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D044342: Malnutrition

Developed by Shray Alag, The Harker School
Sections: Correlations, Clinical Trials, and HPO

Correlations computed by analyzing all clinical trials.

Navigate: Clinical Trials and HPO

Correlated Drug Terms (6)

Name (Synonyms) Correlation
drug1032 Control (standard clinical practice) Wiki 0.50
drug4507 hospitalized children with Covid19 Wiki 0.50
drug1217 Dietary advice Wiki 0.50
Name (Synonyms) Correlation
drug1218 Dietary advice and advice on timing Wiki 0.50
drug504 Back Side of the Moon Wiki 0.50
drug2717 Optimal-Massive Intervention Wiki 0.50

Correlated MeSH Terms (6)

Name (Synonyms) Correlation
D009059 Mouth Diseases NIH 0.58
D003681 Dehydration NIH 0.50
D011502 Protein-Energy Malnutrition NIH 0.50
Name (Synonyms) Correlation
D003680 Deglutition Disorders NIH 0.20
D012141 Respiratory Tract Infections NIH 0.08
D014777 Virus Diseases NIH 0.05

Correlated HPO Terms (4)

Name (Synonyms) Correlation
HP:0004395 Malnutrition HPO 1.00
HP:0001944 Dehydration HPO 0.50
HP:0002015 Dysphagia HPO 0.20
Name (Synonyms) Correlation
HP:0011947 Respiratory tract infection HPO 0.08

Clinical Trials

Navigate: Correlations   HPO

There are 4 clinical trials

1 The (Cost) Effectiveness of Increasing Daily Protein Intake to 1.2 Gram Per Kilo Body Weight on Physical Functioning in Community-dwelling Older Adults With a Habitual Daily Protein Intake < 1.0 Gram Per Kilo Body Weight

In this RCT with the duration of 6 months among 264 community-dwelling older adults (65+ years) with habitual low protein intake, the investigators will examine the long term (cost) effectiveness of increasing daily protein intake to at least 1.2 gram/kg of adjusted body weight on physical functioning in older adults with low protein intake.

  1. Protein-Energy Malnutrition
  2. Physical Disability
  1. Other: Dietary advice
  2. Other: Dietary advice and advice on timing
MeSH:Malnutrition Protein-Energy Malnutrition

Primary Outcomes

Description: Change in walk time on a 400 meter walk test

Measure: 6-month change in walk time on a 400 meter walk test

Time: 6 months

Secondary Outcomes

Description: SPPB consists of three tests: repeated chair stands test, 4 meter walk test, and tandem stand test. The total score ranges from 0-12. A higher score indicates better physical functioning.

Measure: 6-months change in Physical performance assessed by the Short Physical Performance Battery (SPPB)

Time: 6 months

Description: Hand grip strength measured by a hand held dynamometer

Measure: 6-month change in hand grip strength

Time: 6 months

Description: Upper leg strength measured by a measurement chair

Measure: 6-month change in leg strength

Time: 6 months

Description: Body composition (fat-free mass, skeletal muscle mass and fat mass) will be assessed from bioelectrical impedance using body resistance, reactance, impedance and phase angle. In the Dutch sample only, fat-free mass and fat mass will be directly measured by using densitometry (BODPOD).

Measure: 6-month change in body composition

Time: 6 months

Description: Mobility limitations will be assessed by means of a questionnaire; "Because of your health, how much difficulty do you have walking 400 meter?" and "Because of your health, how much difficulty do you have climbing one flight of stairs?" Participants responded using a five level Likert scale: 'No difficulty', 'a little difficulty', 'some difficulty', 'a lot of difficulty', and 'unable to do the activity'.

