Bakgrund Undernäring uppstår om en individs näringsintag är mindre än dennes näringsbehov och är vanligt förekommande hos äldre patienter. Sjuksköterskan har ett viktigt ansvar att identifiera patienter med risk för undernäring och förebygga undernäring, då det skapar ett onödigt lidande för patienten. Syfte Syftet var att genom en litteraturstudie undersöka vilka åtgärder sjuksköterskan vidtar kliniskt och effekten av att åtgärder sätts in vid risk för undernäring, samt sjuksköterskors grundläggande kunskap om nutrition för att förhindra att lidande till följd av undernäring hos äldre uppstår. Metod Originalartiklar söktes i databaserna PubMed och Cinahl. Abstracts lästes igenom för att identifiera artiklar som svarade på denna studies syfte. Artiklarna kvalitetsbedömdes och deras resultat granskades. Resultat Sjuksköterskor förhindrar undernäring genom att tidigt göra en riskbedömning, där viktutveckling, BMI och ätsvårigheter uppmärksammas. Genom att administrera näringsberikad kost och mellanmål, kan sjuksköterskan förebygga undernäring hos äldre patienter, vilket kunde noteras på ett förbättrat BMI och MNA-poäng. Sjuksköterskor upplever sig inte ha den grundläggande kunskapen om nutrition som krävs. Slutsats Energi- och proteinberikning kan vara en effektiv åtgärd för att minska risken för undernäring. Om åtgärder sätts in redan vid risk för undernäring, kan en effekt noteras i ett ökat BMI och MNA-poäng. Sjuksköterskor upplever att de saknar kunskap om nutrition. / Background Malnutrition is developed if a person’s food intake is less than the nutritional requirements and is common among elderly patients. The nurse has an important role to identify patients with risk of malnutrition and to prevent malnutrition, since it is an unnecessary suffering for the patient. Objective A literature study was performed to investigate which nursing interventions nurses use, the effect if these interventions start at an early point and nurses’ knowledge about nutrition to prevent malnutrition and suffering. Method Original articles were searched for in the data bases PubMed and Cinahl. Abstracts were read through, to identify articles that answered this study’s objective. The qualities of the articles were valued and the results were analysed. Just the results that is relevant for this study is present. Results Nurses can prevent malnutrition by using risk assessment tools, where the patients’ weight development, BMI and eating difficulties are continuously registered. There is some evidence that energy and protein fortification can decrease a patient’s risk of getting malnourished. This could be presented with an improved BMI and MNA score. Nurses believe that they have a lack of knowledge about nutrition. Conclusion Nurses can prevent malnutrition by doing a risk assessment. Energy and protein fortification can serve as an effective intervention to prevent malnutrition in the elderly, which could be seen as an increased BMI and MNA score. Nurses believe that they have a lack of knowledge about nutrition.

This dissertation’s three studies investigated the short and long-term relationships of bone-related nutrient intakes with bone mineral density (BMD) in postmenopausal women. This dissertation compared the equivalency of dietary intakes assessed by eight days of diet records (DR) and the Arizona Food Frequency Questionnaire (AFFQ) at one year. It also determined the association of one year (DR) and the average of four-year (AFFQ) dietary intakes with cross-sectional BMD. The dietary intake associations with BMD were further investigated by hormone therapy (HT). Participant’s BMD was measured at the lumbar spine (L2-L4), femur trochanter, femur neck, Ward's triangle and total body using dual energy X-ray absorptiometry. Separate multiple linear regression analysis (p≤0.05), controlled for various covariates, were used to examine the associations between dietary intakes and regional and total body BMD. In study number one (n=266), significant correlations (r=0.30-0.70, p≤0.05) between dietary assessment methods were found with all dietary intake variables. Iron, magnesium, zinc, dietary calcium, phosphorous, potassium, total calcium, and fiber intakes were positively associated with BMD at three or more of the same bone sites regardless of the dietary assessment method at one year. In study number two (n=266), femur trochanter, lumbar spine, and total body BMD had mostly significant inverse associations with dietary polyunsaturated fatty acid (PUFA) intake at one year. In the HT group (n=136), inverse associations with dietary PUFA intake were seen in the spine and total body BMD. In study number three (n=130), average dietary intake of selected bone-related nutrients, were significantly inversely associated with lumbar spine BMD and total body BMD at year four. In the HT group (n=92), inverse associations with dietary PUFA intake were seen in the spine and total body BMD. The DR and AFFQ are acceptable dietary tools used to determine the associations of particular nutrients and BMD sites in healthy postmenopausal women at one year. At one and four year, dietary PUFA intakes had mostly inverse associations with lumbar spine and total body BMD. When categorized by HT use the associations remained significant only in the HT groups, suggesting that HT may influence dietary intake associations with BMD.

