Anthropometric indices, nutrient intakes and health-related characteristics of patients with multiple sclerosis: a cross-sectional study

BACKGROUND

Multiple sclerosis (MS) is accompanied by many health-related issues. This study aimed to evaluate the anthropometric indices, nutrient intakes and health-related characteristics of MS patients as well as their possible correlations.

METHODS

This cross-sectional study was performed on 283 MS patients in Shiraz, Iran, during 2018-2019. Body mass index (BMI) and body composition were measured for each participant. A food frequency questionnaire was used to determine the patients' nutrient intakes. The level of fatigue, disability and quality of life of the individuals were assessed by the modified fatigue impact scale (MFIS), the expanded disability status scale and the multiple sclerosis quality of life-54 questionnaires, respectively.

RESULTS

The results revealed that 43.11% of the patients were overweight or obese, and their %body fat (%BF) was 35.65 ± 7.63. Besides, intakes of vitamins A, E, D, folic acid, calcium, zinc and magnesium were significantly lower than recommendations in both genders, and sodium intake was significantly higher than the tolerable upper intake level in females. A significant positive linear correlation was observed between MFIS and BMI (r = 0.12, P = 0.045). Significant positive correlations were also found between psychosocial subscale of MFIS and both of %BF (r = 0.12, P = 0.049) and visceral fat area (r = 0.14, P = 0.02). Unexpectedly, the patients' quality of life showed significant negative correlations with fat free mass and skeletal muscle mass.

CONCLUSION

Being overweight, having a high %BF and poor nutrient intakes are common among MS patients. Improving the patients' lifestyle and dietary intake is recommended to reduce fatigue and increase their life quality.

Evaluation of Nutritional Status of Intensive Care Unit COVID-19 Patients Based on the Nutritional Risk Screening 2002 Score

BACKGROUND

Patients with COVID-19 are susceptible to malnutrition, which is particularly concerning among critically ill patients. We evaluated the Nutritional Risk Screening 2002 (NRS-2002) score in such patients and determined its relationship with the hospitalization outcome.

METHODS

This cross-sectional study involved COVID-19 patients admitted to the intensive care units (ICUs) of Shahid Faghihi Hospital, Shiraz, Iran, between February and March 2021. We assessed the nutritional status using NRS-2002 and determined disease severity with the APACHE II index. Demographic information, weight, height, clinical signs, previous illness, medications, biochemical test results, and history of anorexia and weight loss were recorded. Data were analyzed using SPSS version 18.

RESULTS

The mean age of 100 patients was 55.36 ± 18.86 years. According to NRS-2002, 30%, 29%, and 41% of patients were at low risk, moderate risk, and high risk of malnutrition, respectively. Age and BUN increased significantly with NRS-2002, while albumin and hematocrit followed the opposite trend (P < 0.001). Patients who died had lower albumin and hematocrit levels but higher age, NRS-2002 scores, and BUN/creatinine levels than those who recovered. Multivariable logistic regression revealed that for every unit increase in the NRS-2002 score, the odds of mortality increased by 354% (OR: 4.54, CI: 1.48, 13.95, P=0.008).

CONCLUSION

NRS-2002 is a valuable prognostic tool for critically ill COVID-19 patients, with each unit's rise in the score being associated with a 354% rise in the odds of mortality. Increased malnutrition risk was linked with higher age and BUN and lower albumin and hematocrit levels.

The effect of flaxseed with or without anti-inflammatory diet in patients with rheumatoid arthritis, a randomized controlled trial

PURPOSE

Beneficial effect of long-chain ω-3 fatty acids against symptoms of rheumatoid arthritis (RA) has been indicated in previous studies. We examined the effect of flaxseed and anti-inflammatory diet in patients with RA.

METHODS

The 12-week intervention was performed on 120 patients with RA who were randomized to three groups of flaxseed (30 g/day) plus anti-inflammatory diet (AIF group), flaxseed (30 g/day) plus regular diet (RF group), and roasted wheat (30 g/day) plus regular diet (RW group). Disease Activity Score 28-joints (DAS28), health assessment questionnaire (HAQ) disability and pain, quality of life, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor, and anti-cyclic citrullinated peptides (anti-CCP) were measured before and after trial. Analysis was performed using per-protocol and intention-to-treat (ITT) approaches.

RESULTS

One hundred and two patients completed the protocol. Flaxseed decreased DAS28 in RF group compared to RW (- 0.87 ± 1.11 vs. - 0.24 ± 0.78; P = 0.014). Pain severity (P ≤ 0.001), morning stiffness (P < 0.05), and disease feeling (P < 0.01) decreased significantly in AIF and RF groups. HAQ disability and quality of life measurements improved in all 3 groups, with a greater extent in AIF and RF groups (P < 0.001) compared to RW. Between-group differences were significant for DAS28, pain scores, and physical and mental health variables. ESR, CRP, anti-CCP, and rheumatoid factor were not different between groups. Results of ITT analysis did not cause much difference.

CONCLUSIONS

In conclusion, flaxseed may be used as a helpful adjuvant therapy for patients with RA. Calls are open for examining the effect of anti-inflammatory diet on RA symptoms.

TRIAL REGISTRATION NUMBER

Registered at irct.ir as IRCT20190923044858N1, February 6, 2020.