Measure: 3, and 6-moths self-reported mobility limitations (questionnaire)

Time: 3 and 6 months

Description: Quality of life measured using the EuroQol-5D instrument. The EuroQol 5D consists of five questions on a Likert scale (mobility, self-care, usual activities, pain/discomfort and anxiety/depression). Answer categories range from (1) 'no problems' to (5) 'unable to'. An additional thermometer for experienced health is scored on a Visual Analogue scale (VAS), ranging from 0-100. The exact point where the line crosses the VAS is the VAS score. The scores are converted to an index value, which facilitates the calculation of quality-adjusted life years (QALYs) that is used to calculate the cost-effectiveness of the study.

Measure: 3, and 6-moths self perceived quality of life

Time: 3 and 6 months

Description: Frailty will be determined using the 5 criteria of the Fried Frailty Index: Self-reported unintentional weight loss: >4 kg in past 6 months. Self-reported exhaustion. Based on two self-reported questions from the Center for Epidemiologic Studies Depression scale on exhaustion in the past week at baseline and follow-up: "I felt that everything I did was an effort" and "I could not get going". Scores ranges from 1 'not at all' to 4 'most of the time'. A score of 3 or 4 on either question indicates exhaustion. Weakness: grip strength in the lowest 20% of the study population, adjusted for gender and BMI. Slow walking speed: walk time on the 400 meter walk test in the slowest 20% of the study population, adjusted for gender and height. Low physical activity: Kilocalories expended/wk based on accelerometer data in the lowest quintile of physical activity for each gender. Outcome: No components:robust 1 or 2 components:intermediate/prefrail 3 or more components:frail

Measure: Incident frailty assessed by the Fried Frailty Index

Time: 6 months

Description: Incidence of sarcopenia risk will be assessed with the SARC-F questionnaire; how much effort do you experience when 1) lifting and carrying a bag of 4.5 kilo, 2) walking across a room, 3) transferring from a chair or bed, 4) climbing a flight of 10 stairs, and 5) how many times have you fallen in the past year. Answering option include no effort (0 points), a bit of effort (1 point) and a lot of effort (2 points), where a score equal to or greater than 4 is predictive of sarcopenia and poor outcomes.

Measure: Incidence of sarcopenia risk

Time: 3 and 6 months

Description: BMI<22 kg/m2 and unintentional weight loss >5% over 6 months

Measure: Incident malnutrition

Time: 6 months

Description: To measure health care costs the investigators will use a modified version of the Resource Utilization in Dementia Questionnaire WIMO. This questionnaire contains questions on hospital admissions, prescribed medicine use, care from health professionals, and use of other health care services in the past three months. These are the domains that the investigators might expect changes in due to the intervention.

Measure: 3, and 6-moths health care costs assessed by questionnaire

Time: 3 and 6 months

Description: Body weight (kg) will be measured to the nearest 0,1 kg using a calibrated scale.

Measure: 3, and 6-month change in body weight

Time: 3 and 6 months

Description: Body height (cm) will be measured to the nearest 0.1 cm using a stadiometer.

Measure: Body height

Time: baseline

Description: Based on measured weight (measured at baseline and after 6 months) and height (measured at baseline) BMI will be calculated as body weight (kg) divided by height (m) squared.

Measure: 3, and 6-month change in body mass index (BMI)

Time: 3 and 6 months

Description: A 24-hour recall is a structured interview intended to capture detailed information about all foods and beverages consumed by the participant in the past 24 hours. Changes in dietary intake (based on data of the 24-hour recalls) enables to investigate compliance; i.e. higher protein intake indicates higher compliance.

Measure: Dietary intake assesed by three 24-hour recalls

Time: 3 and 6 months

Description: Physical activity will be objectively assessed by means of an accelerometer (Axivity, AX3) during 7 subsequent days after each clinic visit.

Measure: Physical activity

Time: 3 and 6 months

Other Outcomes

Description: Examine the effect of persuasive technology on adherence to increasing protein intake. A subsample of the Dutch participants will receive a food storage box that can measure which protein rich food products are taken out and a small-size screen (tablet) that provides reminders and nudges. The investigators will test if there are differences in adherence to the interventions between participants who took part in this sub-study and participants who did not.

