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Article ; Online: Clinical applications of body composition and functional status tools for nutrition assessment of hospitalized adults: A systematic review.

Smith, Luke O / Olieman, Joanne F / Berk, Kirsten A / Ligthart-Melis, Gerdien C / Earthman, Carrie P

JPEN. Journal of parenteral and enteral nutrition

2022 Volume 47, Issue 1, Page(s) 11–29

Abstract: Background: No global consensus exists on diagnostic criteria for malnutrition. Muscular deficits and functional impairments are major components of available malnutrition diagnostic frameworks because these facets of nutrition status significantly ... ...

Abstract	Background: No global consensus exists on diagnostic criteria for malnutrition. Muscular deficits and functional impairments are major components of available malnutrition diagnostic frameworks because these facets of nutrition status significantly impact outcomes. The purpose of this review is to explore which body composition assessment (BCA) and functional status assessment (FSA) tools are being used for nutrition assessment (NA) and monitoring the response to nutrition interventions (RNIs) in adult inpatients. Methods: A literature search of Embase, Medline (Ovid), Web of Science, and Cochrane Central was performed to identify studies that used BCA and/or FSA tools for NA (along with an accepted NA diagnostic framework) and/or for monitoring RNI in adult inpatients. Results: The search yielded 3667 articles; 94 were included in the review. The number of studies using BCA and/or FSA tools for NA was 47 and also 47 for monitoring RNI. Seventy-nine percent of studies used bioimpedance for BCA, and 97% that included FSA utilized handgrip strength. When compared against sets of diagnostic criteria, many of the BCA and FSA tools showed promising associations with nutrition status. Conclusion: Bioimpedance methods are the most widely used bedside BCA tools, and handgrip strength is the most widely used FSA tool; however, these methods are being used with a variety of protocols, algorithms, and interpretation practices in heterogeneous populations. To create a standardized nutrition status assessment process there is a need for validation studies on bedside methods and the development of globally standardized assessment protocols in clinical inpatient settings.
MeSH term(s)	Adult ; Humans ; Nutrition Assessment ; Hand Strength ; Functional Status ; Nutritional Status ; Malnutrition/diagnosis ; Body Composition
Language	English
Publishing date	2022-12-09
Publishing country	United States
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	800861-9
ISSN	1941-2444 ; 0148-6071
ISSN (online)	1941-2444
ISSN	0148-6071
DOI	10.1002/jpen.2444
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Article ; Online: Malnutrition in patients with COVID-19: assessment and consequences.

van der Meij, Barbara S / Ligthart-Melis, Gerdien C / de van der Schueren, Marian A E

Current opinion in clinical nutrition and metabolic care

2021 Volume 24, Issue 6, Page(s) 543–554

Abstract: Purpose of review: COVID-19 disease often presents with malnutrition and nutrition impact symptoms, such as reduced appetite, nausea and loss of taste. This review summarizes the most up-to-date research on nutritional assessment in relation to ... ...

Abstract	Purpose of review: COVID-19 disease often presents with malnutrition and nutrition impact symptoms, such as reduced appetite, nausea and loss of taste. This review summarizes the most up-to-date research on nutritional assessment in relation to mortality and morbidity risk in patients with COVID-19. Recent findings: Numerous studies have been published on malnutrition, muscle wasting, obesity, and nutrition impact symptoms associated with COVID-19, mostly observational and in hospitalized patients. These studies have shown a high prevalence of symptoms (loss of appetite, nausea, vomiting, diarrhea, dysphagia, fatigue, and loss of smell and taste), malnutrition, micronutrient deficiencies and obesity in patients with COVID-19, all of which were associated with increased mortality and morbidity risks. Summary: Early screening and assessment of malnutrition, muscle wasting, obesity, nutrition impact symptoms and micronutrient status in patients with COVID-19, followed by pro-active nutrition support is warranted, and expected to contribute to improved recovery. There is limited research on nutritional status or nutrition impact symptoms in patients living at home or in residential care. RCTs studying the effects of nutrition intervention on clinical outcomes are lacking. Future research should focus on these evidence gaps.
MeSH term(s)	Body Composition ; COVID-19/complications ; Humans ; Malnutrition/diagnosis ; Malnutrition/etiology ; Nutrition Assessment ; Nutritional Status ; Obesity/complications
Language	English
Publishing date	2021-08-23
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1460178-3
ISSN	1473-6519 ; 1363-1950
ISSN (online)	1473-6519
ISSN	1363-1950
DOI	10.1097/MCO.0000000000000783
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Article ; Online: Malnutrition in patients with COVID-19

van der Meij, Barbara S. / Ligthart-Melis, Gerdien C. / de van der Schueren, Marian A.E.