A condição bucal e a falta de condições mastigatórias adequadas têm sido implicadas como indicadores de risco para má alimentação e desnutrição. Indivíduos com um número menor de dentes ou edêntulos são considerados menos propensos a comer alimentos ricos em nutrientes, como vegetais, frutas, carne e grãos integrais. Há evidências que a condição bucal alterada causa restrições dietéticas através da dificuldade em mastigar, comprometendo o estado nutricional e bem-estar dos indivíduos. Esta dissertação é composta por dois estudos, uma revisão sistemática da literatura com meta- análise e um estudo transversal. A revisão sistemática da literatura com meta-analise avaliou e comparou o estado de saúde bucal (perda de dentes, uso de prótese e DMFT) em idosos bem-nutridos, em risco de desnutrição e indivíduos desnutridos. Dois pesquisadores analisaram a inclusão dos títulos, resumos, leitura completa (MPT e FWMGM), outros dois fizeram a extração de dados dos artigos (PSA e MPT) e se um consenso não fosse possível, um terceiro pesquisador estaria incluído neste processo. De 110 artigos lidos na íntegra, 26 foram incluídos na revisão sistemática, dos quais 23 eram transversais. Foi demonstrado que os sujeitos com estado nutricional normal tinham um número significativamente maior de pares de dentes / Unidades Funcionais de Dentes (FTU) em comparação com aqueles que estavam desnutridos ou em risco de desnutrição. As meta-análises não mostraram associação estatisticamente significante entre edentulismo e uso de prótese, pois o risco relativo combinado foi de 1,072 (IC 95% 0,957 - 1,200, p = 0,230) e 0,874 (IC 95%: 0,710 - 1,075, p = 0,202). Por outro lado, o desvio padrão médio do número médio de dentes presentes foi de -0,141 (IC 95% -0,278 - 0,005, p = 0,042) em indivíduos com desnutrição / risco de desnutrição. O estudo transversal avaliou a condição bucal e o estado nutricional de pacientes que se encontravam internados nas enfermarias do Hospital de Clínicas de Porto Alegre (HCPA), no período de dezembro de 2015 e junho de 2016. O presente estudo incluiu 394 participantes com idade média de 63.43±10.76 entre os indivíduos diabéticos (87 mulheres e 110 homens) e 59,85±15,18 entre os não diabéticos (93 mulheres e 104 homens). Os indivíduos diabéticos (18,33±12,79) permaneceram em média mais tempo internados do que os indivíduos não diabéticos (16,53±14,54). As variáveis sexo, número de dentes, tempo de internação e capacidade funcional mastigatória estavam associadas à desnutrição na análise uni-variada. Na análise multivariada, sexo, número de dentes e tempo de internação mantiveram-se associados à desnutrição. Apresente dissertação conclui que existe associação entre a condição bucal e a desnutrição. Indivíduos com perdas dentárias apresentam maior risco desnutrição, o que foi demostrado tanto na meta análise quanto no estudo transversal. / The oral condition and the lack of adequate masticatory conditions have been implicated as risk indicators for malnutrition and malnutrition. Individuals with fewer teeth or edentulous are considered less likely to eat foods rich in nutrients such as vegetables, fruits, meat and whole grains. There is evidence that altered oral status causes dietary restrictions through difficulty in chewing, compromising the nutritional status and well-being of individuals. This dissertation is composed of two studies, a cross-sectional study and a systematic review of the literature with meta-analysis. The cross-sectional study evaluated the oral condition and nutritional status of patients hospitalized in the Hospital das Clinicas de Porto Alegre (HCPA), from December 2015 to June 2016. The present study included 394 middle-aged participants Of 63.43 ± 10.76 among diabetic subjects (87 women and 110 men) and 59.85 ± 15.18 among non-diabetics (93 women and 104 men). Diabetic individuals (18.33 ± 12.79) remained on average longer hospitalized than non-diabetic individuals (16.53 ± 14.54). The variables gender, number of teeth, length of hospital stay and functional masticatory capacity were associated with malnutrition in the univariate analysis. In the multivariate analysis, sex, number of teeth and length of stay remained associated with malnutrition. The systematic review of the literature with meta-analysis evaluated and compared the state of oral health (tooth loss, prosthesis use and FWD) in well-nourished elderly, at risk of malnutrition, and malnourished individuals. Two researchers analyzed the inclusion of titles, abstracts, full reading (MPT and FWMGM), two