the curve, sensitivity, specificity, positive, and negative predictive values for both definitions were also compared. RESULTS Patients diagnosed with sarcopenia by both criteria had almost three times higher risk for mortality (95% confidence interval,1.45-6.06 and 1.44-6.13, respectively). Patients classified with severe sarcopenia by both definitions had a significantly lower survival, even after the adjusted analysis. The areas under the curve for EWGSOP2010 and EWGSOP2019 did not significantly differ. The sensitivity/specificity analysis was considered similar for both criteria, and around 70% of the patients was correctly classified. CONCLUSION Sarcopenia, notably severe sarcopenia, diagnosed by EWGSOP2010 or EWGSOP2019 criteria, is an independent prognostic factor for worse survival in this population. Early detection with effective interventions may decrease the higher mortality risk among patients with sarcopenia and CKD.
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Affiliation(s)
| | - Maristela Böhlke
- PostGraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | | | | | - Maria Cristina Gonzalez
- PostGraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil.
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Maciel de Lima AP, Schneider BC, Bertoldi AD, Tomasi E, Gonzalez MC, Demarco FF, Domingues MR, Bielemann RM. NCD behavioral risk factors and mortality among older adults in Brazil. Clin Nutr ESPEN 2021; 45:462-468. [PMID: 34620356 DOI: 10.1016/j.clnesp.2021.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/25/2021] [Accepted: 06/26/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUNDS & AIMS Literature shows that the most studied concurrent risk factors for mortality in elderly individuals are smoking, inadequate diet, alcohol consumption and physical inactivity. The combination of such habits can increase from 3 to 11 times the chance of death. To measure the association between concurrence of behavioral risk factors (BRF) for non-communicable diseases (NCD's) and mortality up to three years among the elderly. METHODS Cohort study started in 2014 named "COMO VAI?" with community-dwelling aged ≥60 years in Pelotas, Rio Grande do Sul, Brazil. We investigated the deaths from all causes occurred until April 2017. The exposure was defined by the presence of physical inactivity, low-quality diet, alcohol consumption and smoking that composed a score ranging from 0 (none) to 4 (all). Cox proportional hazard regression models were used to evaluate the association between BRF concurrence and mortality. RESULTS In 2014, 1451 elderly people were interviewed, 145 deaths were identified (10%) by April 2017. Higher risk of death was observed for the combinations of physical inactivity + smoking and low-quality diet + physical inactivity. The simultaneous presence of three or more BRF was associated with a nearly six-fold higher risk of death. CONCLUSIONS Higher mortality during a 3-year period was observed among those with at least three BRF for NCD's.
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Affiliation(s)
| | | | - Andréa Dâmaso Bertoldi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Elaine Tomasi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Maria Cristina Gonzalez
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, Pelotas, RS, Brazil; Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | | | | | - Renata Moraes Bielemann
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, Pelotas, RS, Brazil; Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil; Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, RS, Brazil
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Lopes LCC, Gonzalez MC, Avesani CM, Prado CM, Peixoto MDRG, Mota JF. Low hand grip strength is associated with worse functional capacity and higher inflammation in people receiving maintenance hemodialysis. Nutrition 2021; 93:111469. [PMID: 34638101 DOI: 10.1016/j.nut.2021.111469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/08/2021] [Accepted: 08/17/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To evaluate the associations of hand grip strength (HGS) with body composition, functional capacity, muscle quality, and inflammatory markers in people receiving maintenance hemodialysis. METHODS This is a cross-sectional study in people receiving maintenance hemodialysis. HGS was measured by hydraulic dynamometer on the upper limb without fistula. Participants were stratified into low or adequate HGS, based on population-specific cutoff points. Body composition was assessed by dual-energy X-ray absorptiometry, and functional capacity by the Short Physical Performance Battery and timed up-and-go tests. In addition, serum creatinine, interleukin-6 (IL-6), IL-10, tumor necrosis factor-α, and ultra-sensitive C-reactive protein (us-CRP) were measured before the dialysis session. RESULTS A total of 67 participants (41.8% women, 58.2% male; ages 54.1 ± 11.7 y) were included. Those with low HGS had worse functional capacity than those with adequate HGS (timed up-and-go test, 10.7 ± 1.0 versus 8.5 ± 0.8 sec, respectively; P < 0.001). IL-6 and us-CRP were higher in those with low HGS than their counterparts (IL-6: 2.7 ± 0.3 versus 1.9 pg/mL, P = 0.03; us-CRP: 14.8 ± 3.0 versus 4.7 ± 1.9 mg/L, P = 0.03). Multiple linear regression analysis showed that appendicular lean mass, us-CRP, age, sex, and seven-point subjective global assessment score were associated with HGS. CONCLUSIONS Participants with low HGS showed higher inflammation and lower functional capacity. In addition to muscle mass, inflammation and nutritional status also affect HGS.<END ABSTRACT>.
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Affiliation(s)
| | - Maria Cristina Gonzalez
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - Carla Maria Avesani
- Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Technology and Intervention, Karolinska Institute, Stockholm, Sweden
| | - Carla M Prado
- Li Ka Shing Centre for Health Research Innovation, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | | | - João Felipe Mota
- School of Nutrition, Federal University of Goiás, Goiania, Brazil.
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Mello RP, Xavier MO, Tomasi E, Gonzalez MC, Demarco FF, Bielemann RM. Dysphagia Perception Among Community-Dwelling Older Adults from a Municipality in Southern Brazil. Dysphagia 2021; 37:879-888. [PMID: 34319457 DOI: 10.1007/s00455-021-10347-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 07/19/2021] [Indexed: 11/25/2022]
Abstract
To analyse the prevalence of dysphagia perception and associated factors among community-dwelling older adults in Pelotas, Brazil. A total of 1447 community-dwelling individuals aged 60 and older participated in a cross-sectional population-based study carried out in 2014. Dysphagia perception was assessed using the following question: "Do you have swallowing difficulties? (Yes/No)". Independent variables included sociodemographic, behavioural and health characteristics. Poisson regression was used to obtain prevalence ratios. Dysphagia perception prevalence was 8.1%, higher among women (PR 1.63, 95% CI 1.07; 2.46) and in subjects older than 80 years (PR 1.88, 95% CI 1.16; 3.03). Older adults with 1-7 years of schooling were more likely to present dysphagia (PR 1.62; 95% CI 1.09; 2.40). Those who did not use dental prosthesis (PR 1.85; 95% CI 1.08; 3.16), who presented dry mouth sensation (PR 4.10; 95% CI 2.59; 6.51) and multimorbidity (PR 30.0; 95% CI 4.09; 219.45) were more likely to present dysphagia perception. The participants who consumed alcohol were 60% less likely to report dysphagia perception (PR 0.43; 95% CI 0.22; 0.86). One out of twelve older adults presented dysphagia perception, and associations with sociodemographic characteristics and other health problems were found. Early identification of dysphagia should be a public health and clinical concern.
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Affiliation(s)
| | - Mariana Otero Xavier
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro St. 1160-30 Floor, Pelotas, 96020220, Brazil.
| | - Elaine Tomasi
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro St. 1160-30 Floor, Pelotas, 96020220, Brazil
| | - Maria Cristina Gonzalez
- Post-Graduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - Flávio Fernando Demarco
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro St. 1160-30 Floor, Pelotas, 96020220, Brazil.,Post-Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Renata Moraes Bielemann
- Nutrition College, Federal University of Pelotas, Pelotas, Brazil.,Post-Graduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro St. 1160-30 Floor, Pelotas, 96020220, Brazil
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