Current Opinion in Clinical Nutrition and Metabolic Care

assessment and consequences

2021 Volume 24, Issue 6

Abstract: PURPOSE OF REVIEW: COVID-19 disease often presents with malnutrition and nutrition impact symptoms, such as reduced appetite, nausea and loss of taste. This review summarizes the most up-to-date research on nutritional assessment in relation to mortality ...

Abstract	PURPOSE OF REVIEW: COVID-19 disease often presents with malnutrition and nutrition impact symptoms, such as reduced appetite, nausea and loss of taste. This review summarizes the most up-to-date research on nutritional assessment in relation to mortality and morbidity risk in patients with COVID-19. RECENT FINDINGS: Numerous studies have been published on malnutrition, muscle wasting, obesity, and nutrition impact symptoms associated with COVID-19, mostly observational and in hospitalized patients. These studies have shown a high prevalence of symptoms (loss of appetite, nausea, vomiting, diarrhea, dysphagia, fatigue, and loss of smell and taste), malnutrition, micronutrient deficiencies and obesity in patients with COVID-19, all of which were associated with increased mortality and morbidity risks. SUMMARY: Early screening and assessment of malnutrition, muscle wasting, obesity, nutrition impact symptoms and micronutrient status in patients with COVID-19, followed by pro-active nutrition support is warranted, and expected to contribute to improved recovery. There is limited research on nutritional status or nutrition impact symptoms in patients living at home or in residential care. RCTs studying the effects of nutrition intervention on clinical outcomes are lacking. Future research should focus on these evidence gaps.
Keywords	Life Science
Subject code	360
Language	English
Publishing country	nl
Document type	Article ; Online
ZDB-ID	1460178-3
ISSN	1473-6519 ; 1363-1950
ISSN (online)	1473-6519
ISSN	1363-1950
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Walking exercise alters protein digestion, amino acid absorption, and whole body protein kinetics in older adults with and without COPD.

Cruthirds, Clayton L / Deutz, Nicolaas E P / Ligthart-Melis, Gerdien C / Simbo, Sunday Y / Engelen, Mariëlle P K J

Journal of applied physiology (Bethesda, Md. : 1985)

2020 Volume 130, Issue 2, Page(s) 435–444

Abstract: Gut-related symptoms and an increase in markers of gut dysfunction have been observed in patients with chronic obstructive pulmonary disease (COPD). It remains unclear whether exercise, in relation to inducing hypoxia, plays a role in disturbances in ... ...

Abstract	Gut-related symptoms and an increase in markers of gut dysfunction have been observed in patients with chronic obstructive pulmonary disease (COPD). It remains unclear whether exercise, in relation to inducing hypoxia, plays a role in disturbances in protein digestion and amino acid absorption and whole body protein kinetics. Sixteen clinically stable patients with moderate-to-very severe COPD and 12 matched healthy subjects completed the study. Protein digestion and amino acid absorption, whole body protein kinetics were measured in the postabsorptive state via a continuous infusion of stable tracers in combination with orally administered stable tracer sips during 20 min of walking exercise and up to 4 h post exercise. In addition, concentrations of short-chain fatty acid (SCFA) and amino acids were measured. Patients with COPD completed one study day, walking at maximal speed, whereas healthy subjects completed two, one matched to the speed of a patient with COPD and one at maximal speed. The patients with COPD tolerated 20 min of vigorous intensity walking with an elevated heart rate (
MeSH term(s)	Aged ; Amino Acids/metabolism ; Exercise ; Humans ; Kinetics ; Proteolysis ; Pulmonary Disease, Chronic Obstructive ; Walking
Chemical Substances	Amino Acids
Language	English
Publishing date	2020-11-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	219139-8
ISSN	1522-1601 ; 0021-8987 ; 0161-7567 ; 8750-7587
ISSN (online)	1522-1601
ISSN	0021-8987 ; 0161-7567 ; 8750-7587
DOI	10.1152/japplphysiol.00783.2020
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Article ; Online: Frailty, Sarcopenia, and Malnutrition Frequently (Co-)occur in Hospitalized Older Adults: A Systematic Review and Meta-analysis.

