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Article ; Online: Trends of physical fitness related to weight status

Cédric Gubelmann / Zeno Stanga / Kaspar Staub / Pedro Marques-Vidal

Preventive Medicine Reports, Vol 38, Iss , Pp 102591- (2024)

An analysis including over 412,000 Swiss young male conscripts from 2007 to 2022

2024

Abstract: Objective: The high prevalence of obesity among young adults in the civilian population pose challenges in recruiting physically fit soldiers. We assessed the trend of physical fitness related to weight status among Swiss male conscripts. Methods: Cross- ... ...

Abstract	Objective: The high prevalence of obesity among young adults in the civilian population pose challenges in recruiting physically fit soldiers. We assessed the trend of physical fitness related to weight status among Swiss male conscripts. Methods: Cross-sectional data of medical examination data during mandatory conscription for the Swiss Armed Forces, 2007–2022 (N = 412,186). The conscription physical test (CPT) assessed five aspects of physical fitness, each aspect scoring 0–25, one component being an endurance test (ET). CPT and ET categories were defined as per military guidelines: “Insufficient”, “Sufficient”, “Good”, “Very Good” and “Excellent”. Weight status was based on body mass index (BMI). Results: Conscripts with obesity (BMI ≥ 30 kg/m2) and overweight (BMI 25–29.99) had significantly (p < 0.001) lower CPT and ET scores compared to normal weight [multivariable-adjusted mean: 54.7 ± 0.1 and 66.5 ± 0.1, vs. 73.6 ± 0.1 for CPT; 8.8 ± 0.1 and 12.5 ± 0.1, vs. 15.3 ± 0.1 for ET] and a higher likelihood to be categorized as “Insufficient” [weighted relative-risk ratio and (95 %CI): 70.4 (63.7–77.7) and 2.35 (2.16–2.55) for CPT; 77.1 (71.0–83.7) and 3.05 (2.91–3.20) for ET] or “Sufficient” [7.67 (7.38–7.97) and 2.02 (1.99–2.06) for CPT; 8.93 (8.37–9.52) and 2.02 (1.98–2.06) for ET]. Compared to normal weight conscripts, the CPT and ET scores decreased over the conscription years for conscripts with obesity (multivariable-adjusted mean yearly change: −0.11 ± 0.02 for CPT; −0.032 ± 0.007 for ET) and overweight (−0.16 ± 0.01 for CPT and −0.044 ± 0.004 for ET). Conclusion: Male Swiss conscripts with overweight and obesity have lower physical fitness than normal weight conscripts, and this condition tends to worsen over the conscription years.
Keywords	Physical fitness ; Obesity ; Weight status ; Army ; Conscription ; Trend ; Medicine ; R
Subject code	796
Language	English
Publishing date	2024-02-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Effect of a Modified Mindfulness-Based Stress Reduction (MBSR) Program on Symptoms of Stress and Depression and on Saliva Cortisol and Serum Creatine Kinase among Male Wrestlers

Elham Mousavi / Dena Sadeghi-Bahmani / Habibolah Khazaie / Annette Beatrix Brühl / Zeno Stanga / Serge Brand

Healthcare, Vol 11, Iss 1643, p

2023 Volume 1643

Abstract: Objectives: The aims of the present study were two-fold: to investigate whether, compared to an active control condition, a modified mindfulness-based stress reduction (MBSR) program could (1) reduce symptoms of stress and depression, and (2) regulate ... ...