others extracted data from articles (PSA and MPT) and if a consensus was not possible, a third researcher would be included in this process. Of 110 articles read in full, 26 were eligible for inclusion. Twenty-six studies were included in the systematic review, of which 23 were cross-sectional. It was shown that subjects with normal nutritional status had significantly more pairs of teeth / functional tooth units (FTU) compared to those who were malnourished or at risk of malnutrition. The meta-analyzes did not show a statistically significant association between edentulism and prosthesis use, since the combined relative risk was 1.072 (95% CI 0.957-1.1200, p = 0.230) and 0.874 (95% CI: 0.710-0.075, p = 0.202 ). On the other hand, the mean standard deviation of the mean number of teeth present was -0.141 (95% CI -0.278-0.005, p = 0.042) in subjects with malnutrition / risk of malnutrition. The present dissertation concludes that there is an association between the oral condition and malnutrition. Individuals with dental losses present a greater risk of malnutrition, which was demonstrated both in the meta-analysis and in the cross-sectional study.

Despite surf lifesavers being national icons of good health and good nutrition, surprisingly little factual information is known about the nutritional status of this unique aquatic fellowship. The purpose of this study was to investigate the nutritional intake and nutritional knowledge of three distinct groups of Australian surf lifesavers. Weighed food diaries are commonly used to assess the nutritional intake of athletes but this method has the disadvantage of a heavy respondent burden. Individuals being investigated must be literate and highly motivated to keep accurate records of food and drinks consumed. Food frequency questionnaires (FFQ) offer an alternative assessment method to weighed food records as they are relatively quick and easy to complete and do not require a high level of literacy. A secondary purpose of this study was to compare seven-day weighed food diaries with a FFQ that had already been validated for use with an older mixed gender population. The nutrient intakes of 60 members of Surf Lifesaving Australia were measured. Nineteen, who were professional lifeguards completed a FFQ. Thirty lifesavers and 11 surf ironmen each completed the FFQ, a seven-day weighed food diary and a nutritional knowledge questionnaire consisting of 15 multiple choice questions. There were significant differences between the three groups in age and activity with ironmen being significantly younger (mean age 22.9yrs) and significantly more physically active (mean 134mins/day) than either lifesavers (mean age, 31.3yrs, mean activity 46min/day) or lifeguards (mean age 35.8yrs, mean activity 65min/day). There were no significant differences in these parameters between lifesavers and lifeguards. The seven-day food diary revealed significant differences in nutrient intake between lifesavers and ironmen. Lifesavers consumed 1 1,807kJ, 125g protein (1.6g/kg) and 327g carbohydrate (4.Og/kg) while ironmen consumed 14,69/kJ, 1519 protein (1.9g/kg) and 4629 carbohydrate (5.6g/kg). Lifesavers and ironmen exceeded the RDIs for all vitamins and minerals measured. The seven day food diary demonstrated significant differences between the lifesavers and ironmen in energy, protein, fat, carbohydrate, alcohol, thiamin, niacin, calcium and iron. When the nutrient analysis data set for the FFQ was checked this method of dietary assessment was found to be unreliable as greater than 20 per cent of subjects were identified as being under-reporters. Lifesavers and ironmen both had good scores on the nutritional knowledge questionnaire and were able to identify groups of foods as being rich sources of fat, fibre, protein and iron. Ironmen were better able to answer questions specifically related to sport nutrition. All three groups meet the current recommendations for daily physical activity. Lifesavers and ironmen meet the current recommendations for, protein, fibre, vitamin and mineral intake and consume alcohol at levels within the current health guidelines. Ironmen have the highest carbohydrate intake which meets the current general health recommendations but consume less than the current special recommendations of sport nutritionists while lifesavers consume only 44% of energy as carbohydrate. These results suggest that while the both lifesavers and ironmen consume a relatively healthy diet only the surf ironmen could possibly be considered nutritional icons.

