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van Dronkelaar C, Tieland M, Cederholm T, Reijnierse EM, Weijs PJM, Kruizenga H. Malnutrition Screening Tools Are Not Sensitive Enough to Identify Older Hospital Patients with Malnutrition. Nutrients 2023; 15:5126. [PMID: 38140387 PMCID: PMC10745606 DOI: 10.3390/nu15245126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/06/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
This study evaluates the concurrent validity of five malnutrition screening tools to identify older hospitalized patients against the Global Leadership Initiative on Malnutrition (GLIM) diagnostic criteria as limited evidence is available. The screening tools Short Nutritional Assessment Questionnaire (SNAQ), Malnutrition Universal Screening Tool (MUST), Malnutrition Screening Tool (MST), Mini Nutritional Assessment-Short Form (MNA-SF), and the Patient-Generated Subjective Global Assessment-Short Form (PG-SGA-SF) with cut-offs for both malnutrition (conservative) and moderate malnutrition or risk of malnutrition (liberal) were used. The concurrent validity was determined by the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the level of agreement by Cohen's kappa. In total, 356 patients were included in the analyses (median age 70 y (IQR 63-77); 54% male). The prevalence of malnutrition according to the GLIM criteria without prior screening was 42%. The conservative cut-offs showed a low-to-moderate sensitivity (32-68%) and moderate-to-high specificity (61-98%). The PPV and NPV ranged from 59 to 94% and 67-86%, respectively. The Cohen's kappa showed poor agreement (k = 0.21-0.59). The liberal cut-offs displayed a moderate-to-high sensitivity (66-89%) and a low-to-high specificity (46-95%). The agreement was fair to good (k = 0.33-0.75). The currently used screening tools vary in their capacity to identify hospitalized older patients with malnutrition. The screening process in the GLIM framework requires further consideration.
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Affiliation(s)
- Carliene van Dronkelaar
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (M.T.); (E.M.R.); (P.J.M.W.); (H.K.)
- Department of Nutrition and Dietetics, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health, Aging & Later Life, 1081 HV Amsterdam, The Netherlands
| | - Michael Tieland
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (M.T.); (E.M.R.); (P.J.M.W.); (H.K.)
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences, Uppsala University, 751 22 Uppsala, Sweden;
- Theme Ageing, Karolinska University Hospital, 14186 Stockholm, Sweden
| | - Esmee M. Reijnierse
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (M.T.); (E.M.R.); (P.J.M.W.); (H.K.)
- Amsterdam Movement Sciences, Ageing & Vitality, 1081 HZ Amsterdam, The Netherlands
| | - Peter J. M. Weijs
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (M.T.); (E.M.R.); (P.J.M.W.); (H.K.)
- Department of Nutrition and Dietetics, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health, Aging & Later Life, 1081 HV Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Ageing & Vitality, 1081 HZ Amsterdam, The Netherlands
| | - Hinke Kruizenga
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, 1067 SM Amsterdam, The Netherlands; (M.T.); (E.M.R.); (P.J.M.W.); (H.K.)