Ligthart-Melis, Gerdien C / Luiking, Yvette C / Kakourou, Alexia / Cederholm, Tommy / Maier, Andrea B / de van der Schueren, Marian A E

Journal of the American Medical Directors Association

2020 Volume 21, Issue 9, Page(s) 1216–1228

Abstract: Objectives: The purpose of this systematic review and meta-analysis was to summarize the prevalence of, and association between, physical frailty or sarcopenia and malnutrition in older hospitalized adults.: Design: A systematic literature search was ...

Abstract	Objectives: The purpose of this systematic review and meta-analysis was to summarize the prevalence of, and association between, physical frailty or sarcopenia and malnutrition in older hospitalized adults. Design: A systematic literature search was performed in 10 databases. Setting and participants: Articles were selected that evaluated physical frailty or sarcopenia and malnutrition according to predefined criteria and cutoffs in older hospitalized patients. Measures: Data were pooled in a meta-analysis to evaluate the prevalence of prefrailty and frailty [together (pre-)frailty], sarcopenia, and risk of malnutrition and malnutrition [together (risk of) malnutrition], and the association between either (pre-)frailty or sarcopenia and (risk of) malnutrition. Results: Forty-seven articles with 18,039 patients (55% female) were included in the systematic review, and 39 articles (8868 patients, 62% female) were eligible for the meta-analysis. Pooling 11 studies (2725 patients) revealed that 84% [95% confidence interval (CI): 77%, 91%, I Conclusions and implications: The association between and prevalence of (pre-)frailty or sarcopenia and (risk of) malnutrition in older hospitalized adults is substantial. About half of the hospitalized older adults suffer from 2 and perhaps 3 of these debilitating conditions. Therefore, standardized screening for these conditions at hospital admission is highly warranted to guide targeted nutritional and physical interventions.
MeSH term(s)	Aged ; Cross-Sectional Studies ; Female ; Frail Elderly ; Frailty/epidemiology ; Humans ; Male ; Malnutrition/epidemiology ; Prevalence ; Sarcopenia/epidemiology
Language	English
Publishing date	2020-04-21
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Review ; Systematic Review
ZDB-ID	2171030-2
ISSN	1538-9375 ; 1525-8610
ISSN (online)	1538-9375
ISSN	1525-8610
DOI	10.1016/j.jamda.2020.03.006
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Article: Preserved anabolic threshold and capacity as estimated by a novel stable tracer approach suggests no anabolic resistance or increased requirements in weight stable COPD patients

Jonker, Renate / Deutz, Nicolaas E.P / Ligthart-Melis, Gerdien C / Zachria, Anthony J / Veley, Eugene A / Harrykissoon, Rajesh / Engelen, Mariëlle P.K.J

Clinical nutrition. 2019 Aug., v. 38, no. 4

2019

Abstract: Assessing the ability to respond anabolic to dietary protein intake during illness provides important insight in the capacity of lean body mass maintenance. We applied a newly developed stable tracer approach to assess in one session in patients with ... ...