Background: Studies have consistently found a high prevalence of vitamin D deficiency in adolescents. Few validated dietary intake assessment tools for vitamin D exist for adolescents. Objective: The aim of this study was to determine if a short food frequency questionnaire (SFFQ) can be used to effectively assess vitamin D intake in adolescents compared to a previously validated long food frequency questionnaire (LFFQ). Participants/setting: 140 healthy 6-12 year old (male n=81) Caucasian and African American (n=94) children from Pittsburgh, Pennsylvania completed a SFFQ and LFFQ at two time points 6 months apart. Main outcome measures: Reliability and validity of a SFFQ by comparison with a previously validated LFFQ for children and adolescents. Statistical analysis: Reliability, validity, sensitivity, specificity, positive, and negative predictive values were assessed using Pearson correlation coefficients. Results: Mean vitamin D intake from the SFFQ (range, 434 to 485 IU) was higher than the LFFQ (range, 320 to 378 IU). Overall association between the SFFQ and the LFFQ for vitamin D intake was modest (r=0.36, P<0.001). When stratified by race, the overall degree of association was weak for African Americans (r=0.26, P=0.001) and moderate for Caucasians (r=0.57, P<0.001). Overall reliability testing results were modest and significant for the LFFQ (r=0.28, P=0.002) and SFFQ (r=0.33, P<0.001). Association between mean vitamin D intake from LFFQs and SFFQs was used to determine validity. The association for validity was found to be modest (r=0.51, P<0.001). Sensitivity, specificity, positive predictive value, and negative predictive value for the SFFQ were 90%, 64%, 0.78, and 0.58, respectively. Conclusion: The SFFQ was found to be modestly valid and reliable in an early adolescent population. Associations between African Americans were not as strong as Caucasians which may be due to errors in reporting dietary consumption related to higher body weight.

Introdução: A Bioimpedância Elétrica (BIA) é um método fácil de usar, rápido, barato, não invasivo e de fácil reprodutibilidade utilizado para verificar as mudanças na composição corporal. O Ângulo de Fase (AF), obtido através da BIA, reflete a relativa contribuição dos fluidos e membranas para o corpo humano, sendo associado como um marcador prognóstico em diversas situações clínicas. Objetivos: Avaliar o AF como indicador de desfechos negativos em pacientes cirúrgicos (ocorrência de infecção e/ou morte e tempo de permanência hospitalar). Metodologia: Foram avaliados pacientes com idade de 18 a 80 anos internados no Hospital de Clínicas de Porto Alegre com indicação de cirurgia eletiva. As avaliações foram realizadas no momento da internação, 48 e 72 horas após a cirurgia. Foram avaliados peso, altura e Índice de Massa Corporal (IMC), estado nutricional através da Avaliação Nutricional Subjetiva Global (ANSG) e Ângulo de Fase através da BIA. Resultados: Foram avaliados 142 pacientes, segundo o IMC, 59,2% dos pacientes foram classificados como eutróficos, 3,5% moderadamente desnutridos e 37,3% apresentaram algum grau obesidade. A avaliação por ANSG verificou que 76,1% dos pacientes estavam eutróficos, 23,2% moderadamente desnutridos e 0,7% desnutridos graves. Os baixos valores para o AF obtidos nas 3 avaliações não se apresentaram como indicadores de desfechos negativos em pacientes cirúrgicos. Conclusões: O AF não se demonstrou um indicador para desfechos negativos em pacientes cirúrgicos. / Introduction: Electrical Bioimpedance (BIA) is an easy to use, fast, inexpensive, noninvasive and highly reproducible used to verify the changes in body composition. The Phase Angle (PA), obtained by BIA reflects the relative contribution of fluid and membranes for the human body, being associated as a prognostic marker in various clinical situations. Objectives: To evaluate the AF as an indicator of negative outcomes in surgical patients. Methodology: We studied patients aged 18 to 80 years at the Hospital de Clínicas de Porto Alegre with indication of elective surgery. Evaluations were performed at admission, 48 and 72 hours after surgery. Body weight, height and Body Mass Index (BMI), nutritional status by Subjective Global Assessment (SGA) and Phase Angle through the BIA. Results: According to BMI, 59.2% of patients were classified as eutrophic, 3.5% moderately malnourished and 37.3% had some degree obesity. The assessment by SGA found that 76.1% of patients were eutrophic, 23.2% moderately malnourished and 0.7% severely malnourished. The low values obtained for the AF in three evaluations were not presented as indicators of negative outcomes in surgical patients. Conclusions: AF is not an indicator to show negative outcomes in surgical patients.