Measure: Effectiveness of persuasive technology sub-study on protein intake

Time: 6 months

Description: The effect of increasing protein intake to at least 1.2 g/kg body weight/d on faecal and oral microbiota composition

Measure: Microbiota sub-study

Time: 6 months

Description: To examine the effects of increasing protein intake on food-stimuli related central nervous system satiety and reward responses involved in the regulation of food intake, measured by functional magnetic resonance imaging. BOLD fMRI will be used to measure neuronal activity in CNS satiety and reward circuits (including striatum, amygdala, orbitofrontal cortex, insula) in response to visual food stimuli (pictures of food items) and to the actual consumption of food (chocolate milk).

Measure: Effect of protein intake on satiety and reward responses measured by functional magnetic resonance imaging

Time: 6 months
2 Back Side of the Moon Study: What is the Efficiency of Nutritional Therapy (Calories and Nitrogen) in ICU and on the Ward and What is the Metabolic Profile of Patients After ICU? Could Supplemental Nutrition Fill the Gap?

Prospective observational follow-up of Intensive Care Unit (ICU) survivors on the adequacy of nutritional therapy: what is the mean caloric and nitrogen intake and how does their metabolic profile evolve over time? Is supplemental nutrition, in any forms, indicated to fill the caloric and protein gap? Would IV access be a barrier for SPN, and would subcutaneous parenteral nutrition be welcomed by health care practitioners and patients? Are patient centered outcomes (physical function, quality of life, performance in activities of daily living) correlated with nutritional adequacy and metabolic profile? Overall: are ICU survivors well fed after they leave ICU until hospital discharge? What kind of nutrition would possibly be useful to optimize the intake? How do their energy and protein requirements evolve? What is the physical and mental status of ICU survivors and is this correlated with nutritional status?

  1. Nutritional Deficiency
  2. Hospitalism
  1. Dietary Supplement: Back Side of the Moon

Primary Outcomes

Description: Morbidity

Measure: Morbidity

Time: 6 months after hospital discharge

Secondary Outcomes

Description: Mortality

Measure: Mortality

Time: 6 months after hospital discharge
3 Covid-19 and Prevention of Malnutrition After Confinement by Dentists: Prospective Study Among 100 Adults Received in Dental Consultation at Nice University Hospital and Sent to Their Physician for Assessment and Nutritional Care

Background. The Covid-19 pandemic reached France in January 2020 and the French government decreed the confinement of the population for eight weeks, from March 17 to May 10, 2020. Dental surgeries were closed and only dental emergency services were provided. Dental surgeries reopened on May 11th, with a limited focus on urgent care, by applying new occupational hygiene standards to limit the circulation of SARS-Cov-2 coronavirus. Hypothesis. From May 11th, chronic patients and elderly patients who come to the hospital for dental consultations will have two risks of malnutrition:

  1. Nutrition Poor
  2. Infection Viral
  3. Oral Disease
MeSH:Virus Diseases Mouth Diseases Malnutrition

Primary Outcomes

Description: Body Mass Index evolution from baseline

Measure: Body Mass Index

Time: 1 Month

Description: Body Mass Index evolution from baseline

Measure: Body Mass Index

Time: 3 Months

Secondary Outcomes

Description: Usual weight at baseline vs weight before confinement (gk)

Measure: Weight changes during confinement

Time: 8 weeks

Description: number and type of nutritional supplements from baseline

Measure: prescription of nutritional supplements and observance

Time: 3 months
4 Evaluation of the Effectiveness of an Optimal-Massive Intervention in Older Patients With Oropharyngeal Dysphagia