Abstract	Objectives: The aims of the present study were two-fold: to investigate whether, compared to an active control condition, a modified mindfulness-based stress reduction (MBSR) program could (1) reduce symptoms of stress and depression, and (2) regulate salivary cortisol and serum creatine kinase (CK) concentrations, two physiological stress markers. Methods: Thirty male wrestlers ( M age = 26.73 years) were randomly assigned either to the MBSR intervention or the active control condition. Both at the beginning and at the end of the intervention, the participants completed questionnaires on perceived stress and depression; in parallel, salivary samples were collected to measure cortisol in saliva, while blood samples were collected to assess serum CK. The study lasted for eight consecutive weeks. The intervention consisted of 16 group sessions (90 min each); the active control condition had an identical schedule, though without bona fide interventions. During the study period, the participants kept their sleeping, nutritional and exercising schedules unaltered. Results: Over time, symptoms of stress and depression decreased; the level of decrease was more prominent in the MBSR condition than the active control condition (significant p values and large effect sizes of interaction). Further, cortisol and creatine kinase concentrations also decreased more in the MBSR condition compared to the active control condition (large effect sizes of interaction). Conclusions: The present study’s findings suggest that among male wrestlers, a modified MBSR intervention have the potential to reduce both psychological (stress and depression) and physiological (cortisol and creatine kinase) indices as compared to an active control condition.
Keywords	mental health ; mindfulness-based stress reduction (MBSR) ; cortisol ; athletes ; creatine kinase ; Medicine ; R
Subject code	150
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Efficacy and Efficiency of Nutritional Support Teams

Emilie Reber / Rachel Strahm / Lia Bally / Philipp Schuetz / Zeno Stanga

Journal of Clinical Medicine, Vol 8, Iss 9, p

2019 Volume 1281

Abstract: Malnutrition is frequent in patients during a hospital admission and may further worsen during the hospital stay without appropriate nutritional support. Malnutrition causes greater complication rates, morbidity, and mortality rates, which increases the ... ...

Abstract	Malnutrition is frequent in patients during a hospital admission and may further worsen during the hospital stay without appropriate nutritional support. Malnutrition causes greater complication rates, morbidity, and mortality rates, which increases the length of hospital stay and prolongs rehabilitation. Early recognition of individual nutritional risk and timely initiation of a tailored nutritional therapy are crucial. Recent evidence from large-scale trials suggests that efficient nutritional management not only improves the nutritional status, but also prevents negative clinical outcomes and increases patients’ quality of life. Multifaceted clinical knowledge is required to ensure optimal nutritional support, according to a patient’s individual situation and to avoid potential complications. Furthermore, clear definition of responsibilities and structuring of patient, and work processes are indispensable. Interdisciplinary and multiprofessional nutritional support teams have been built up to ensure and improve the quality and safety of nutritional treatments. These teams continuously check and optimize the quality of procedures in the core areas of nutritional management by implementing nutritional screening processes using a validated tool, nutritional status assessment, an adequate nutritional care plan development, prompt and targeted nutritional treatment delivery, and provision of accurate monitoring to oversee all aspects of care, from catering to artificial nutrition. The foundation of any nutritional care plan is the identification of patients at risk. The aim of this narrative review is to provide an overview about composition, tasks, and challenges of nutritional support teams, and to discuss the current evidence regarding their efficiency and efficacy in terms of clinical outcome and cost effectiveness.
Keywords	nutritional support team ; nutritional management ; malnutrition ; efficacy ; Medicine ; R
Subject code	360
Language	English
Publishing date	2019-08-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Multimodal prehabilitation for major surgery in elderly patients to lower complications

Lia Bally / Martin Verra / Matthias Wilhelm / Prisca Eser / Zeno Stanga / Christian M Beilstein / Gabija Krutkyte / Thomas Vetsch / Markus Huber / Patrick Y Wuethrich / Dominique Engel

BMJ Open, Vol 13, Iss

protocol of a randomised, prospective, multicentre, multidisciplinary trial (PREHABIL Trial)

2023 Volume 1

Abstract: Introduction The global volume of surgery is growing and the population ageing, and economic pressure is rising. Major surgery is associated with relevant morbidity and mortality. Postoperative reduction in physiological and functional capacity is ... ...