A condição bucal e a falta de condições mastigatórias adequadas têm sido implicadas como indicadores de risco para má alimentação e desnutrição. Indivíduos com um número menor de dentes ou edêntulos são considerados menos propensos a comer alimentos ricos em nutrientes, como vegetais, frutas, carne e grãos integrais. Há evidências que a condição bucal alterada causa restrições dietéticas através da dificuldade em mastigar, comprometendo o estado nutricional e bem-estar dos indivíduos. Esta dissertação é composta por dois estudos, uma revisão sistemática da literatura com meta- análise e um estudo transversal. A revisão sistemática da literatura com meta-analise avaliou e comparou o estado de saúde bucal (perda de dentes, uso de prótese e DMFT) em idosos bem-nutridos, em risco de desnutrição e indivíduos desnutridos. Dois pesquisadores analisaram a inclusão dos títulos, resumos, leitura completa (MPT e FWMGM), outros dois fizeram a extração de dados dos artigos (PSA e MPT) e se um consenso não fosse possível, um terceiro pesquisador estaria incluído neste processo. De 110 artigos lidos na íntegra, 26 foram incluídos na revisão sistemática, dos quais 23 eram transversais. Foi demonstrado que os sujeitos com estado nutricional normal tinham um número significativamente maior de pares de dentes / Unidades Funcionais de Dentes (FTU) em comparação com aqueles que estavam desnutridos ou em risco de desnutrição. As meta-análises não mostraram associação estatisticamente significante entre edentulismo e uso de prótese, pois o risco relativo combinado foi de 1,072 (IC 95% 0,957 - 1,200, p = 0,230) e 0,874 (IC 95%: 0,710 - 1,075, p = 0,202). Por outro lado, o desvio padrão médio do número médio de dentes presentes foi de -0,141 (IC 95% -0,278 - 0,005, p = 0,042) em indivíduos com desnutrição / risco de desnutrição. O estudo transversal avaliou a condição bucal e o estado nutricional de pacientes que se encontravam internados nas enfermarias do Hospital de Clínicas de Porto Alegre (HCPA), no período de dezembro de 2015 e junho de 2016. O presente estudo incluiu 394 participantes com idade média de 63.43±10.76 entre os indivíduos diabéticos (87 mulheres e 110 homens) e 59,85±15,18 entre os não diabéticos (93 mulheres e 104 homens). Os indivíduos diabéticos (18,33±12,79) permaneceram em média mais tempo internados do que os indivíduos não diabéticos (16,53±14,54). As variáveis sexo, número de dentes, tempo de internação e capacidade funcional mastigatória estavam associadas à desnutrição na análise uni-variada. Na análise multivariada, sexo, número de dentes e tempo de internação mantiveram-se associados à desnutrição. Apresente dissertação conclui que existe associação entre a condição bucal e a desnutrição. Indivíduos com perdas dentárias apresentam maior risco desnutrição, o que foi demostrado tanto na meta análise quanto no estudo transversal. / The oral condition and the lack of adequate masticatory conditions have been implicated as risk indicators for malnutrition and malnutrition. Individuals with fewer teeth or edentulous are considered less likely to eat foods rich in nutrients such as vegetables, fruits, meat and whole grains. There is evidence that altered oral status causes dietary restrictions through difficulty in chewing, compromising the nutritional status and well-being of individuals. This dissertation is composed of two studies, a cross-sectional study and a systematic review of the literature with meta-analysis. The cross-sectional study evaluated the oral condition and nutritional status of patients hospitalized in the Hospital das Clinicas de Porto Alegre (HCPA), from December 2015 to June 2016. The present study included 394 middle-aged participants Of 63.43 ± 10.76 among diabetic subjects (87 women and 110 men) and 59.85 ± 15.18 among non-diabetics (93 women and 104 men). Diabetic individuals (18.33 ± 12.79) remained on average longer hospitalized than non-diabetic individuals (16.53 ± 14.54). The variables gender, number of teeth, length of hospital stay and functional masticatory capacity were associated with malnutrition in the univariate analysis. In the multivariate analysis, sex, number of teeth and length of stay remained associated with malnutrition. The systematic