The purpose of the present investigation was to study the effect of prolonged protein-calorie malnutrition on intestinal disaccharidase activities and on disaccharide absorption, as carbohydrate intolerance is a major problem in children suffering from protein-calorie malnutrition. Four groups of rats (90 to 120 grams) were fed the following diets for 8 to 9 weeks: control (18% lactalbumin, 66% carbohydrate); low protein low carbohydrate (0.5% lactalbumin, 66% carbohydrate); low protein high carbohydrate (0.5% lactalbumin, 83.5% carbohydrate); and low protein restricted (1% lactalbumin, restricted to 4 grams per day). After 8.5 weeks, part of the group on the 0.5% lactalbumin low carbohydrate diet was fed the control diet (18% lactalbumin, 66% carbohydrate) for 8 weeks. At the end of the feeding period, the following assays were performed: 1) in vivo absorption of radioactive (¹⁴C) lactose, sucrose, and maltose; 2) activities of intestinal lactase, sucrase, and maltase; 3) plasma albumin concentrations; and 4) mucosal protein concentrations. In the three protein deficient groups (0.5% lactalbumin low carbohydrate, 0.5% lactalbumin high carbohydrate, and 1% lactalbumin), the activity of both the jejunal and ileal disaccharidases and the absorption of lactose, sucrose and maltose were significantly higher when compared with the controls. The jejunal sucrase and maltase activities were significantly higher in the 0.5% lactalbumin high carbohydrate group than in the 0.5% lactalbumin low carbohydrate group, but the absorption of lactose, sucrose and maltose were alike. When the 1% lactalbumin (restricted to 4 grams per day) and the 0.5% lactalbumin low carbohydrate groups were compared, there were no statistically significant differences in the specific activities of the intestinal disaccharidases or the absorption of the disaccharides. The absorption of lactose, sucrose, or maltose were similar in the controls and the protein repleted group. The disaccharidase activities were also similar in these two groups except for a significant depression of jejunal maltase and ileal sucrase and maltase activities in the protein repleted group. Therefore, these results indicate that protein deprivation in rats for 8.5 weeks causes an increase in specific activities of the intestinal disaccharidases in both the jejunum and ileum, and that these changes caused by protein depletion may be reversed by feeding a diet high in protein. Also, an increase in the carbohydrate content of the protein deficient diet results in an induction of jejunal sucrase and maltase activities. The high specific activity of the intestinal disaccharidases following protein-calorie malnutrition may be in part due to a preferential loss of structural proteins rather than to an increase in enzymatic protein in the intestinal mucosa. The increase in the disaccharidase activities in the protein deficient rats is accompanied by an increase in disaccharide absorption which could be due to the higher levels of disaccharidases or to an increase in the transport of the constituent monosaccharides. The demonstration of statistically significant differences in sucrase and maltase activities between the 0.5% lactalbumin high carbohydrate and the 0.5% lactalbumin low carbohydrate groups without a concomitant increase in sucrose and maltose absorption, supports the view that the higher absorption of sucrose and maltose in the protein deficient rats is a result of increased monosaccharide transport. The results of this study are not consistent with the suggestion that protein-calorie malnutrition is responsible for disaccharide intolerance in children. / Land and Food Systems, Faculty of / Graduate

The present research work is a transverse and descriptive study, which had as its principal objective to determine the Food and Nutritional Situation of the communities of Villa Santa Chacoma, Hancara, Hichuraya Grande and Pan de Azucar of the Ingavi province of the department of the La Paz. The most relevant part of the study was in finding the elevated percentage of infant population that presents an elevated prevalence and different levels of malnutrition. In adults what calls the attention is the physical exhaustion and the loss of muscle tissue, this situation was seen as a consequence of poverty, food consumption, prolonged exposure to breastfeeding, complementary feeding, type of foods that those under the age of 2 eat, the lack of knowledge about nutrition, geographical location in the communities, the degree of instruction of the heads of family, sanitary conditions and above all the economic factor.