- Department of Nutrition and Dietetics, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
- Amsterdam Public Health, Aging & Later Life, 1081 HV Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Ageing & Vitality, 1081 HZ Amsterdam, The Netherlands
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de Leeuwerk M, de Groot V, Dam ST, Kruizenga H, Weijs P, Geleijn E, van der Leeden M, van der Schaaf M. The efficacy of a blended intervention to improve physical activity and protein intake for optimal physical recovery after oncological gastrointestinal and lung cancer surgery, the Optimal Physical Recovery After Hospitalization (OPRAH) trial: study protocol for a randomized controlled multicenter trial. Trials 2023; 24:757. [PMID: 38008734 PMCID: PMC10680183 DOI: 10.1186/s13063-023-07705-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/05/2023] [Indexed: 11/28/2023] Open
Abstract
BACKGROUND Improving physical activity, especially in combination with optimizing protein intake, after surgery has a potential positive effect on recovery of physical functioning in patients after gastrointestinal and lung cancer surgery. The aim of this randomized controlled trial is to evaluate the efficacy of a blended intervention to improve physical activity and protein intake after hospital discharge on recovery of physical functioning in these patients. METHODS In this multicenter single-blinded randomized controlled trial, 161 adult patients scheduled for elective gastrointestinal or lung cancer surgery will be randomly assigned to the intervention or control group. The purpose of the Optimal Physical Recovery After Hospitalization (OPRAH) intervention is to encourage self-management of patients in their functional recovery, by using a smartphone application and corresponding accelerometer in combination with coaching by a physiotherapist and dietician during three months after hospital discharge. Study outcomes will be measured prior to surgery (baseline) and one, four, eight, and twelve weeks and six months after hospital discharge. The primary outcome is recovery in physical functioning six months after surgery, and the most important secondary outcome is physical activity. Other outcomes include lean body mass, muscle mass, protein intake, symptoms, physical performance, self-reported limitations in activities and participation, self-efficacy, hospital readmissions and adverse events. DISCUSSION The results of this study will demonstrate whether a blended intervention to support patients increasing their level of physical activity and protein intake after hospital discharge improves recovery in physical functioning in patients after gastrointestinal and lung cancer surgery. TRIAL REGISTRATION The trial has been registered at the International Clinical Trials Registry Platform at 14-10-2021 with registration number NL9793. Trial registration data are presented in Table 1.
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Affiliation(s)
- Marijke de Leeuwerk
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Rehabilitation Medicine, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
- Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam, The Netherlands.
| | - Vincent de Groot
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Rehabilitation Medicine, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, The Netherlands
| | - Suzanne Ten Dam
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Nutrition and Dietetics, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Hinke Kruizenga
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Nutrition and Dietetics, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Peter Weijs
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Nutrition and Dietetics, De Boelelaan 1117, Amsterdam, The Netherlands
- Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Edwin Geleijn
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Rehabilitation Medicine, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Marike van der Leeden
- Amsterdam UMC, Location Vrije Universiteit Amsterdam, Rehabilitation Medicine, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam, The Netherlands
| | - Marike van der Schaaf
- Amsterdam Movement Sciences, Ageing & Vitality, Amsterdam, The Netherlands
- Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
- Amsterdam UMC, Location University of Amsterdam, Rehabilitation Medicine, Meibergdreef 9, Amsterdam, The Netherlands
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3
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van Dronkelaar C, Fultinga M, Hummel M, Kruizenga H, Weijs PJM, Tieland M. Minerals and Sarcopenia in Older Adults: An Updated Systematic Review. J Am Med Dir Assoc 2023:S1525-8610(23)00481-4. [PMID: 37355247 DOI: 10.1016/j.jamda.2023.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/17/2023] [Accepted: 05/17/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVE This systematic review aims to reevaluate the role of minerals on muscle mass, muscle strength, physical performance, and the prevalence of sarcopenia in community-dwelling and institutionalized older adults. DESIGN Systematic review. SETTING AND PARTICIPANTS In March 2022, a systematic search was performed in PubMed, Scopus, and Web of Sciences using predefined search terms. Original studies on dietary mineral intake or mineral serum blood concentrations on muscle mass, muscle strength, and physical performance or the prevalence of sarcopenia in older adults (average age ≥65 years) were included. METHODS Eligibility screening and data extraction was performed by 2 independent reviewers. Quality assessment was performed with the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies. Risk of bias was evaluated using the Risk Of Bias In Non-randomized Studies-of Exposure (ROBINS-E) tool. RESULTS From the 15,622 identified articles, a total of 45 studies were included in the review, mainly being cross-sectional and observational studies. Moderate quality of evidence showed that selenium (n = 8) and magnesium (n = 7) were significantly associated with muscle mass, strength, and physical performance as well as the prevalence of sarcopenia. For calcium and zinc, no association could be found. For potassium, iron, sodium, and phosphorus, the association with sarcopenic outcomes remains unclear as not enough studies could be included or were nonconclusive (low quality of evidence). CONCLUSIONS AND IMPLICATIONS This systematic review shows a potential role for selenium and magnesium on the prevention and treatment of sarcopenia in older adults. More randomized controlled trials are warranted to determine the impact of minerals on sarcopenia in older adults.