review of the literature with meta-analysis evaluated and compared the state of oral health (tooth loss, prosthesis use and FWD) in well-nourished elderly, at risk of malnutrition, and malnourished individuals. Two researchers analyzed the inclusion of titles, abstracts, full reading (MPT and FWMGM), two others extracted data from articles (PSA and MPT) and if a consensus was not possible, a third researcher would be included in this process. Of 110 articles read in full, 26 were eligible for inclusion. Twenty-six studies were included in the systematic review, of which 23 were cross-sectional. It was shown that subjects with normal nutritional status had significantly more pairs of teeth / functional tooth units (FTU) compared to those who were malnourished or at risk of malnutrition. The meta-analyzes did not show a statistically significant association between edentulism and prosthesis use, since the combined relative risk was 1.072 (95% CI 0.957-1.1200, p = 0.230) and 0.874 (95% CI: 0.710-0.075, p = 0.202 ). On the other hand, the mean standard deviation of the mean number of teeth present was -0.141 (95% CI -0.278-0.005, p = 0.042) in subjects with malnutrition / risk of malnutrition. The present dissertation concludes that there is an association between the oral condition and malnutrition. Individuals with dental losses present a greater risk of malnutrition, which was demonstrated both in the meta-analysis and in the cross-sectional study.

A condição bucal e a falta de condições mastigatórias adequadas têm sido implicadas como indicadores de risco para má alimentação e desnutrição. Indivíduos com um número menor de dentes ou edêntulos são considerados menos propensos a comer alimentos ricos em nutrientes, como vegetais, frutas, carne e grãos integrais. Há evidências que a condição bucal alterada causa restrições dietéticas através da dificuldade em mastigar, comprometendo o estado nutricional e bem-estar dos indivíduos. Esta dissertação é composta por dois estudos, uma revisão sistemática da literatura com meta- análise e um estudo transversal. A revisão sistemática da literatura com meta-analise avaliou e comparou o estado de saúde bucal (perda de dentes, uso de prótese e DMFT) em idosos bem-nutridos, em risco de desnutrição e indivíduos desnutridos. Dois pesquisadores analisaram a inclusão dos títulos, resumos, leitura completa (MPT e FWMGM), outros dois fizeram a extração de dados dos artigos (PSA e MPT) e se um consenso não fosse possível, um terceiro pesquisador estaria incluído neste processo. De 110 artigos lidos na íntegra, 26 foram incluídos na revisão sistemática, dos quais 23 eram transversais. Foi demonstrado que os sujeitos com estado nutricional normal tinham um número significativamente maior de pares de dentes / Unidades Funcionais de Dentes (FTU) em comparação com aqueles que estavam desnutridos ou em risco de desnutrição. As meta-análises não mostraram associação estatisticamente significante entre edentulismo e uso de prótese, pois o risco relativo combinado foi de 1,072 (IC 95% 0,957 - 1,200, p = 0,230) e 0,874 (IC 95%: 0,710 - 1,075, p = 0,202). Por outro lado, o desvio padrão médio do número médio de dentes presentes foi de -0,141 (IC 95% -0,278 - 0,005, p = 0,042) em indivíduos com desnutrição / risco de desnutrição. O estudo transversal avaliou a condição bucal e o estado nutricional de pacientes que se encontravam internados nas enfermarias do Hospital de Clínicas de Porto Alegre (HCPA), no período de dezembro de 2015 e junho de 2016. O presente estudo incluiu 394 participantes com idade média de 63.43±10.76 entre os indivíduos diabéticos (87 mulheres e 110 homens) e 59,85±15,18 entre os não diabéticos (93 mulheres e 104 homens). Os indivíduos diabéticos (18,33±12,79) permaneceram em média mais tempo internados do que os indivíduos não diabéticos (16,53±14,54). As variáveis sexo, número de dentes, tempo de internação e capacidade funcional mastigatória estavam associadas à desnutrição na análise uni-variada. Na análise multivariada, sexo, número de dentes e tempo de internação mantiveram-se associados à desnutrição. Apresente dissertação conclui que existe associação entre a condição bucal e a desnutrição. Indivíduos com perdas dentárias apresentam