Abstract	Introduction The global volume of surgery is growing and the population ageing, and economic pressure is rising. Major surgery is associated with relevant morbidity and mortality. Postoperative reduction in physiological and functional capacity is especially marked in the elderly, multimorbid patient with low fitness level, sarcopenia and malnutrition. Interventions aiming to optimise the patient prior to surgery (prehabilitation) may reduce postoperative complications and consequently reduce health costs.Methods and analysis This is a multicentre, multidisciplinary, prospective, 2-arm parallel-group, randomised, controlled trial with blinded outcome assessment. Primary outcome is the Comprehensive Complications Index at 30 days. Within 3 years, we aim to include 2×233 patients with a proven fitness deficit undergoing major surgery to be randomised using a computer-generated random numbers and a minimisation technique. The study intervention consists of a structured, multimodal, multidisciplinary prehabilitation programme over 2–4 weeks addressing deficits in physical fitness and nutrition, diabetes control, correction of anaemia and smoking cessation versus standard of care.Ethics and dissemination The PREHABIL trial has been approved by the responsible ethics committee (Kantonale Ethikkomission Bern, project ID 2020-01690). All participants provide written informed consent prior to participation. Participant recruitment began in February 2022 (10 and 8 patients analysed at time of submission), with anticipated completion in 2025. Publication of the results in peer-reviewed scientific journals are expected in late 2025.Trial registration number NCT04461301.
Keywords	Medicine ; R
Subject code	616
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Energy and protein intake in medical and geriatric inpatients with MEDPass versus conventional administration of oral nutritional supplements

Silvia Kurmann / Emilie Reber / Maria F. Vasiloglou / Philipp Schuetz / Andreas W. Schoenenberger / Katja Uhlmann / Anna-Barbara Sterchi / Zeno Stanga

Trials, Vol 22, Iss 1, Pp 1-

study protocol for the randomized controlled MEDPass Trial

2021 Volume 11

Abstract: Abstract Background Disease-related malnutrition is highly prevalent in hospitalized medical and geriatric inpatients. It is associated with negative outcomes such as muscle wasting, decline of functional status, and increased morbidity and mortality. ... ...

Abstract	Abstract Background Disease-related malnutrition is highly prevalent in hospitalized medical and geriatric inpatients. It is associated with negative outcomes such as muscle wasting, decline of functional status, and increased morbidity and mortality. Oral nutritional supplements (ONS) are frequently used in nutritional therapy to increase intake. However, compliance to ONS is often limited and maybe improved by prescribing ONS in small portions timed with the medication (MEDPass). However, it is unknown whether the MEDPass administration enhances patients’ total energy and protein intake. Methods The MEDPass Trial is a randomized, controlled, open-label superiority trial. Patients in the MEDPass group receive 50 ml of ONS four times per day, distributed with the medication rounds. Patients in the control group receive ONS between meals. The primary outcome is average daily energy intake (% of calculated daily requirement). For our power analysis, we assumed that administration of ONS in the MEDPass administration mode increases energy intake by at least 10% (i.e., by 200 kcal for an average energy requirement of 2200 kcal/day). Thus, with the inclusion of 200 patients, this trial has 80% power to demonstrate that intervention group patients have an average intake of 2200 kcal/day (SD 500 kcal) versus 2000 kcal/day (SD 500 kcal) in control group patients. Energy and protein intakes from ONS and all food consumed are monitored continuously throughout the hospital stay and are statistically compared to the patient’s requirements. Secondary outcomes include average daily protein intake (% of calculated daily requirement), average intake of ONS/day, the course of body weight, handgrip strength, appetite, and nausea. Furthermore, hospital length of stay and 30-day mortality are assessed. The primary statistical analysis will be performed as an intention-to-treat analysis adjusted for the stratification factors used in randomization. Discussion To our knowledge, this is the first randomized controlled trial assessing ...
Keywords	Oral nutritional supplements ; Energy intake ; Protein intake ; Malnutrition ; MEDPass ; Nutrition as medication ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Cost savings associated with nutritional support in medical inpatients

Philipp Schuetz / Beat Mueller / Suela Sulo / Stefan Walzer / Lutz Vollmer / Cory Brunton / Nina Kaegi-Braun / Zeno Stanga / Filomena Gomes

BMJ Open, Vol 11, Iss

an economic model based on data from a systematic review of randomised trials

2021 Volume 7

Abstract: Background and aims Nutritional support improves clinical outcomes during hospitalisation as well as after discharge. Recently, a systematic review of 27 randomised, controlled trials showed that nutritional support was associated with lower rates of ... ...

