nutritional status, screening and assessment (lecture) Flashcards
What is sarcopenia ?
loss of muscle mass and strength as a result of aging
Define: Nutritional status …
intake of a diet sufficient to meet/exceed the bodily need of the individual to keep composition and function within the normal range
status range: undernutrition - relative balance - over nutrition
What is the WHO definition of malnutrition ?
a deficiency, excess or imbalance of a wide range of nutrients, resulting in a measurable adverse effect on body composition, function and clinical outcome
Define malnutrition/under nutrition …
insufficient energy and nutrients to meet bodily requirements that ensure growth, maintenance and specific functions
Who are the higher risk groups when it comes to undernutrition?
- elderly
- chronic diseases
- prolonged bed rest
- living in institutional care
What % of hospital patients are under nourished in high income countries ?
50%
What % of hospital patients are under nourished in low income countries ?
up to 70%
What negative outcomes are associated with malnourished patients ?
- higher infection and complication rates
- increased muscle loss
- impaired wound healing
- longer length of stay in hospital
- increased morbidity and mortality
What are the 4 major causes of malnutrition?
- inadequate intake
- malabsorption
- excess loss
- altered nutrient processing
What are some things that might cause malnutrition via inadequate intake ?
- poor diet
- poor appetite
- pain/nausea with eating
- dysphasia
- depression/mental health struggles
- unconsciousness
- inability to afford food
- poor food choices available
What are some things that might cause malnutrition via malabsorption ?
- damaged pathology of stomach, pancreas, intestines, liver
What are some things that might cause malnutrition via excessive loss ?
- vomiting
- diarrhoea
- surgical drains
- fistulas
- stomas
- NG tube drainage
What are some things that might cause malnutrition via altered nutrient processing ?
- increased/altered metabolic demands
- liver dysfunction
- mutations causing lack of transport proteins
What are the physiological effects of malnutrition ?
loss of …
- muscle mass and function
- cardio-resp function
- GI function
- immunity/wound healing
- endocrine function
- bone structure
- psychological
- microbiome
What symptom is the main indicator of malnutrition ?
weight loss
Which stores are the body’s first port of call if it is not getting the correct nutrients?
glucose (glycogen) stores in the liver
After glycogen stores, what does the body reach for to provide nutrients if malnourished?
- fat stores
- muscle (skeletal + organs)
What is cachexia?
weakness and wasting of the body due to severe chronic illness
How are malnutrition and cachexia linked ?
cachexia = disease-related malnutrition associated with chronic inflammation
inflammation:
- increases energy expenditure
- decreases absorption
