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-   -   Doctors urged to tackle malnutrition in obesity (http://forum.lowcarber.org/showthread.php?t=484516)

Demi Wed, Oct-07-20 05:54

Doctors urged to tackle malnutrition in obesity
 
Not low carb per se, but I expect this interesting observation will probably be of interest to forum members regardless.


Quote:
Doctors urged to tackle malnutrition in obesity

A recent editorial calls on doctors to address the underrecognized problem of malnutrition among individuals with obesity to help prevent early death from cardiovascular events.


A study has found that malnutrition is common among people with acute coronary syndrome, which is the sudden reduction of blood flow to the heart that causes angina or a heart attack.

The researchers — at the University Hospital Álvaro Cunqueiro in Vigo, Spain — found that malnutrition in these individuals was an independent risk factor for all-cause mortality and major cardiovascular events, such as stroke or another heart attack.

Surprisingly, they found that malnutrition was common even among those with overweight or obesity.

The results appear in the Journal of the American College of Cardiology.

In an accompanying editorial, two cardiologists write that physicians commonly perceive malnutrition to be a problem that only affects people who are “undernourished” — in other words, underweight.

In fact, individuals with overweight or obesity are often malnourished as a result of their low intake of micronutrients and the poor quality of the foods that they eat.

“Malnutrition is a largely underrecognized and undertreated condition in patients with increased body mass index, as increased abdominal girth is too often mistaken for overnutrition rather than undernutrition,” says Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver, CO.

Dr. Freeman co-authored the editorial with Dr. Monica Aggarwal, who is an associate professor of medicine at the University of Florida in Gainesville.

Quality not quantity

“It’s important to dispel the thought that weight is correlated with food quality and that [patients with obesity] are not at risk of malnutrition,” says Dr. Freeman.

The World Health Organization (WHO) estimate that 462 million adults have underweight worldwide, whereas 1.9 billion have overweight or obesity. However, they note that the term malnutrition can apply to both of these groups.

The researchers in Spain conducted a retrospective analysis of 5,062 people admitted to the University Hospital of Vigo with acute coronary syndrome.

They calculated the body mass index (BMI) of each person and scored their nutritional status using three standard measures: the Controlling Nutritional Status score, the Nutritional Risk Index, and the Prognostic Nutritional Index.

These measures use different combinations of values, such as BMI and blood levels of albumin, white blood cells, and cholesterol, to estimate the quality of the nutrition that a person is receiving.

According to these three measures, between 8.9% and 39.5% of all of the participants — depending on the specific measure — were moderately or severely malnourished.

Although those whose BMI labeled them as having underweight were the most likely to be moderately or severely malnourished, between 8.4% and 36.7% of those whose BMI suggested they had overweight or obesity fell into these categories.

Moreover, up to 57.8% of those with overweight or obesity had some degree of malnutrition, again depending on the index used.

During the median follow-up period of 3.6 years, 20.7% of the participants had a major cardiovascular event, and 16.4% of them died.

After adjusting for other risk factors, malnutrition was associated with a significantly increased risk of having a major cardiovascular event and dying from any cause.

Assessment and counseling

Previous research has linked poor nutrition to serious health conditions, including diabetes, hypertension, and heart disease.

“It is imperative that individuals undergo nutritional assessments and are offered counseling and resources to ensure they are taking in the right nutrients to adequately fuel their body,” says Dr. Freeman.

“Paying lip service with the usual phrases, such as ‘Be sure to exercise and eat right,’ simply doesn’t cut it,” he adds. “Clinicians should be well-versed in the dietary patterns known to reduce or even reverse cardiovascular disease, as well as physical activity guidelines and self-care practices, such as stress relief, mindfulness, and good quality sleep.”

Concluding their paper, the study authors write:

“Malnutrition is common among patients with [acute coronary syndrome] and is strongly associated with increased mortality and cardiovascular events. Clinical trials are needed to prospectively evaluate the efficacy of nutritional interventions on outcomes in patients with [acute coronary syndrome].”

The study had some limitations. The participants’ scores on the three different nutrition indices varied widely, which suggests that these measures do not precisely reflect the quality of nutrition.