Abstract	Background and aims Nutritional support improves clinical outcomes during hospitalisation as well as after discharge. Recently, a systematic review of 27 randomised, controlled trials showed that nutritional support was associated with lower rates of hospital readmissions and improved survival. In the present economic modelling study, we sought to determine whether in-hospital nutritional support would also return economic benefits.Methods The current economic model applied cost estimates to the outcome results from our recent systematic review of hospitalised patients. In the underlying meta-analysis, a total of 27 trials (n=6803 patients) were included. To calculate the economic impact of nutritional support, a Markov model was developed using transitions between relevant health states. Costs were estimated accounting for length of stay in a general hospital ward, hospital-acquired infections, readmissions and nutritional support. Six-month mortality was also considered. The estimated daily per-patient cost for in-hospital nutrition was US$6.23.Results Overall costs of care within the model timeframe of 6 months averaged US$63 227 per patient in the intervention group versus US$66 045 in the control group, which corresponds to per patient cost savings of US$2818. These cost savings were mainly due to reduced infection rate and shorter lengths of stay. We also calculated the costs to prevent a hospital-acquired infection and a non-elective readmission, that is, US$820 and US$733, respectively. The incremental cost per life-day gained was −US$1149 with 2.53 additional days. The sensitivity analyses for cost per quality-adjusted life day provided support for the original findings.Conclusions For medical inpatients who are malnourished or at nutritional risk, our findings showed that in-hospital nutritional support is a cost-effective way to reduce risk for readmissions, lower the frequency of hospital-associated infections, and improve survival rates.
Keywords	Medicine ; R
Subject code	360
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	BMJ Publishing Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Management of Glucose Control in Noncritically Ill, Hospitalized Patients Receiving Parenteral and/or Enteral Nutrition

Céline Isabelle Laesser / Paul Cumming / Emilie Reber / Zeno Stanga / Taulant Muka / Lia Bally

Journal of Clinical Medicine, Vol 8, Iss 7, p

A Systematic Review

2019 Volume 935

Abstract: Hyperglycemia is a common occurrence in hospitalized patients receiving parenteral and/or enteral nutrition. Although there are several approaches to manage hyperglycemia, there is no consensus on the best practice. We systematically searched PubMed, ... ...

Abstract	Hyperglycemia is a common occurrence in hospitalized patients receiving parenteral and/or enteral nutrition. Although there are several approaches to manage hyperglycemia, there is no consensus on the best practice. We systematically searched PubMed, Embase, Cochrane Central, and ClinicalTrials.gov to identify records (published or registered between April 1999 and April 2019) investigating strategies to manage glucose control in adults receiving parenteral and/or enteral nutrition whilst hospitalized in noncritical care units. A total of 15 completed studies comprising 1170 patients were identified, of which 11 were clinical trials and four observational studies. Diabetes management strategies entailed adaptations of nutritional regimens in four studies, while the remainder assessed different insulin regimens and administration routes. Diabetes-specific nutritional regimens that reduced glycemic excursions, as well as algorithm-driven insulin delivery approaches that allowed for flexible glucose-responsive insulin dosing, were both effective in improving glycemic control. However, the assessed studies were, in general, of limited quality, and we see a clear need for future rigorous studies to establish standards of care for patients with hyperglycemia receiving nutrition support.
Keywords	glucose control ; hyperglycemia ; parenteral nutrition ; enteral nutrition ; nutritional support ; insulin ; Medicine ; R
Subject code	610
Language	English
Publishing date	2019-06-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Management of Dehydration in Patients Suffering Swallowing Difficulties

Emilie Reber / Filomena Gomes / Ilka A. Dähn / Maria F. Vasiloglou / Zeno Stanga

Journal of Clinical Medicine, Vol 8, Iss 11, p

2019 Volume 1923

Abstract: Swallowing difficulties, also called dysphagia, can have various causes and may occur at many points in the swallowing process. The treatment and rehabilitation of dysphagia represent a major interdisciplinary and multiprofessional challenge. In ... ...