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Affiliation(s)
- Carliene van Dronkelaar
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands; Amsterdam Public Health, Aging and Later Life, Amsterdam, the Netherlands; Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
| | - Maaike Fultinga
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Mitchell Hummel
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Hinke Kruizenga
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands; Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Peter J M Weijs
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands; Amsterdam Public Health, Aging and Later Life, Amsterdam, the Netherlands
| | - Michael Tieland
- Center of Expertise Urban Vitality, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
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4
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van Dijk ML, te Loo LM, Vrijsen J, van den Akker-Scheek I, Westerveld S, Annema M, van Beek A, van den Berg J, Boerboom AL, Bouma A, de Bruijne M, Crasborn J, van Dongen JM, Driessen A, Eijkelenkamp K, Goelema N, Holla J, de Jong J, de Joode A, Kievit A, Klooster JV, Kruizenga H, van der Leeden M, Linders L, Marks-Vieveen J, Mulder DJ, Muller F, van Nassau F, Nauta J, Oostvogels S, Oude Sogtoen J, van der Ploeg HP, Rijnbeek P, Schouten L, Schuling R, Serné EH, Smuling S, Soeters MR, Verhagen EALM, Zwerver J, Dekker R, van Mechelen W, Jelsma JGM. LOFIT (Lifestyle front Office For Integrating lifestyle medicine in the Treatment of patients): a novel care model towards community-based options for lifestyle change-study protocol. Trials 2023; 24:114. [PMID: 36803271 PMCID: PMC9936650 DOI: 10.1186/s13063-022-06960-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 11/25/2022] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND A healthy lifestyle is indispensable for the prevention of noncommunicable diseases. However, lifestyle medicine is hampered by time constraints and competing priorities of treating physicians. A dedicated lifestyle front office (LFO) in secondary/tertiary care may provide an important contribution to optimize patient-centred lifestyle care and connect to lifestyle initiatives from the community. The LOFIT study aims to gain insight into the (cost-)effectiveness of the LFO. METHODS Two parallel pragmatic randomized controlled trials will be conducted for (cardio)vascular disorders (i.e. (at risk of) (cardio)vascular disease, diabetes) and musculoskeletal disorders (i.e. osteoarthritis, hip or knee prosthesis). Patients from three outpatient clinics in the Netherlands will be invited to participate in the study. Inclusion criteria are body mass index (BMI) ≥25 (kg/m2) and/or smoking. Participants will be randomly allocated to either the intervention group or a usual care control group. In total, we aim to include 552 patients, 276 in each trial divided over both treatment arms. Patients allocated to the intervention group will participate in a face-to-face motivational interviewing (MI) coaching session with a so-called lifestyle broker. The patient will be supported and guided towards suitable community-based lifestyle initiatives. A network communication platform will be used to communicate between the lifestyle broker, patient, referred community-based lifestyle initiative and/or other relevant stakeholders (e.g. general practitioner). The primary outcome measure is the adapted Fuster-BEWAT, a composite health risk and lifestyle score consisting of resting systolic and diastolic blood pressure, objectively measured physical activity and sitting time, BMI, fruit and vegetable consumption and smoking behaviour. Secondary outcomes include cardiometabolic markers, anthropometrics, health behaviours, psychological factors, patient-reported outcome measures (PROMs), cost-effectiveness measures and a mixed-method process evaluation. Data collection will be conducted at baseline, 3, 6, 9 and 12 months follow-up. DISCUSSION This study will gain insight into the (cost-)effectiveness of a novel care model in which patients under treatment in secondary or tertiary care are referred to community-based lifestyle initiatives to change their lifestyle. TRIAL REGISTRATION ISRCTN ISRCTN13046877 . Registered 21 April 2022.