In today’s world, eating disorders are plaguing adolescent women at alarming rates. Anorexia nervosa and bulimia nervosa are the two most common disorders and differ in their symptoms and prognoses. While the symptoms of these diseases are not readily visible in systemic health, deteriorating oral health can be a positive indication of abnormal eating habits. Anorexia nervosa and bulimia nervosa result in declining systemic health due to resulting nutritional imbalances and physical harm that patients exert upon themselves. Malnutrition results in altered endocrine function and consequent loss of menstruation, abnormal hair growth, and decreased peak bone mass. Although risk factors for anorexia nervosa and bulimia nervosa vary, the resulting nutritional impoverishment produces the similar systemic effects. In addition to systemic health degradation, symptoms of anorexia and bulimia commonly manifest in the oral cavity. Chemically, salivary composition may be altered resulting in lower pH values. Patients may also exhibit temporary bilateral parotid gland swelling as a result of repeated purge episodes. The most critical oral effect of repeated purge episodes is loss of permanent enamel and is defined as perimolysis. Presently, research does not agree on whether or not eating disorders elevate the risk of dental carries. Although current literature unanimously agrees on the importance of early oral health detection and diagnosis of eating disorders, most dentist are not trained to properly identify and diagnose the manifestations of AN and BN within the oral cavity. Dental school and dental hygiene curriculums lack emphasis on the severity of eating disorders in general and do not allot adequate teaching hours for this matter. Sadly, even when dentists suspect the presence of eating disorders, they are not likely to intervene. Fortunately, full recovery is possible in eating disorder patients if proper therapy and medical attention is provided in a timely manner. Damaged dentition may also be fully restored with the use of crowns, composite fillings, and porcelain veneers. However, if disordered eating habits persist after dental restoration, the dentition will once again erode and deteriorate accordingly. Anorexia nervosa and bulimia nervosa are serious diseases that need proper attention and medical intervention. Their severity should not be minimized as they may ultimately result in grave side effects and eventual death. Dental health practitioners have the ability of observe the presence of these diseases before others as obvious symptoms may present in the oral cavity. Dentists and dental hygienists need to be educated on the oral manifestations of eating disorders and proper protocol regarding timely intervention. With proper education and knowledge, dental health practitioners can reduce the severity of disease, resulting in better prognoses for patients.

In this study, six regression equations are used to determine the effects of credit and other factors on the nutritional status of boys and girls in Malawi. No significant effects of access to credit on child nutritional status were found. Same-sex parental preference for child nutrition was found. Infrastructural variables are determined to have the most significant influence in reducing child malnutrition levels. Access to credit is a new measure and its limitations are brought out in the study. / Master of Science

Bakgrund: Sverige har cirka 2 miljoner äldre, av dem anses ungefär 60 procent vara riskpatienter för malnutrition. Vårdgivaren har det yttersta ansvaret för att fastställa rutiner för när och hur vårdtagare ska utredas och behandlas. Riskbedömning med ett validerat nutritionsbedömningsinstrument är första steget i nutritions-vårdsprocessen. Rutinmässig övervakning och uppföljning kan förhindra att äldre utvecklar malnutrition. Syftet var att undersöka vilka faktorer som förhindrade nutritionsvårdsprocessen hos äldre. Metod: Studien genomfördes som en litteratur-översikt baserat på 13 artiklar. Resultatet delades in i kategorier som belyste organisations, - personal, - och patientrelaterade faktorer. De påvisade faktorerna uppgavs förhindra nutritionsvårdsprocessen på olika vis och ibland i relation till varandra. Konklusion: De beskrivna hindren för nutritionsvårdsprocessen är betydelsefulla för att kvalitetssäkra vården. Stöd och strategier på flera olika nivåer behövs för att överkomma de hinder som försvårar nutritionsvården. / Background: Sweden has about 2 million older people, of whom about 60 percent are at risk for malnutrition. The care provider has the ultimate responsibility for establishing routines for when and how care recipients will be investigated and treated. Risk assessment with a validated nutrition assessment instrument is the first step in the nutrition care process. Routine monitoring and follow up can prevent older people from developing malnutrition. The aim was to investigate factors which prevented the nutrition care process in older people. Method: The study was conducted as a literature review including 13 articles. The result was divided into categories which highlighted organizational, - personnel, - and patient related factors. The demonstrated factors were reported to prevent the nutrition care process in different ways and sometimes in relation to each other. Conclusion: The described barriers to the nutrition care process are important for quality assurance. Support and strategies at several levels are needed to overcome the barriers that hinder nutritional care.