In addition, the participants did not fill out food questionnaires or keep diaries of their food intake, so the study was unable to provide any direct insights into their diet.


https://www.medicalnewstoday.com/ar...tion-in-obesity


Ms Arielle Wed, Oct-07-20 06:50

Doctors cant teach nutrition to patients.....they are as ignorant as their patients.

And ya, its easy to see malnutrition as obesity. Its in the 'thin" people too. The TOFI's.

The ailses in the middle of a grocery store where the nutritionally deficient is displayed FAR out numbers the footage of the outer perimeter.

Even dr atkins wrote about the poor state and need to build up the nutritional state of those who ate the standard American diet. Medical study is 20 plus years behind Dr Atkins, at least.( Likely back to his first edition in '72, sooooo 50 years!)

Dodger Wed, Oct-07-20 09:03

The carbage that many people continuosly eat causes malnutrition.

Quote:
...scored their nutritional status using three standard measures: the Controlling Nutritional Status score, the Nutritional Risk Index, and the Prognostic Nutritional Index
I have never heard of any of these measures.

GRB5111 Wed, Oct-07-20 09:11

I agree with Arielle. If doctors are expected to teach nutrition, they better adjust the curriculum in medical school. Then, they'll learn to eat less, move more and stay away from red and processed meats and sources of saturated fats. Can't wait for that :bash:

Merpig Wed, Oct-07-20 11:13

Quote:
Originally Posted by GRB5111
I agree with Arielle. If doctors are expected to teach nutrition, they better adjust the curriculum in medical school. Then, they'll learn to eat less, move more and stay away from red and processed meats and sources of saturated fats. Can't wait for that :bash:
Exactly, in an article about obesity and Covid in the NY Times a week or two ago there were lots of comments - the mostly traditional "put down your fork you fat pig" sort of comments.

One doctor replied "I'm a doctor, and I know the solution. You need to cut down on what you eat and get more exercise" the classic "eat less, move more" most doctors suggest. And said he couldn't understand why his patients couldn't seem to do it when the answer was so obvious.

Once woman replied "if 95% of your patients can't follow your advice (which is about the failure rate of the 'eat less, move more' advice) then maybe the problem is not your patients, but that the advice you're giving them is wrong". And naturally everyone jumped all over her telling her she was an idiot.

BawdyWench Thu, Oct-08-20 07:12

But it's not just the "carbage" and poor food choices causing the malnutrition. I've been following a low-carb whole-food lifestyle since the late 1990s. Yes, I slip up and eat carbage sometimes, but 90% of the time I consider my diet to be filled with healthful foods.

Around 2014 when I was seeing a new doc and complaining that "I'm doing everything right and still can't lose weight," he had me do several nutrition tests (like NutrEval and others) and stool tests to determine how my body was using the nutrients I was taking in. Turns out my digestion was sub-par and I was on the verge of malnutrition. He said this explained why I kept gaining and couldn't lose the fat. Since my body couldn't digest/metabolize the food, it was simply storing it as fat.

The recommendation was for me to take several different probiotics every day and to take digestive enzymes every time I eat something.

I will admit that I don't always do this, probably not even half the time. Why? I wish someone would tell me. I set reminders on my computer and phone, I've tried keeping my supplements in the bathroom, or the kitchen, or in my home office, thinking that if I see them, I'll take them. Nope. After a day or two I don't even notice them anymore.

And get this. One of my cats needs to take 3 medications morning and night, and has since last February. Do you think I've forgotten to give them to him even once? Nope. But I routinely forget to take my own meds/supplements.

deirdra Thu, Oct-08-20 10:30

Quote:
Originally Posted by BawdyWench
And get this. One of my cats needs to take 3 medications morning and night, and has since last February. Do you think I've forgotten to give them to him even once? Nope. But I routinely forget to take my own meds/supplements.
I was the same way until I kept my own supplements with the cats' meds and we took them together!

BawdyWench Thu, Oct-08-20 10:45

Quote:
Originally Posted by deirdra
I was the same way until I kept my own supplements with the cats' meds and we took them together!

Tried that, too. Still didn't work. But, your post made me go take them all just now. :lol:


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