Abstract	Assessing the ability to respond anabolic to dietary protein intake during illness provides important insight in the capacity of lean body mass maintenance. We applied a newly developed stable tracer approach to assess in one session in patients with chronic obstructive pulmonary disease (COPD) and healthy older adults both the minimal amount of protein intake to obtain protein anabolism (anabolic threshold) and the efficiency of dietary protein to promote protein anabolism (anabolic capacity).We studied 12 clinically and weight stable patients with moderate to very severe COPD (mean ± SE forced expiratory volume in 1 s: 36 ± 3% of predicted) and 10 healthy age-matched older adults. At 2-h intervals and in consecutive order, all participants consumed a mixture of 0.0, 0.04, 0.10 and 0.30 g hydrolyzed casein protein×kg ffm−1×2 h−1 and carbohydrates (2:1). We assessed whole body protein synthesis (PS), breakdown (PB), net PS (PS−PB) and net protein balance (phenylalanine (PHE) intake - PHE to tyrosine (TYR) hydroxylation) by IV primed and continuous infusion of L-[ring-2H5]PHE and L-[13C9,15N]-TYR. Anabolic threshold (net protein balance = 0) and capacity (slope) were determined on an individual basis from the assumed linear relationship between protein intake and net protein balance.We confirmed a linear relationship between protein intake and net protein balance for all participants (R2 range: 0.9988–1.0, p ≤ 0.0006). On average, the anabolic threshold and anabolic capacity were comparable between the groups (anabolic threshold COPD vs. healthy: 3.82 ± 0.31 vs. 4.20 ± 0.36 μmol PHE × kg ffm−1 × hr−1; anabolic capacity COPD vs. healthy: 0.952 ± 0.007 and 0.954 ± 0.004). At protein intake around the anabolic threshold (0.04 and 0.10 g protein×kg ffm−1×2 h−1), the increase in net PS resulted mainly from PB reduction (p < 0.0001) whereas at a higher protein intake (0.30 g protein×kg ffm−1×2 h−1) PS was also stimulated (p < 0.0001).The preserved anabolic threshold and capacity in clinically and weight stable COPD patients suggests no disease related anabolic resistance and/or increased protein requirements.ClinicalTrials.gov; No. NCT01734473; URL: www.clinicaltrials.gov.
Keywords	elderly ; protein synthesis ; respiratory tract diseases ; carbohydrates ; tyrosine ; casein ; protein intake ; patients ; phenylalanine ; hydroxylation ; lean body mass
Language	English
Dates of publication	2019-08
Size	p. 1833-1843.
Publishing place	Elsevier Ltd
Document type	Article
Note	2019-12-06
ZDB-ID	604812-2
ISSN	1532-1983 ; 0261-5614
ISSN (online)	1532-1983
ISSN	0261-5614
DOI	10.1016/j.clnu.2018.07.018
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Preserved anabolic threshold and capacity as estimated by a novel stable tracer approach suggests no anabolic resistance or increased requirements in weight stable COPD patients.

Jonker, Renate / Deutz, Nicolaas E P / Ligthart-Melis, Gerdien C / Zachria, Anthony J / Veley, Eugene A / Harrykissoon, Rajesh / Engelen, Mariëlle P K J

Clinical nutrition (Edinburgh, Scotland)

2018 Volume 38, Issue 4, Page(s) 1833–1843

Abstract: Background & aims: Assessing the ability to respond anabolic to dietary protein intake during illness provides important insight in the capacity of lean body mass maintenance. We applied a newly developed stable tracer approach to assess in one session ... ...

Abstract	Background & aims: Assessing the ability to respond anabolic to dietary protein intake during illness provides important insight in the capacity of lean body mass maintenance. We applied a newly developed stable tracer approach to assess in one session in patients with chronic obstructive pulmonary disease (COPD) and healthy older adults both the minimal amount of protein intake to obtain protein anabolism (anabolic threshold) and the efficiency of dietary protein to promote protein anabolism (anabolic capacity). Methods: We studied 12 clinically and weight stable patients with moderate to very severe COPD (mean ± SE forced expiratory volume in 1 s: 36 ± 3% of predicted) and 10 healthy age-matched older adults. At 2-h intervals and in consecutive order, all participants consumed a mixture of 0.0, 0.04, 0.10 and 0.30 g hydrolyzed casein protein×kg ffm Results: We confirmed a linear relationship between protein intake and net protein balance for all participants (R Conclusions: The preserved anabolic threshold and capacity in clinically and weight stable COPD patients suggests no disease related anabolic resistance and/or increased protein requirements. Trial registry: ClinicalTrials.gov; No. NCT01734473; URL: www.clinicaltrials.gov.
MeSH term(s)	Aged ; Amino Acids/chemistry ; Amino Acids/metabolism ; Body Composition/physiology ; Carbon Isotopes/chemistry ; Carbon Isotopes/metabolism ; Caseins/chemistry ; Caseins/metabolism ; Dietary Carbohydrates/metabolism ; Dietary Proteins/metabolism ; Female ; Humans ; Male ; Middle Aged ; Nitrogen Isotopes/chemistry ; Nitrogen Isotopes/metabolism ; Nutritional Requirements/physiology ; Protein Biosynthesis ; Pulmonary Disease, Chronic Obstructive/metabolism ; Pulmonary Disease, Chronic Obstructive/physiopathology
Chemical Substances	Amino Acids ; Carbon Isotopes ; Caseins ; Dietary Carbohydrates ; Dietary Proteins ; Nitrogen Isotopes
Language	English
Publishing date	2018-07-31
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural
ZDB-ID	604812-2
ISSN	1532-1983 ; 0261-5614
ISSN (online)	1532-1983
ISSN	0261-5614
DOI	10.1016/j.clnu.2018.07.018
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Article ; Online: Metabolic Consequences of Supplemented Methionine in a Clinical Context.

