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You don't even suspect that you might be malnourished, but your body is giving you a sign. Do you function much worse lately, you tire faster, are you weakened, or maybe you have lost some weight? So how do you judge proper nutrition? Just take the SGA test, i.e. the Subjective Global Assessment of Nutritional Status, and find out if you are at risk of malnutrition.

Malnutrition is a condition resulting from deficiencies in energy, proteins, vitamins and minerals. A characteristicsymptom of malnutritionis weight loss along with a decrease in immunity, progressive weakening of muscle strength, decreased life activity, often accompanied by water and electrolyte disturbances.

What are the most common diseases associated with malnutrition?

- The likelihood of malnutrition increases in cancer patients, especially with neoplasms of the digestive system (mainly pancreas, liver and small intestine). The use of chemotherapy in the treatment process contributes to vomiting, nausea and reduces the appetite. Malnutrition is also observed in patients in neurological departments, after stroke or stroke, as well as in the advanced stage of Parkinson's disease, amyotrophic lateral sclerosis, because these diseases make it difficult to chew and swallow food. Malnutrition is quite common in patients with intestinal diseases such as Crohn's syndrome, ulcerative colitis, celiac disease or liver failure. In burns of the 2nd and 3rd degree, covering more than 30 percent. of the body, the patients' need for energy and protein for tissue regeneration increases - explains Aneta Kościołek, M.Sc., dietician at the Sapphire Clinic, biotechnologist and public he alth specialist. It is known that burned people have no appetite or cannot eat food due to severe burns. - Among the respiratory system diseases, malnutrition is most often observed in pneumonia, COPD, and cystic fibrosis. We cannot forget about surgical patients who have an increased demand for energy, protein and vitamins necessary for the healing process - adds Aneta Kościołek.

Important

Assessment of the patient's nutritional status is a legal obligation of the hospital

- From January 1, 2012, all hospitals in Poland are required to carry outscreening the nutritional status of each patient received. This applies to all hospital departments, except emergency departments (HEDs). - explains Dr. Łukasz Drozd, MD, an expert in medical nutrition from the NUTRICO center. It is worrying that, despite legal regulations, such an assessment is not always performed. However, a document assessing the nutritional status of each patient should be included in the medical history of each patient.

How is the risk of a patient malnourished?

- To assess the nutritional status, it is recommended to use one of the two scales: Nutritional Risk Score NRS 2002 or Subjective Overall Nutritional Assessment (SGA). Patients diagnosed with malnutrition should receive specialist nutritional support - explains Dr. Łukasz Drozd.

What to do if the hospital fails to perform the mandatory screening of nutritional status during hospitalization? The patient can do it himself, e.g. via the Internet, before admission to hospital or during hospitalization. Test, the so-called Subjective Global Nutrition Assessment (SGA) is available online. It includes questions about e.g. height, weight, possible weight change in the last three months or the type of diet used in the last two weeks.

If a patient has been classified as at risk related to malnutrition and is to be hospitalized, doctors should conduct an in-depth examination including anthropometric tests, biochemical tests and nutritional history. In anthropometric studies, the assessment of BMI (body mass index) is particularly important. Biochemical tests are also very useful in qualifying a patient for nutritional treatment and monitoring its effectiveness. Moreover, they are objective and repeatable. Several proteins, such as albumin, transferrin, prealbumin and the total number of lymphocytes, are of greatest importance in assessing the nutritional status of a patient. A biochemical test checks their level on the basis of a blood test.

A nutritional interview is also very often performed, consisting in collecting information related to eating habits, medications taken, possible eating disorders or weight loss in the last three months or in the period when the patient for some reason restricts food intake or he gives up on them at all. A significant indicator of malnutrition is the loss of 10 percent. body weight within the last three months from the survey.

Diagnosis: malnutrition. What's next?

- If malnutrition is found, take howthe fastest nutritional intervention. Sometimes it is enough just to increase the number of calories or eat more foods rich in wholesome protein, micro- and macroelements, vitamins, especially A, C, E, B12, as well as iron, potassium, calcium, selenium. But it also happens that it is necessary to introduce medical nutrition. In the latter case, it will be necessary to use oral nutritional supplements or enteral or parenteral nutrition - advises Aneta Kościołek, MSc. Only the doctor decides about the necessity and type of medical nutrition. Remember, a malnourished patient recovers much longer than a properly nourished patient, and each treatment process is strongly related to what nutrients we provide to our body.

Worth knowing

A handful of statistics: who is at risk of malnutrition

The world data shows that as many as 40% of patients admitted to hospitals are malnourished. In particular, oncological and neurological patients are at risk of malnutrition. Therefore, people with cancer face this problem - 30-90 percent; with inflammatory bowel diseases - as much as 80 percent; respiratory diseases - 45 percent; severe burns and premature babies, preschool children and seniors - about 50 percent.

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Category:

Obesity