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Affiliation(s)
- Marlinde L. van Dijk
- grid.16872.3a0000 0004 0435 165XAmsterdam UMC, VU University Medical Center, Department of Public and Occupational Health, Amsterdam Public Health research institute, Van der Boechorststraat 7, 1081BT Amsterdam, The Netherlands ,grid.12380.380000 0004 1754 9227Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XHealth Behaviors & Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XQuality of Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Leonie M. te Loo
- grid.12380.380000 0004 1754 9227Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XHealth Behaviors & Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,grid.448984.d0000 0003 9872 5642Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Haarlem, The Netherlands
| | - Joyce Vrijsen
- grid.4494.d0000 0000 9558 4598Department of Orthopedics, Groningen, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Inge van den Akker-Scheek
- grid.4494.d0000 0000 9558 4598Department of Orthopedics, Groningen, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sanne Westerveld
- grid.4494.d0000 0000 9558 4598Department of Orthopedics, Groningen, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marjan Annema
- Department of Orthopedics, Ommelander Hospital Groningen, Scheemda, Groningen, The Netherlands
| | - André van Beek
- grid.4494.d0000 0000 9558 4598Department of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jip van den Berg
- grid.4494.d0000 0000 9558 4598Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Alexander L. Boerboom
- grid.4494.d0000 0000 9558 4598Department of Orthopedics, Groningen, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Adrie Bouma
- grid.4494.d0000 0000 9558 4598Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Martine de Bruijne
- grid.12380.380000 0004 1754 9227Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XQuality of Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Jeroen Crasborn
- grid.491477.80000 0004 4907 7789Health Insurance Expertise (formerly Zilveren Kruis), Utrecht, The Netherlands
| | - Johanna M. van Dongen
- grid.12380.380000 0004 1754 9227Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Anouk Driessen
- grid.12380.380000 0004 1754 9227Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XHealth Behaviors & Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Karin Eijkelenkamp
- grid.4494.d0000 0000 9558 4598Department of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nies Goelema
- Department of Orthopedics, Ommelander Hospital Groningen, Scheemda, Groningen, The Netherlands
| | - Jasmijn Holla
- grid.448984.d0000 0003 9872 5642Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Haarlem, The Netherlands ,grid.418029.60000 0004 0624 3484Amsterdam Rehabilitation Research Centre, Reade, Amsterdam, The Netherlands
| | - Johan de Jong
- grid.411989.c0000 0000 8505 0496Institute of Sports Studies, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Anoek de Joode
- grid.4494.d0000 0000 9558 4598Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Arthur Kievit
- grid.7177.60000000084992262Department of Orthopedics, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Josine van’t Klooster
- grid.4494.d0000 0000 9558 4598Department of Strategy, Development and External Relations, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Hinke Kruizenga
- grid.509540.d0000 0004 6880 3010Department of Nutrition & Dietetics, Amsterdam UMC location Vrije Universiteit, De Boelelaan, 1117 Amsterdam, The Netherlands
| | - Marike van der Leeden
- grid.16872.3a0000 0004 0435 165XDepartment of Rehabilitation Medicine, Amsterdam Movement Sciences Research Institute, Amsterdam Public Health Research Institute, Amsterdam UMC location Vrije Universiteit, Amsterdam, The Netherlands
| | - Lilian Linders
- grid.448984.d0000 0003 9872 5642Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Haarlem, The Netherlands
| | - Jenny Marks-Vieveen
- grid.12380.380000 0004 1754 9227Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XHealth Behaviors & Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,grid.509540.d0000 0004 6880 3010Department of Anesthesiology, Amsterdam UMC location Vrije Universiteit, De Boelelaan, 1117 Amsterdam, The Netherlands
| | - Douwe Johannes Mulder
- grid.4494.d0000 0000 9558 4598Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Femmy Muller
- grid.491477.80000 0004 4907 7789Zilveren Kruis, Leiden, The Netherlands