Thesis (MPH.) -- University of Limpopo, 2021 / Background: Malnutrition has become a problem in the world, with 2.2 million deaths of children under five years of age globally have been linked to growth retardation, stunting and severe wasting, while other 600 000 children in the same age group are said to have died due to deficiencies in Vitamin A (Black, Allen, Bhutta, Caulfield, De Onis, Ezzati, Mathers, Rivera, and Maternal and Child Undernutrition Study Group, 2008 ). Objectives: This study aimed at determining the prevalence of malnutrition in children below 5 years of age, and to quantify stunting, underweight, wasting, overweight and obesity of children in the same group. Methods: This was a descriptive quantitative study. The data for the study was collected from 10 clinics, situated in the Ba-Phalaborwa District Municipality, using a standardized questionnaire. Stratified random sampling was used and stata program was used to analyse the data. Results: A total of 404 of mothers gave positive responses for children to participate in the current study, yielding to 97.1% response rate. Fifty-two-point-two percent of these children were females. The average age of the mothers of these children was 28.3 ±7.0 years Fifty-three-point-four percent of the mothers were single, 27% were divorced, 18.6% were married and 0.5% were widowed. The overall prevalence of malnutrition among the children was 26.7%. Males had higher percentage of underweight with 19.1%, compared to females (9.9%). The highest prevalence of malnutrition in females occurred in the age group 48-59 months, at 40.0%, followed by the age groups 0-11 months, 36-47 months, 24-35 months and 12-23 months at 26.9%, 25.0%, 24.0% and 17.5%, respectively. Of the different types of malnutrition, the occurrence of obesity was the lowest among the children. Conclusion The results of the findings are consistent with the findings of other studies. However, this study could not find that characteristics such as education, type of residence or financial background contribute immensely to child malnutrition.

La dépression et la malnutrition ne sont pas des conditions inévitables du vieillissement et elles représentent des problèmes de santé très importants étant donné leur prévalence élevée et leurs effets néfastes sur les capacités fonctionnelles. Précédemment, aucun travail de recherche ne s'est intéressé à étudier l'effet explicatif de la nutrition dans la relation entre la dépression et la capacité fonctionnelle. Objectifs. 1) Déterminer l'effet du risque nutritionnel (RN) dans la relation entre les symptômes dépressifs (SD) et la capacité fonctionnelle (CF) des personnes âgées. Méthodologie. Les données de base (TI) des 1,793 hommes (48 %) et femmes (52 %) (74,4[plus ou moins]4,1 ans) de la cohorte NuAge ont été utilisées pour les analyses. La CF a été mesurée par le score global de 4 tests de performance physique selon la méthode proposée par Guralnik et coil. (Timed"up & go", vitesse de marche (4 m), levée de chaise (5X), équilibre unipodal). Un résultat [supérieur ou égal à] 11 ou [inférieur ou égal à] 20 à l'Échelle de dépression gériatrique indique la présence de SD et un score [supérieur ou égal à] 3 au Dépistage nutritionnel des aînés (DNA[copyright]), un RN. Des analyses de variance ont été utilisées pour comparer les groupes suivants sur leur CF : saris RN et sans SD, avec RN et sans SD, sans RN et avec SD, avec RN et avec SD. La régression linéaire multivariée a permis de tester l'effet modificateur du RN VII dans la relation SD/CF ainsi que les associations entre le score global de CF et plusieurs variables sociodémographiques et sanitaires. Résultats. Le RN est présent chez 51% des sujets et sa prévalence est plus élevée dans les groupes plus âgés dans les 2 sexes ([rhô][inférieur à]0,001). La prévalence des SD est plus élevée chez les femmes (12,7%) que chez les hommes (7,7%) ([rhô]=0,001) de même que le score de CF (H: 10,59[plus ou moins]3,41; F: 9,25[plus ou moins]3,40; [rhô][inférieur à]0,001). Chez les deux sexes, la meilleure performance a été observée chez les plus jeunes et chez ceux qui rapportaient plus d'activités physiques. Par contre, le score de CF est plus faible dans le groupe avec RN et avec SD (8,86[plus ou moins]3,42) en comparaison avec le groupe sans RN et sans SD (10,55[plus ou moins]3,28) ([rhô]=0,001). L'inclusion du RN dans un modèle comprenant l'âge, le sexe et les SD a montré que le RN a un effet additionnel indépendant sur la CF ([rhô][inférieur à]0,001), lequel persiste après l'ajustement selon la scolarité, le revenu, l'indice de masse corporelle, le fardeau de la maladie et l'activité physisque. Par contre, l'interaction (RN*SD) n'est pas significative indiquant que le RN ne modifie pas la relation entre les SD et le score de CF. Ce dernier modèle explique 34% de la variabilité observée dans le score de la CF. Conclusion. Le risque nutritionnel est associé, de façon indépendante, à une capacité fonctionnelle réduite, mais ne modifie pas la relation entre cette dernière et les symptômes dépressifs. Étant donné l'importance des capacités fonctionnelles pour le maintien de l'autonomie, le développement de programmes comprenant la prévention du risque nutritionnel est une voie plausible et raisonnable d'intervention. De plus, ces programmes devraient inclure des composantes psychosociales qui auraient le potentiel de soulager les symptômes dépressifs. Malgré leurs limites liées aux analyses transversales, nos résultats proposent des hypothèses pour identifier les personnes âgées les plus à risque de présenter des limites fonctionnelles.

