Nutrition and nutritional status of underweight patients
AbstractInsufficient body weight is one of the manifestations of nutritional disorders. Diseases associated with malnutrition occur in 10-12% of the population.
The aim of the work was to study indicators of nutritional status and actual nutrient intake in patients with insufficient body weight.
Material and methods. The study included 48 women aged 31.4±11.8 years, with a body mass index below 18.5 kg/m2. The body composition was estimated by bioelectrical impedance analysis. Nutrient intake was assessed using food frequency questionnaire, physical activity was evaluated by the survey method, using the computer program “Evaluation of nutrition”, also blood biochemical parameters were determined.
Results. Body fat mass was below average values in 93.8% of patients, while only 50.0% of women had a skeletal muscle deficiency, and 10.4% surveyed had skeletal muscle mass above average values. The energy value of the daily diet was 1982 ±282 kcal, and daily energy expenditure was 2158±255 kcal. In the structure of the diet, fats prevailed (42.0±10.5% of daily calorie intake) and there was a significant lack of total carbohydrates (39.9±10.4% of daily calorie intake) and dietary fiber. Fat intake was exceeded in 92.9% of patients. Insufficient carbohydrate intake was also observed in 92.9% of patients. In most patients, daily intake of potassium, calcium, magnesium, iron, B vitamins did not reach the recommended level, while sodium and phosphorus intake was excessive. The nutrient intake imbalance affected blood biochemical parameters in hypercholesterolemia (in 41.7% of patients) and hypertriglyceridemia (31.3%), and decreased calcium (30.0%), iron (12.8%) and vitamin D (52.2%) levels.
Conclusion. Thus, for underweight patients, correction of the diet and dispensary observation is required to determine body composition and biochemical parameters, in particular, the fat and muscle components of the body weight, lipid metabolism indicators, the supply with macro- and micronutrients in order to develop treatment and prevention tactics of diet-related diseases, combined with reduced body weight.
Keywords:low body weight, nutritional status, anthroponutriciology, body composition, diet
Funding. Research was carried out at the expense of subsidies for the implementation of a state task within the framework of the Exploratory Research Program (topic No. 0410-2020-0004).
Conflict of interest. The authors declare no conflicts of interest.
For citation: Burlyaeva E.A., Prunceva Т.А., Korotkova T.N., Semenov M.M. Nutrition and nutritional status of underweight patients. Voprosy pitaniia [Problems of Nutrition]. 2021; 90 (6): 77-84. DOI: https://doi.org/10.33029/0042-8833-2021-90-6-77-84 (in Russian)
REFERENCES
1. Atamanov V.M., Demicheva T.P., Ivashova E.S. Psychosomatic and organic causes of cachexia. Eksperimental’naya i klinicheskaya gastoenterologiya [Experimental and Clinical Gastroenterology]. 2016: 3 (127): 56. DOI: https://doi.org/10.18821/0023-2149-2018-96-3-262-266 (in Russian)
2. Klochkova I.S., Astaf’eva L.I., Kadashev B.A., Sidneva Yu.G., Kalinin P.L. Pathogenetic aspects of cachexia syndrome. Ozhirenie i metabolism [Obesity and Metabolism]. 2020; 17 (1): 33–40. DOI: https://doi.org/10.14341/omet10173 (in Russian)
3. Zakharova L.I. Anorexia nervosa: prevalence, diagnostic criteria and psychosomatic relationships (review). Nauchnye rezul’taty biomeditsinskikh issledovaniy [Scientific Results of Biomedical Research]. 2019; 5 (1):108–21. DOI: https://doi.org/10.18413/2313-8955-2019-5-1-0-8 (in Russian)
4. Golubnitschaja O., Liskova A., Koklesova L., Samec M., Biringer K., Büsselberg D., et al. Caution, «normal» BMI: health risks associated with potentially masked individual underweight – EPMA Position Paper 2021. EPMA J. 2021; 12 (3): 243–64. DOI: https://doi.org/10.1007/s13167-021-00251-4
5. Lowe M. R., Piers A. D., Benson L. Weight suppression in eating disorders: a research and conceptual update. Curr Psychiatry Rep. 2018; 20 (10): 80. DOI: https://doi.org/10.1007/s11920-018-0955-2
6. Do J.G., Park C.H., Lee Y.T., Yoon K.J. Association between underweight and pulmonary function in 282,135 healthy adults: a cross-sectional study in Korean population. Sci Rep. 2019; 9 (1): 14308. DOI: https://doi.org/10.1038/s41598-019-50488-3
7. Federal State Statistics Service. Selective observation of the diet of the population. URL: https://rosstat.gov.ru/free_doc/new_site/food18/index.html (date of access November 18 2020) (in Russian)
8. Tutelyan V.A. Healthy food for public health. Obshchestvennoe zdorov’e [Public Health]. 2021; 1 (1): 56–64. DOI: https://doi.org/10.21045/2782-1676-2021-1-1-56-64 (in Russian)
9. Nikityuk D.B. Anthroponutriciology: the development of the ideas of the founders of a new scientific direction. Voprosy pitaniia [Problems of Nutrition]. 2020; 89 (4): 82–8. DOI: https://doi.org/10.24411/0042-8833-2020-10044 (in Russian)
10. Kaufmann L.K., Moergeli H., Milos G.F. Lifetime weight characteristics of adult in patients with severe anorexia nervosa: maximal lifetime BMI predicts treatment outcome. Front Psychiatry. 2021; 12: 682952. DOI: https://doi.org/10.3389/fpsyt.2021.682952
11. Tutelyan V.A., Nikityuk D.B., Klochkova S.V., Alekseeva N.T., Pogonchenkova I.V., Rassulova M.A., et al. Using the method of complex anthropometry in sports and clinical practice. Moscow: Sport, 2018. ISBN 978-5-9500179-9-5. (in Russian)
12. Lebiedowska A., Hartman-Petrycka M., Błońska-Fajfrowska B. How reliable is BMI? Bioimpedance analysis of body composition in underweight, normal weight, overweight, and obese women. Ir J Med Sci. 2021; 190 (3): 993–8. DOI: https://doi.org/10.1007/s11845-020-02403-3
13. Rudnev S.G., Soboleva N.P., Sterlikov S.A., et al. Bioimpedance study of the body composition in Russian population. Moscow: RIO TsNIIOIZ, 2014: 493 p. ISBN 5-94116-018-6. (in Russian)
14. Sudakov K.V Normal physiology. Moscow: Meditsinskoe informatsionnoe agentstvo, 2006: 75–8. ISBN 5894812941. (in Russian)
15. Burlyaeva E.A., Kambarov A.O., Nikityuk D.B. Changes in the nutritional structure of the population of Russia for 100 years. Klinicheskoe pitanie i metabolism [Clinical Nutrition and Metabolism]. 2020; 1 (1): 17–26. DOI: https://doi.org/10.36425/clinnutrit21188 (in Russian)
16. Suplotova L.A., Avdeeva V.A., Pigarova E.A., Rozhinskaya L.Y., Troshina E.A. Vitamin D deficiency in Russia: the first results of a registered, non-interventional study of the frequency of vitamin D deficiency and insufficiency in various geographic regions of the country. Problemy endokrinologii [Problems of Endocrinology]. 2021; 67 (2): 84–92. DOI: https://doi.org/10.14341/probl12736 (in Russian)