Ligthart-Melis, Gerdien C / Engelen, Mariëlle P K J / Simbo, Sunday Y / Ten Have, Gabrie A M / Thaden, John J / Cynober, Luc / Deutz, Nicolaas E P

The Journal of nutrition

2020 Volume 150, Issue Suppl 1, Page(s) 2538S–2547S

Abstract: The central position of methionine (Met) in protein metabolism indicates the importance of this essential amino acid for growth and maintenance of lean body mass. Therefore, Met might be a tempting candidate for supplementation. However, because Met is ... ...

Abstract	The central position of methionine (Met) in protein metabolism indicates the importance of this essential amino acid for growth and maintenance of lean body mass. Therefore, Met might be a tempting candidate for supplementation. However, because Met is also the precursor of homocysteine (Hcy), a deficient intake of B vitamins or excessive intake of Met may result in hyperhomocysteinemia (HHcy), which is a risk factor for cardiovascular disease. This review discusses the evidence generated in preclinical and clinical studies on the importance and potentially harmful effects of Met supplementation and elaborates on potential clinical applications of supplemental Met with reference to clinical studies performed over the past 20 y. Recently acquired knowledge about the NOAEL (no observed adverse effect level) of 46.3 mg · kg-1 · d-1 and the LOAEL (lowest observed adverse effect level) of 91 mg · kg-1 · d-1 of supplemented Met will guide the design of future studies to further establish the role of Met as a potential (safe) candidate for nutritional supplementation in clinical applications.
MeSH term(s)	Animals ; Body Fluid Compartments/metabolism ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/metabolism ; Dietary Supplements ; Female ; Homocysteine/metabolism ; Humans ; Hyperhomocysteinemia/etiology ; Hyperhomocysteinemia/metabolism ; Male ; Methionine/adverse effects ; Methionine/metabolism ; Methionine/pharmacology ; Methionine/therapeutic use ; Proteins/metabolism ; Vitamin B Complex/blood ; Vitamin B Deficiency/blood ; Vitamin B Deficiency/complications
Chemical Substances	Proteins ; Homocysteine (0LVT1QZ0BA) ; Vitamin B Complex (12001-76-2) ; Methionine (AE28F7PNPL)
Language	English
Publishing date	2020-09-30
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	218373-0
ISSN	1541-6100 ; 0022-3166
ISSN (online)	1541-6100
ISSN	0022-3166
DOI	10.1093/jn/nxaa254
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Article ; Online: Glutamine supplementation, citrulline production, and de novo arginine synthesis: is there a relation?

Ligthart-Melis, Gerdien C / Marini, Juan C / Engelen, Marielle P K J / Deutz, Nicolaas E P

The American journal of clinical nutrition

2015 Volume 101, Issue 4, Page(s) 890–892

MeSH term(s)	Arginine/biosynthesis ; Dietary Supplements ; Dipeptides/administration & dosage ; Female ; Glutamine/metabolism ; Humans ; Kidney/drug effects ; Male
Chemical Substances	Dipeptides ; Glutamine (0RH81L854J) ; Arginine (94ZLA3W45F)
Language	English
Publishing date	2015-04-29
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	280048-2
ISSN	1938-3207 ; 0002-9165
ISSN (online)	1938-3207
ISSN	0002-9165
DOI	10.3945/ajcn.114.104679
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Article ; Online: Tolerance to increased supplemented dietary intakes of methionine in healthy older adults.

Deutz, Nicolaas Ep / Simbo, Sunday Y / Ligthart-Melis, Gerdien C / Cynober, Luc / Smriga, Miro / Engelen, Mariëlle Pkj

The American journal of clinical nutrition

2017 Volume 106, Issue 2, Page(s) 675–683

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Aged ; Aging/metabolism ; Dietary Supplements/adverse effects ; Dose-Response Relationship, Drug ; Female ; Homocysteine/blood ; Humans ; Male ; Methionine/administration & dosage ; Methionine/adverse effects ; Middle Aged ; Reference Values
Chemical Substances	Homocysteine (0LVT1QZ0BA) ; Methionine (AE28F7PNPL)
Language	English
Publishing date	2017-06-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	280048-2
ISSN	1938-3207 ; 0002-9165
ISSN (online)	1938-3207
ISSN	0002-9165
DOI	10.3945/ajcn.117.152520
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