The purpose of the study was to assess the coverage and effectiveness of the management of severe acute malnutrition project implemented in Dhas district of Borena zone, Ethiopia, from July 2010 to December 2010. Quantitative, descriptive study was conducted to assess the comparability of the outcome of community-based management of acute malnutrition in a pastoralist area to International Sphere standards using performance indicators. Data collection was done using data capturing sheet. Outpatient therapeutic programme (OPT) registers in all health facilities were the sources of data. Clinical records of children admitted to the programme (n=163) were analysed. Standard nutrition survey result was used to estimate the malnutrition prevalence and programme coverage. International Sphere standard was achieved for mortality rate but not for recovery rate, defaulter rate, length of stay and weight gain / Health Studies / M.A. (Public Health)

Le présent travail repose sur l’hypothèse que l’infection par le VIH provoque et/ou aggrave les déficits nutritionnels de l’enfant. Ces déficits nutritionnels aggravent le déficit immunitaire et ont un impact négatif sur la survie de l’enfant infecté par le VIH/SIDA. Mais cette malnutrition même grave peut être améliorée et l’amélioration de l’état nutritionnel peut améliorer la santé d’enfants infectés par le VIH, en stade avancé de la maladie, afin de rendre possible leur prise en charge par les antirétroviraux. Les travaux ont été réalisés au Burkina Faso. Le contexte géographique est favorable au développement des maladies infectieuses et parasitaires. La mortalité infanto juvénile y est élevée et ainsi que la proportion d’enfant malnutris. Bien que la courbe de la prévalence du VIH montre un début de ralentissement, l’infection continue de progresser chez les enfants. Principales conclusions et implications de nos travaux :  Au Burkina Faso, la létalité pédiatrique demeure élevée (>15%) et la malnutrition est la cause sous jacente de plus des 2/3 des décès. Une évaluation de l’état nutritionnel à l’admission permettrait de sélectionner les enfants à risque et de réduire la mortalité par une prise en charge adéquate de la malnutrition et de l’infection.  Les unités de réhabilitation nutritionnelle sont confrontées à des enfants gravement malnutris qui présentent un risque très accru de décès. Il est urgent de donner à ce type de structure les moyens de mettre en œuvre efficacement le protocole OMS de prise en charge des enfants malnutris sévères. Il est également urgent d’organiser la prise en charge communautaire de la malnutrition pour une meilleure prévention de la malnutrition et une prise en charge précoce des cas.  Plusieurs des enfants admis dans les unités de traitement de la malnutrition sévère sont également infectés par le VIH/SIDA. Les indices anthropométriques de sont ne discriminent pas les enfants atteints du VIH/SIDA de ceux non atteints. Proposer le diagnostic du VIH/SIDA à tous les enfants malnutris sévères au moment de leur admission au CREN ne semble pas une approche de santé publique efficiente dans un contexte étudié. Des indices sociaux établit à partir de variables sociales permettent de classer les enfants malnutris sévères, dans le groupe de ceux à qui il faut d’emblée proposer un diagnostic du VIH/SIDA. L’utilisation d’un schéma d’aide à la décision médicale a été proposée, la spécificité de cette approche atteint 97,6%.  Dans le processus du diagnostic du VIH/SIDA de l’enfant, il est indispensable d’impliquer les parents, notamment le père dont le rôle est capital dans l’acceptation du test diagnostique et du résultat, notamment positif.  