| | - Femke van Nassau
- grid.12380.380000 0004 1754 9227Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XHealth Behaviors & Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Joske Nauta
- grid.12380.380000 0004 1754 9227Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XHealth Behaviors & Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | | | | | - Hidde P. van der Ploeg
- grid.12380.380000 0004 1754 9227Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XHealth Behaviors & Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | | | - Linda Schouten
- Team Sportservice Noord-Holland, Haarlem, The Netherlands
| | - Rhoda Schuling
- grid.411989.c0000 0000 8505 0496Institute of Sports Studies, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Erik H. Serné
- grid.509540.d0000 0004 6880 3010Department of Internal Medicine, Amsterdam UMC location Vrije Universiteit, De Boelelaan, 1117 Amsterdam, The Netherlands
| | - Simone Smuling
- Huis voor de Sport in Groningen, Groningen, The Netherlands
| | - Maarten R. Soeters
- grid.7177.60000000084992262Department of Internal Medicine, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Evert A. L. M. Verhagen
- grid.12380.380000 0004 1754 9227Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XHealth Behaviors & Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Johannes Zwerver
- grid.4494.d0000 0000 9558 4598Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands ,grid.415351.70000 0004 0398 026XSports Valley, Sports Medicine, Gelderse Vallei Hospital, Ede, The Netherlands
| | - Rienk Dekker
- grid.4494.d0000 0000 9558 4598Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Willem van Mechelen
- grid.12380.380000 0004 1754 9227Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XHealth Behaviors & Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Judith G. M. Jelsma
- grid.12380.380000 0004 1754 9227Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XHealth Behaviors & Chronic Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,grid.16872.3a0000 0004 0435 165XQuality of Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Wierdsma N, Kruizenga H, Konings L, Krebbers D, Jorissen J, Joosten MH, van Aken L, Tan F, van Bodegraven A, Soeters M, Weijs P. Nutrition related complaints, poor nutritional status and risk of sarcopenia are prevalent in Covid-19 patients during hospital admission. Clin Nutr ESPEN 2021. [PMCID: PMC8629520 DOI: 10.1016/j.clnesp.2021.09.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Dam M, Hartman EA, Kruizenga H, van Jaarsveld BC, Weijs PJM. Are we overfeeding hemodialysis patients with protein? Exploring an alternative method to estimate protein needs. Clin Nutr ESPEN 2021; 44:230-235. [PMID: 34330471 DOI: 10.1016/j.clnesp.2021.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 06/16/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND & AIMS Sufficient protein intake is of great importance in hemodialysis (HD) patients, especially for maintaining muscle mass. Daily protein needs are generally estimated using bodyweight (BW), in which individual differences in body composition are not accounted for. As body protein mass is best represented by fat free mass (FFM), there is a rationale to apply FFM instead of BW. The agreement between both estimations is unclear. Therefore, the aim of this study is to compare protein needs based on either FFM or BW in HD patients. METHODS Protein needs were estimated in 115 HD patients by three different equations; FFM, BW and BW adjusted for low or high BMI. FFM was measured by multi-frequency bioelectrical impedance spectroscopy and considered the reference method. Estimations of FFM x 1.5 g/kg and FFM x 1.9 g/kg were compared with (adjusted)BW x 1.2 and x 1.5, respectively. Differences were assessed with repeated measures ANOVA and Bland-Altman plots. RESULTS Mean protein needs estimated by (adjusted)BW were higher compared to those based on FFM, across all BMI categories (P < 0.01) and most explicitly in obese patients. In females with BMI >30, protein needs were 69 ± 17.4 g/day higher based on BW and 45 ± 9.3 g/day higher based on BMI adjusted BW, compared to FFM. In males with BMI >30, protein needs were 51 ± 20.4 g/day and 23 ± 20.9 g/day higher compared to FFM, respectively. CONCLUSIONS Our data show large differences and possible overestimations of protein needs when comparing BW to FFM. We emphasize the importance of more research and discussion on this topic.