Abstract	Swallowing difficulties, also called dysphagia, can have various causes and may occur at many points in the swallowing process. The treatment and rehabilitation of dysphagia represent a major interdisciplinary and multiprofessional challenge. In dysphagic patients, dehydration is frequent and often accelerated as a result of limited fluid intake. This condition results from loss of water from the intracellular space, disturbing the normal levels of electrolytes and fluid interfering with metabolic processes and body functions. Dehydration is associated with increased morbidity and mortality rates. Dysphagic patients at risk of dehydration thus require close monitoring of their hydration state, and existing imbalances should be addressed quickly. This review gives an overview on dehydration, as well as its pathophysiology, risk factors, and clinical signs/symptoms in general. Available management strategies of dehydration are presented for oral, enteral, and parenteral fluid replacement.
Keywords	dehydration ; dysphagia ; fluid intake ; water ; Medicine ; R
Subject code	610
Language	English
Publishing date	2019-11-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Economic Challenges in Nutritional Management

Emilie Reber / Kristina Norman / Olga Endrich / Philipp Schuetz / Andreas Frei / Zeno Stanga

Journal of Clinical Medicine, Vol 8, Iss 7, p

2019 Volume 1005

Abstract: Disease-related malnutrition (DRM) is a highly prevalent independent risk and cost factor with significant influence on mortality, morbidity, length of hospital stay (LOS), functional impairment and quality of life. The aim of our research was to ... ...

Abstract	Disease-related malnutrition (DRM) is a highly prevalent independent risk and cost factor with significant influence on mortality, morbidity, length of hospital stay (LOS), functional impairment and quality of life. The aim of our research was to estimate the economic impact of the introduction of routinely performed nutritional screening (NS) in a tertiary hospital, with subsequent nutritional interventions (NI) in patients with potential or manifest DRM. Economic impact analysis of natural detection of inpatients at risk and estimation of the change in economic activity after the implementation of a systematic NS were performed. The reference population for natural detection of DRM is about 20,000 inpatients per year. Based on current data, DRM prevalence is estimated at 20%, so 4000 patients with potential and manifest DRM should be detected. The NI costs were estimated at CHF 0.693 million, with savings of CHF 1.582 million (LOS reduction) and CHF 0.806 million in additional revenue (SwissDRG system). Thus, the introduction of routine NS generates additional costs of CHF 1.181 million that are compensated by additional savings of CHF 2.043 million and an excess in additional revenue of CHF 2.071 million. NS with subsequent adequate nutritional intervention shows an economic potential for hospitals.
Keywords	economic challenges ; nutritional management ; malnutrition ; Medicine ; R
Subject code	360
Language	English
Publishing date	2019-07-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Nutritional Risk Screening and Assessment

Emilie Reber / Filomena Gomes / Maria F. Vasiloglou / Philipp Schuetz / Zeno Stanga

Journal of Clinical Medicine, Vol 8, Iss 7, p

2019 Volume 1065

Abstract: Malnutrition is an independent risk factor that negatively influences patients’ clinical outcomes, quality of life, body function, and autonomy. Early identification of patients at risk of malnutrition or who are malnourished is crucial in order to start ...

Abstract	Malnutrition is an independent risk factor that negatively influences patients’ clinical outcomes, quality of life, body function, and autonomy. Early identification of patients at risk of malnutrition or who are malnourished is crucial in order to start a timely and adequate nutritional support. Nutritional risk screening, a simple and rapid first-line tool to detect patients at risk of malnutrition, should be performed systematically in patients at hospital admission. Patients with nutritional risk should subsequently undergo a more detailed nutritional assessment to identify and quantify specific nutritional problems. Such an assessment includes subjective and objective parameters such as medical history, current and past dietary intake (including energy and protein balance), physical examination and anthropometric measurements, functional and mental assessment, quality of life, medications, and laboratory values. Nutritional care plans should be developed in a multidisciplinary approach, and implemented to maintain and improve patients’ nutritional condition. Standardized nutritional management including systematic risk screening and assessment may also contribute to reduced healthcare costs. Adequate and timely implementation of nutritional support has been linked with favorable outcomes such as a decrease in length of hospital stay, reduced mortality, and reductions in the rate of severe complications, as well as improvements in quality of life and functional status. The aim of this review article is to provide a comprehensive overview of nutritional screening and assessment methods that can contribute to an effective and well-structured nutritional management (process cascade) of hospitalized patients.
Keywords	nutritional risk screening ; nutritional assessment ; malnutrition ; Medicine ; R
Subject code	610 ; 360
Language	English
Publishing date	2019-07-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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