Lorsqu’ils sont à la phase de malnutrition sévère le pronostic des enfants atteints du VIH/SIDA est réservé. Dans les unités de traitement de la malnutrition sévère il est important de détecter ses enfants rapidement pour leur offrir des soins adaptées (traitement des infections opportunistes), voir les évacués rapidement vers les milieux pédiatriques. Et en amont il est indispensable, que les différents acteurs conjuguent les efforts pour rendre possible le diagnostic précoce de l’infection par le VIH chez l’enfant et accélérer l’accès à la prophylaxie (Cotrimoxazole, vaccination, suivi nutritionnel) des enfants infectés et l’accès aux ARV.  Nos travaux n’ont pas mis en évidence un intérêt d’une dose additionnelle de micronutriments par rapport à la dose actuellement recommandée pour la prise en charge nutritionnelle des malnutris sévères infectés par le VIH/SIDA. En conclusion : Malnutrition et infection par le VIH interagissent pour accroitre le risque de survenue du décès chez l’enfant. La réhabilitation nutritionnelle est possible chez les enfants malnutris sévères qui ne décèdent pas de façon précoce, cependant, il faudrait entamer la trithérapie le plus rapidement possible étant donné l’immunodépression sévère observée chez ces enfants. La prévention des infections opportunistes et le suivi nutritionnel des enfants nés de mères séropositives et le diagnostic précoce de l’infection chez les enfants et l’accès rapide aux ARV de ceux qui sont infectés sont les actions qui permettront de réduire la survenue de la malnutrition sévère chez ces enfants et alors de réduire la forte mortalité observée.

This study was undertaken to assess factors contributing to difference in nutritional status of patients at high risk for malnutrition. Twenty-five patients hospitalized for treatment of cancer and other disorders and for surgery were assessed using anthropometric, biochemical and dietary measures.Significant malnutrition was found. Males, as compared with females, had lower percent triceps skinfold, percent weight-for-height, percent hemoglobin, decreased appetites and total iron binding capacity. Mean total iron binding capacity for males was 62 percent of normal suggesting acute malnutrition similar to kwashiorkor. Cancer patients had lower total lymphocyte counts than those with other diagnosis. Patients hospitalized more than 23 days showed evidence of marasmus, with lower percent mid-arm muscle circumference, percent hematocrit, percent hemoglobin and a tendency for decreased weight/height than those hospitalized for a short time. Compared with patients with good appetites, those experiencing poor appetites had increased caloric and protein needs but lower protein intake compared to needs and lower creatinine-height-index.Five subjects with decreased weight/height had lower total iron binding capacity. The mean was 61 percent of normal indication severe depletion. The mid-arm muscle circumference was 82 percent of normal suggesting acute malnutrition imposed upon compromised somatic protein stores. Nine subjects showed evidence of frank kwashiorkor, three other subjects experienced marasmic-kwashiokor indication acute malnutrition imposed upon chronic malnutrition.In conclusion, this study suggests several characteristic features of hospitalized patients at risk for malnutrition: hospitalization for over three weeks, inadequate caloric and protein intake relation to need and anorexia. These patients are candidates for nutritional assessment and support.