The aim of this study is to evaluate the efficacy of an optimal-massive intervention (OMI) based on increasing shear viscosity of fluids, nutritional support with oral nutritional supplements (ONS) and triple adaptation of food (rheological and textural, caloric and protein and organoleptic) and oral hygiene improvement on the incidence of respiratory infections in older patients with OD. We have designed a randomized clinical trial, with two parallel arms and 6 months follow-up. The study population will be constituted by older patients of 70 years or more with OD hospitalized at Hospital de Mataró by an acute process that will be identified by using the volume-viscosity swallow clinical test. We will consecutively recruit 500 subjects during admission (Geriatrics, Internal medicine, etc.) at the Hospital de Mataró. Patients included will be randomly assigned to one of both interventional groups: a) study intervention: multifactorial intervention based on fluid viscosity adaptation (with a xanthan gum thickener -> Nutilis Clear®), nutritional support with a triple adaptation of food (texture, caloric and protein content, organoleptic) + pre-thickened ONS and evaluation and treatment of oral hygiene (tooth brushing + antiseptic mouthwashes + professional dental cleaning), or b) control intervention: standard clinical practice (fluid adaptation with Nutilis Powder and simple texture adaptation for solids). Main outcome measures: respiratory infection incidence during the 6-month period follow-up. Secondary outcomes: mortality at 6 months, general hospital readmissions and readmissions due to respiratory infections, nutritional status, hydration status, quality of life, functional status, oral hygiene and dysphagia severity and its relationship with other study variables.

  1. Swallowing Disorder
  2. Oropharyngeal Dysphagia
  3. Respiratory Infection
  4. Malnutrition
  5. Dehydration
  6. Oral Disease
  1. Other: Optimal-Massive Intervention
  2. Other: Control (standard clinical practice)
MeSH:Respiratory Tract Infections Deglutition Disorders Mouth Diseases Malnutrition Dehydration
HPO:Dehydration Dysphagia Malnutrition Oral-pharyngeal dysphagia Respiratory tract infection

Primary Outcomes

Description: Respiratory infections incidence (includes LRTI, pneumonia and exacerbations of COPD): all new episodes of respiratory infections recorded in the clinical history or in the reports presented by the patient will be recorded. LRTI: presence of at least 2 of the following symptoms without other cause to explain them: fever, cough, purulent expectoration, rhonchi or wheezing. Pneumonia: performing 1 or more radiographic tests with new condensation, fever or leukopenia or leukocytosis and at least: cough, purulent expectoration, dyspnea, tachypnea, suggestive auscultation or worsening of gas exchange. COPD exacerbation: acute exacerbation of COPD is a sudden worsening of COPD symptoms (shortness of breath, quantity and color of phlegm) that typically lasts for several days. It may be triggered by an infection with bacteria or viruses or by environmental pollutants.

Measure: Respiratory infections incidence.

Time: From discharge to 6 months follow-up

Secondary Outcomes

Description: Mortality: the date and reason for death will be recorded (hospitalization, 1, 3 and 6 months).

Measure: Mortality

Time: Through study completion, during hospitalization, and at 1, 3 and 6 months from disharge.

Description: General readmissions and readmissions for respiratory infections (1, 3 and 6 months): LRTI, pneumonia and exacerbations of COPD: the reason for admission will be that stated in the hospital database (CMBDAH) according to CIM-10. The information source of the readmissions will be the registration of hospital discharges that is integrated into the hospital information system and that includes the CIM-10 codes of the main and secondary diagnoses of the episode that caused the admission, the date of admission and discharge and the days of hospitalization. Readmissions from pneumonia (codes CIM-10): J13, J18.1, J15.1, J14, J15.4, J15.211, J15.5, A48.1, J15.8, J18.0, J18.8, J69.0; readmissions for LRTI (no pneumonic): J20.0 - J20.9, J10.1, J11.1, J41.8, J44.1 and J44.0. Readmissions from exacerbation of COPD: J441.

Measure: General readmissions and readmissions for respiratory infections

Time: Through study completion, at 1, 3 and 6 months from disharge.

Description: Mini-nutritional assessment form (MNA) (hospitalization, 1, 3 and 6 months).

Measure: Nutritional status (MNA)

Time: Through study completion, during hospitalization, and at 1, 3 and 6 months from disharge.