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Affiliation(s)
- Manouk Dam
- Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands.
| | - Eva Anne Hartman
- Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands.
| | - Hinke Kruizenga
- Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Location VUmc, Boelelaan 1117, 1081, HV, Amsterdam, the Netherlands.
| | - Brigit C van Jaarsveld
- Department of Nephrology, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands.
| | - Peter J M Weijs
- Department of Nutrition and Dietetics, Amsterdam University Medical Centers, Location VUmc, Boelelaan 1117, 1081, HV, Amsterdam, the Netherlands; Amsterdam University of Applied Sciences, Faculty of Sports and Nutrition, Department of Nutrition and Dietetics, Dr. Meurerlaan 8, 1067, SM, Amsterdam, the Netherlands.
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7
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Soeters MR, Kruizenga H. [Personalised nutrition care or standard care?]. Ned Tijdschr Geneeskd 2019; 163:D4266. [PMID: 31556503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Optimal nutrition is an important condition for optimal recovery from illness, both in and outside the hospital setting. In addition, in developed countries hospital-related malnutrition remains a major problem which can lead to complications, longer hospital stays and increased costs. The EFFORT study investigated if individualised nutritional support targeted at reaching protein and caloric goals, would reduce the risk of adverse outcomes. Achieving optimal nutrition is difficult due to illness-induced anorexia, inadequate education of medical doctors and little financial incentive. Guidelines focus on protein and energy, negating those illness-induced anorexia and individual patient aspects such as taste, portion size and eating habits. Although the EFFORT study showed benefit on the composite and individual endpoints, we should point out that the intervention group received standard care. Malnutrition needs multidisciplinary and transmural care including physiotherapy/exercise. As such, a more holistic approach is needed; optimal care as described by the EFFORT study should be the standard.
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Affiliation(s)
- Maarten R Soeters
- Amsterdam UMC, afd. Endocrinologie en Metabolisme, Amsterdam
- Contact: M.R. Soeters
| | - Hinke Kruizenga
- Amsterdam UMC, afd. Diëtetiek en Voedingswetenschappen, Amsterdam
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Leistra E, Kruizenga H. SUN-P182: Impact of Drinking 1L water on Bia Measurement in Healthy Students. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30446-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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9
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Kruizenga H, van Keeken S, Weijs P, Bastiaanse L, Beijer S, Huisman-de Waal G, Jager-Wittenaar H, Jonkers-Schuitema C, Klos M, Remijnse-Meester W, Witteman B, Thijs A. Undernutrition screening survey in 564,063 patients: patients with a positive undernutrition screening score stay in hospital 1.4 d longer. Am J Clin Nutr 2016; 103:1026-32. [PMID: 26961930 DOI: 10.3945/ajcn.115.126615] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Undernutrition is a common complication of disease and a major determinant of hospital stay outcome. Dutch hospitals are required to screen for undernutrition on the first day of admission. OBJECTIVE We sought to determine the prevalence of the screening score "undernourished" with the use of the Short Nutritional Assessment Questionnaire (SNAQ) or Malnutrition Universal Screening Tool (MUST) and its relation to length of hospital stay (LOS) in the general hospital population and per medical specialty. DESIGN We conducted an observational cross-sectional study at 2 university, 3 teaching, and 8 general hospitals. All adult inpatients aged ≥18 y with an LOS of at least 1 d were included. Between 2007 and 2014, the SNAQ/MUST score, admitting medical specialty, LOS, age, and sex of each patient were extracted from the digital hospital chart system. Linear regression analysis with ln(LOS) as an outcome measure and SNAQ ≥3 points/MUST ≥2 points, sex, and age as determinant variables was used to test the relation between SNAQ/MUST score and LOS. RESULTS In total, 564,063 patients were included (48% males and 52% females aged 62 ± 18 y). Of those, 74% (419,086) were screened with SNAQ and 26% (144,977) with MUST, and 13.7% (SNAQ) and 14.9% (MUST) of the patients were defined as being undernourished. Medical specialties with the highest percentage of the screening score of undernourished were geriatrics (38%), oncology (33%), gastroenterology (27%), and internal medicine (27%). Patients who had an undernourished screening score had a higher LOS than did patients who did not (median 6.8 compared with 4.0 d; P < 0.001). Regression analysis showed that a positive SNAQ/MUST score was significantly associated with LOS [SNAQ: +1.43 d (95% CI: 1.42, 1.44 d), P < 0.001; MUST: +1.47 d (95% CI: 1.45, 1.49 d), P < 0.001]. CONCLUSIONS This study provides benchmark data on the prevalence of undernutrition, including more than half a million patients. One out of 7 patients was scored as undernourished. For geriatrics, oncology, gastroenterology, and internal medicine, this ratio was even greater (1 out of 3–4). Hospital stay was 1.4 d longer among undernourished patients than among those who were well nourished.
