nutritional status, screening and assessment (lecture)

Question 1

What is sarcopenia ?

Answer 1

loss of muscle mass and strength as a result of aging

Question 2

Define: Nutritional status …

Answer 2

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

Question 3

What is the WHO definition of malnutrition ?

Answer 3

a deficiency, excess or imbalance of a wide range of nutrients, resulting in a measurable adverse effect on body composition, function and clinical outcome

Question 4

Define malnutrition/under nutrition …

Answer 4

insufficient energy and nutrients to meet bodily requirements that ensure growth, maintenance and specific functions

Question 5

Who are the higher risk groups when it comes to undernutrition?

Answer 5

• elderly
• chronic diseases
• prolonged bed rest
• living in institutional care

Question 6

What % of hospital patients are under nourished in high income countries ?

Answer 6

50%

Question 7

What % of hospital patients are under nourished in low income countries ?

Answer 7

up to 70%

Question 8

What negative outcomes are associated with malnourished patients ?

Answer 8

• higher infection and complication rates
• increased muscle loss
• impaired wound healing
• longer length of stay in hospital
• increased morbidity and mortality

Question 9

What are the 4 major causes of malnutrition?

Answer 9

1. inadequate intake
2. malabsorption
3. excess loss
4. altered nutrient processing

Question 10

What are some things that might cause malnutrition via inadequate intake ?

Answer 10

• poor diet
• poor appetite
• pain/nausea with eating
• dysphasia
• depression/mental health struggles
• unconsciousness
• inability to afford food
• poor food choices available

Question 11

What are some things that might cause malnutrition via malabsorption ?

Answer 11

• damaged pathology of stomach, pancreas, intestines, liver

Question 12

What are some things that might cause malnutrition via excessive loss ?

Answer 12

• vomiting
• diarrhoea
• surgical drains
• fistulas
• stomas
• NG tube drainage

Question 13

What are some things that might cause malnutrition via altered nutrient processing ?

Answer 13

• increased/altered metabolic demands
• liver dysfunction
• mutations causing lack of transport proteins

Question 14

What are the physiological effects of malnutrition ?

Answer 14

loss of …
- muscle mass and function
- cardio-resp function
- GI function
- immunity/wound healing
- endocrine function
- bone structure
- psychological
- microbiome

Question 15

What symptom is the main indicator of malnutrition ?

Answer 15

weight loss

Question 16

Which stores are the body’s first port of call if it is not getting the correct nutrients?

Answer 16

glucose (glycogen) stores in the liver

Question 17

After glycogen stores, what does the body reach for to provide nutrients if malnourished?

Answer 17

• fat stores
• muscle (skeletal + organs)

Question 18

What is cachexia?

Answer 18

weakness and wasting of the body due to severe chronic illness

Question 19

How are malnutrition and cachexia linked ?

Answer 19

cachexia = disease-related malnutrition associated with chronic inflammation

inflammation:
- increases energy expenditure
- decreases absorption