Description: Heigh in cm (hospitalization, 1, 3 and 6 months).

Measure: Nutritional status (Anthropometric measures)

Time: Through study completion, during hospitalization, and at 1, 3 and 6 months from disharge.

Description: Weight in kg (hospitalization, 1, 3 and 6 months).

Measure: Nutritional status (Anthropometric measures2)

Time: Through study completion, during hospitalization, and at 1, 3 and 6 months from disharge.

Description: Biochemical parameters from blood analysis (hospitalization, 3 and 6 months).

Measure: Nutritional status (Biochemical parameters)

Time: Through study completion, during hospitalization, and at 1, 3 and 6 months from disharge.

Description: Hydration status: we will register total body water and intracellular water with bioimpedance (hospitalization, 1, 3 and 6 months).

Measure: Hydration status (bioimpedance)

Time: Through study completion, during hospitalization, and at 1, 3 and 6 months from disharge.

Description: Quality of life: EQ-5D questionnaire will be used (hospitalization, 1, 3 and 6 months).

Measure: Quality of life of patients during the study period

Time: Through study completion, during hospitalization, and at 1, 3 and 6 months from disharge.

Description: Functional status: we will use the Barthel Index (hospitalization, 1, 3 and 6 months).

Measure: Functional status

Time: Through study completion, during hospitalization, and at 1, 3 and 6 months from disharge.

Description: Oral Hygiene: the OHI-S (simplified oroal hygiene index) will be collected (hospitalization, 1, 3 and 6 months).

Measure: Oral Hygiene

Time: Through study completion, during hospitalization, and at 1, 3 and 6 months from disharge.

Description: Severity of dysphagia: according to the different viscosities that patients will be able to swallow and with the Functional Oral Intake Scale (V-VST/FOIS) (hospitalization, 1, 3 and 6 months).

Measure: Dysphagia severity

Time: Through study completion, during hospitalization, and at 1, 3 and 6 months from disharge.

Other Outcomes

Description: Sociodemographic characteristics of the study population.

Measure: Sociodemographics

Time: Baseline

Description: Swallowing function (V-VST) (hospitalization, 1, 3 and 6 months).

Measure: Swallowing function (V-VST)

Time: Through study completion, during hospitalization, and at 1, 3 and 6 months from disharge.

Description: Rate of institutionalization (1, 3 and 6 months).

Measure: Institutionalization

Time: Through study completion, at 1, 3 and 6 months from disharge.

Description: Drugs taken by the patient.

Measure: Pharmacological treatment

Time: Baseline

Description: Geriatric syndromes

Measure: Geriatric syndromes

Time: Baseline

Description: Fried criteria (hospitalization, 1, 3 and 6 months).

Measure: Frailty 1

Time: Through study completion, during hospitalization, and at 1, 3 and 6 months from disharge.

Description: Edmonton frail scale (hospitalization, 1, 3 and 6 months).

Measure: Frailty 2

Time: Through study completion, during hospitalization, and at 1, 3 and 6 months from disharge.

Description: Smoking and alcohol consumption

Measure: Toxic habits

Time: Baseline

Description: Compliance with the recommendations of the study intervention (adaptations of fluid, prescribed diets and oral hygiene) (hospitalization, 1, 3 and 6 months).

Measure: Compliance

Time: Through study completion, during hospitalization, and at 1, 3 and 6 months from disharge.

Description: Palatability of the intervention products will be measured with the 5-point facial hedonic scale (hospitalization, 1, 3 and 6 months).

Measure: Palatability

Time: Through study completion, during hospitalization, and at 1, 3 and 6 months from disharge.

Description: Acceptability of the dietes will be measured with the Food Action Rating Scale (hospitalization, 1, 3 and 6 months)

Measure: Acceptability

Time: Through study completion, during hospitalization, and at 1, 3 and 6 months from disharge.

HPO Nodes


Data processed on September 26, 2020.

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