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Weijs P, Kruizenga H. PP292-SUN: Improved Tool for Protein Needs Calculation in Clinical Practice: The Amsterdam Equation. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50333-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hertroijs D, Wijnen C, Leistra E, Visser M, Heijden E, Kruizenga H. Rehabilitation patients: Undernourished and obese? J Rehabil Med 2012; 44:696-701. [DOI: 10.2340/16501977-0993] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Neelemaat F, Meijers J, Kruizenga H, van Ballegooijen H, van Bokhorst-de van der Schueren M. Comparison of five malnutrition screening tools in one hospital inpatient sample. J Clin Nurs 2011; 20:2144-52. [DOI: 10.1111/j.1365-2702.2010.03667.x] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Molling JW, Kölgen W, van der Vliet HJJ, Boomsma MF, Kruizenga H, Smorenburg CH, Molenkamp BG, Langendijk JA, Leemans CR, von Blomberg BME, Scheper RJ, van den Eertwegh AJM. Peripheral blood IFN-gamma-secreting Valpha24+Vbeta11+ NKT cell numbers are decreased in cancer patients independent of tumor type or tumor load. Int J Cancer 2005; 116:87-93. [PMID: 15756674 DOI: 10.1002/ijc.20998] [Citation(s) in RCA: 165] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Natural killer T (NKT) cells are CD1d-restricted lymphoid cells and are characterized by an invariant T-cell receptor, which in humans consists of a Valpha24 chain paired with a Vbeta11 chain. These cells are known for their rapid production of large amounts of cytokines (e.g., IFN-gamma and IL-4), thereby modulating other cells of the immune system such as T cells, NK cells and dendritic cells. NKT cells have been reported to play important regulatory roles in many immune responses, including antitumor immune responses. Here, we demonstrate an age-dependent decrease in circulating Valpha24(+)Vbeta11(+) NKT cell numbers in both healthy controls and cancer patients and demonstrate that in both groups females have higher NKT cell levels compared to males. In a large group of 120 cancer patients, we show that circulating Valpha24(+)Vbeta11(+) NKT cell numbers are about 50% lower than in age- and gender-matched healthy controls and that this decrease is independent of tumor type or tumor load. This decrease was not restored upon tumor removal by means of surgery or radiotherapy. Even though the percentage of NKT cells that secrete IFN-gamma, as detected by ELISPOT, is normal in cancer patients, the absolute number of circulating IFN-gamma-secreting NKT cells is reduced. Together, our results suggest that the reduced circulating Valpha24(+)Vbeta11(+) NKT cell numbers in cancer patients are not affected by tumor load, but might actually reflect a risk factor for tumor development, e.g., by hampering efficient tumor immunosurveillance.
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Affiliation(s)
- Johan W Molling
- Department of Pathology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands
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