Treatment – Social/Environmental-Related Malnutrition
Jennifer Doley, Mary J. Marian in Adult Malnutrition, 2023
Avoidant/Restrictive Food Intake Disorder is more than “picky eating”; it is characterized by highly selected eating habits and disturbed feeding patterns driven by a psychiatric disorder.69 Common patterns include reported difficulty digesting food; avoidance of certain food textures, colors, or smells; eating abnormally slowly; and having a general lack of appetite. Avoidant/Restrictive Food Intake Disorder often results in persistent failure to meet nutritional needs, leading to nutrient deficiencies and malnutrition. Up to 14% of people diagnosed with another FED will also be diagnosed with ARFID.70 Children with ARFID may be more likely to develop chronic malnutrition, and are at higher risk of other mental disorders such as mood disorder, anxiety disorder, and an autism spectrum condition.70,71
Bariatric Surgery
Emmanuel C. Opara, Sam Dagogo-Jack in Nutrition and Diabetes, 2019
The DS is the most complex of the four bariatric procedures described here. In the best reports, the procedure can be performed with a mortality of 1 in 500 [36]. In the reports from Drs. Hess and Marceau, early complications occurred in approximately 8%–10% of patients [35,36]. The most common serious complications included GI leak, intra-abdominal abscess, sepsis, pancreatitis, and entero-cutaneous fistula. Readmission rates vary between 6% and 8%, and re-operation rates from 4% to 13%. Fortunately, with experience and laparoscopy, these rates continue to improve to even lower levels. The most common complications for the DS are related to the malabsorption of this procedure. These complications include anemia, vitamin or mineral deficiencies, osteoporosis, and protein-calorie malnutrition. With appropriate follow-up and supplementation, these issues occur less than 2% of the time [36]. Unfortunately, with poor follow-up and supplementation, these problems can be significant and require a re-operation [35]. That aside, the DS is still very safe and one of the most effective weight loss surgeries.
Etiology of Geophagia
Anil Gupta in Geophagia, 2019
Dietary adequacy is the intake of macronutrients and micronutrients in compliance with the recommended daily allowance (Dhonukshe-Rutten et al. 2013). A balanced diet is essential to fulfill the physiological and metabolic demands of the body for optimal growth and development as in Figure 4.1 (Gupta 2015). It is noteworthy that the quantity of a particular nutrient is variable. A nutrient in a higher quantity could be injurious to body tissues (Robert 2013); for example, sodium is an important mineral of extracellular fluid and its intake exceeding the recommended daily allowance could predispose a person to hypertension. Gupta (2015) suggested that adequacy of diet is necessary to prevent deficiency disorders, systemic disorders, and malnutrition among children and adults. It is difficult to predict the exact adequacy of a diet for every individual (NRC 1986). Moreover, inadequate quantity in the diet is unable to furnish the requisite calories and minerals to the human body. Therefore, inadequacy of diet is responsible for deficiency of calories and micronutrients.
Rapid refeeding does not worsen anxiety in adolescents with anorexia nervosa: a pilot study
Published in Eating Disorders, 2022
Sinem Akgül, Andrea E Bonny, Brittny E. Manos, Kenneth Jackson, Cynthia Holland-Hall
Similar to the current study, Kelzman et al. examined anxiety in adolescent patients hospitalized and treated with a rapid-refeeding protocol. In this study anxiety decreased and stabilized during the course of treatment. The mean duration of admission was longer in this study (26.9 days) as compared to the current investigation, and all patients received both group and individual psychotherapy during their admission while our patients did not (Kezelman et al., 2016) . Our findings may be particularly relevant to medical settings in which inpatient treatment is focused almost entirely on nutritional rehabilitation, with only minimal psychological support available. As patients often are admitted shortly after their initial diagnosis of malnutrition due to an eating disorder, they may lack the skills needed to tolerate the distress caused by food and eating.
Nutritional Therapy for Patients with Esophageal Cancer
Published in Nutrition and Cancer, 2018
Taja Jordan, Denis Mlakar Mastnak, Nizra Palamar, Nada Rotovnik Kozjek
In patients with esophageal cancer, nutrition disorders are frequent. Most such patients suffer from malnutrition, which is defined as “a state resulting from lack of intake or uptake of nutrition that leads to altered body composition (decreased fat free mass) and body cell mass leading to diminished physical and mental function and impaired clinical outcome from disease” (1) and up to 79% of them are nutritionally compromised (2). According to available data, this is nutritionally the most compromised group of cancer patients—the loss of body weight (BW) >10% is present in more than 70% of patients at diagnosis (3). The loss of BW is, in most cases, quite rapid and starts in the first few months. The underlying cause is a rapidly developing dysphagia which is the primary symptom of esophageal cancer. Initially, patients experience difficulty swallowing solid food, followed by difficulty swallowing soft food, and ultimately also liquids and saliva (3). Following the onset of the cachectic state, dysphagia is often accompanied by anorexia (2). Cachexia is defined as “a complex metabolic syndrome associated with underlying illness and characterized by loss of muscle mass with or without loss of fat.” The prominent feature of cachexia is weight loss in adults (4, 5). Because the loss of BW is an alarming prognostic indicator in cancer treatment, early nutritional intervention is a priority in patients with esophageal cancer (6).
The Relationship of Food Insecurity to Nutritional Risk in Independent Living Older Adults
Published in Journal of Nutrition in Gerontology and Geriatrics, 2023
S. M. Carlson, M. E. Giovanni, M. Neyman Morris
The number of Americans reaching 65 years of age is rapidly increasing; by 2030, this age group will make up 20% of the U.S. population.1 Nutrient requirements change with age, and prioritizing preventative health measures is critical to decreasing the risk of chronic diseases, as four of the eight leading causes of death have a known nutritional source: stroke, heart disease, cancer, diabetes.2 Although older adults should meet these changing needs by consuming nutrient-dense foods, the prevalence of malnutrition among people 65 years of age and older is estimated to be almost 50 percent, due to an inadequate intake of both macro- and micronutrients.3 Many older adults live on a limited income, which often decreases the amount and nutritional quality of food consumed, resulting in a poor diet.4–6 Up to 10% of older Americans experience food insecurity, defined as limited or intermittent access to safe, nutritionally adequate, and acceptable foods accessed with appropriate methods.7 In addition, food intake may be limited by the loss of appetite, chronic diseases, polypharmacy, poor dentition, overly restrictive diets, depression, social isolation, and reduced functional status, which are also risk factors for malnutrition.8–10
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