maior risco desnutrição, o que foi demostrado tanto na meta análise quanto no estudo transversal. / The oral condition and the lack of adequate masticatory conditions have been implicated as risk indicators for malnutrition and malnutrition. Individuals with fewer teeth or edentulous are considered less likely to eat foods rich in nutrients such as vegetables, fruits, meat and whole grains. There is evidence that altered oral status causes dietary restrictions through difficulty in chewing, compromising the nutritional status and well-being of individuals. This dissertation is composed of two studies, a cross-sectional study and a systematic review of the literature with meta-analysis. The cross-sectional study evaluated the oral condition and nutritional status of patients hospitalized in the Hospital das Clinicas de Porto Alegre (HCPA), from December 2015 to June 2016. The present study included 394 middle-aged participants Of 63.43 ± 10.76 among diabetic subjects (87 women and 110 men) and 59.85 ± 15.18 among non-diabetics (93 women and 104 men). Diabetic individuals (18.33 ± 12.79) remained on average longer hospitalized than non-diabetic individuals (16.53 ± 14.54). The variables gender, number of teeth, length of hospital stay and functional masticatory capacity were associated with malnutrition in the univariate analysis. In the multivariate analysis, sex, number of teeth and length of stay remained associated with malnutrition. The systematic review of the literature with meta-analysis evaluated and compared the state of oral health (tooth loss, prosthesis use and FWD) in well-nourished elderly, at risk of malnutrition, and malnourished individuals. Two researchers analyzed the inclusion of titles, abstracts, full reading (MPT and FWMGM), two others extracted data from articles (PSA and MPT) and if a consensus was not possible, a third researcher would be included in this process. Of 110 articles read in full, 26 were eligible for inclusion. Twenty-six studies were included in the systematic review, of which 23 were cross-sectional. It was shown that subjects with normal nutritional status had significantly more pairs of teeth / functional tooth units (FTU) compared to those who were malnourished or at risk of malnutrition. The meta-analyzes did not show a statistically significant association between edentulism and prosthesis use, since the combined relative risk was 1.072 (95% CI 0.957-1.1200, p = 0.230) and 0.874 (95% CI: 0.710-0.075, p = 0.202 ). On the other hand, the mean standard deviation of the mean number of teeth present was -0.141 (95% CI -0.278-0.005, p = 0.042) in subjects with malnutrition / risk of malnutrition. The present dissertation concludes that there is an association between the oral condition and malnutrition. Individuals with dental losses present a greater risk of malnutrition, which was demonstrated both in the meta-analysis and in the cross-sectional study.

Introdução: A Bioimpedância Elétrica (BIA) é um método fácil de usar, rápido, barato, não invasivo e de fácil reprodutibilidade utilizado para verificar as mudanças na composição corporal. O Ângulo de Fase (AF), obtido através da BIA, reflete a relativa contribuição dos fluidos e membranas para o corpo humano, sendo associado como um marcador prognóstico em diversas situações clínicas. Objetivos: Avaliar o AF como indicador de desfechos negativos em pacientes cirúrgicos (ocorrência de infecção e/ou morte e tempo de permanência hospitalar). Metodologia: Foram avaliados pacientes com idade de 18 a 80 anos internados no Hospital de Clínicas de Porto Alegre com indicação de cirurgia eletiva. As avaliações foram realizadas no momento da internação, 48 e 72 horas após a cirurgia. Foram avaliados peso, altura e Índice de Massa Corporal (IMC), estado nutricional através da Avaliação Nutricional Subjetiva Global (ANSG) e Ângulo de Fase através da BIA. Resultados: Foram avaliados 142 pacientes, segundo o IMC, 59,2% dos pacientes foram classificados como eutróficos, 3,5% moderadamente desnutridos e 37,3% apresentaram algum grau obesidade. A avaliação por ANSG verificou que 76,1% dos pacientes estavam eutróficos, 23,2% moderadamente desnutridos e 0,7% desnutridos graves. Os baixos valores para o AF obtidos nas 3 avaliações não se apresentaram como indicadores de desfechos negativos em pacientes cirúrgicos. Conclusões: O AF não se demonstrou um indicador para desfechos negativos em pacientes cirúrgicos. / Introduction: Electrical Bioimpedance (BIA) is an easy to use, fast, inexpensive, noninvasive and highly reproducible used to verify the changes in body composition. The Phase Angle (PA), obtained by BIA reflects the relative contribution of fluid and membranes for the human body, being associated as a prognostic marker in various clinical situations. Objectives: To evaluate the AF as an indicator of negative outcomes in surgical patients. Methodology: We studied patients aged 18 to 80 years at the Hospital de Clínicas de Porto Alegre with indication of elective surgery. Evaluations were performed at admission, 48 and 72 hours after surgery. Body weight, height and Body Mass Index (BMI), nutritional status by Subjective Global Assessment (SGA) and Phase Angle through the BIA. Results: According to BMI, 59.2% of patients were classified as eutrophic, 3.5% moderately malnourished and 37.3% had some degree obesity. The assessment by SGA found that 76.1% of patients were eutrophic, 23.2% moderately malnourished and 0.7% severely malnourished. The low values obtained for the AF in three evaluations were not presented as indicators of negative outcomes in surgical patients. Conclusions: AF is not an indicator to show negative outcomes in surgical patients.

Introdução: A Bioimpedância Elétrica (BIA) é um método fácil de usar, rápido, barato, não invasivo e de fácil reprodutibilidade utilizado para verificar as mudanças na composição corporal. O Ângulo de Fase (AF), obtido através da BIA, reflete a relativa contribuição dos fluidos e membranas para o corpo humano, sendo associado como um marcador prognóstico em diversas situações clínicas. Objetivos: Avaliar o AF como indicador de desfechos negativos em pacientes cirúrgicos (ocorrência de infecção e/ou morte e tempo de permanência hospitalar). Metodologia: Foram avaliados pacientes com idade de 18 a 80 anos internados no Hospital de Clínicas de Porto Alegre com indicação de cirurgia eletiva. As avaliações foram realizadas no momento da internação, 48 e 72 horas após a cirurgia. Foram avaliados peso, altura e Índice de Massa Corporal (IMC), estado nutricional através da Avaliação Nutricional Subjetiva Global (ANSG) e Ângulo de Fase através da BIA. Resultados: Foram avaliados 142 pacientes, segundo o IMC, 59,2% dos pacientes foram classificados como eutróficos, 3,5% moderadamente desnutridos e 37,3% apresentaram algum grau obesidade. A avaliação por ANSG verificou que 76,1% dos pacientes estavam eutróficos, 23,2% moderadamente desnutridos e 0,7% desnutridos graves. Os baixos valores para o AF obtidos nas 3 avaliações não se apresentaram como indicadores de desfechos negativos em pacientes cirúrgicos. Conclusões: O AF não se demonstrou um indicador para desfechos negativos em pacientes cirúrgicos. / Introduction: Electrical Bioimpedance (BIA) is an easy to use, fast, inexpensive, noninvasive and highly reproducible used to verify the changes in body composition. The Phase Angle (PA), obtained by BIA reflects the relative contribution of fluid and membranes for the human body, being associated as a prognostic marker in various clinical situations. Objectives: To evaluate the AF as an indicator of negative outcomes in surgical patients. Methodology: We studied patients aged 18 to 80 years at the Hospital de Clínicas de Porto Alegre with indication of elective surgery. Evaluations were performed at admission, 48 and 72 hours after surgery. Body weight, height and Body Mass Index (BMI), nutritional status by Subjective Global Assessment (SGA) and Phase Angle through the BIA. Results: According to BMI, 59.2% of patients were classified as eutrophic, 3.5% moderately malnourished and 37.3% had some degree obesity. The assessment by SGA found that 76.1% of patients were eutrophic, 23.2% moderately malnourished and 0.7% severely malnourished. The low values obtained for the AF in three evaluations were not presented as indicators of negative outcomes in surgical patients. Conclusions: AF is not an indicator to show negative outcomes in surgical patients.