Browsing Han Publications by Author "Schueren, M.A.E. de van der"

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Diseases, Health-Related Problems, and the Incidence of Malnutrition in Long-Term Care Facilities
Borkent, J.W. ; Hout, H.P.J. van ; Feskens, E.J.M. ; Naumann, E. ; Schueren, M.A.E. de van der
2023, Article / Letter to editor (International Journal of Environmental Research and Public Health, (2023))
Too low protein and energy intake in nursing homes residents
Manders, M ; Nijhof, A ; Wijker, L ; Feskens, E ; Naumann, E. ; Schueren, M.A.E. de van der ; Borkent, J.W.
2023, Article / Letter to editor (Nutrition, iss. 110, (2023))
Behavioral and Cognitive Problems as Determinants of Malnutrition in Long-Term Care Facilities, a Cross-Sectional and Prospective Study
Borkent, J.W. ; Hout, H.P.J. van ; Feskens, E.J.M. ; Naumann, E. ; Schueren, M.A.E. de van der
2022, Article / Letter to editor (Journal of Nutrition, Health & Aging, vol. 26, iss. 8, (2022), pp. 749-759)
Wat kan digitale voedingscoach LIZ bij kwetsbare ouderen thuis betekenen in de dieetbehandeling
Kotten-Lips, K. ; De Graaf-Spikmans, F. ; Schueren, M.A.E. de van der ; Vastenburg, M. ; Kruif, A. De
2022, Article / Letter to editor (Nederlands Tijdschrift voor Voeding & Diëtetiek, vol. 77, (2022), pp. 26-31)
Evaluation of Allied Healthcare in Patients Recovering from Covid-19: Study Protocol and Baseline Data of a National Prospective Cohort Study.
Bie, R.A. de ; Verburg, K. ; Agasi-Idenburg, C. ; Cup, E.H.C. ; Dekker, C. ; Dongen, J.M. van ; Geleijn, E. ; Gerards, M.H.G. ; Graff, M. ; Heerde, R. Van ; Kalf, H. ; Kammerer, M. ; Kruif, A. De ; Kruizenga, H.M. ; Leeden, M van der ; Lenssen, T.A.F. ; Meijer, W.M. ; Ostelo, R. ; Ronteltap, A. ; Schaaf, M. Van der ; Schueren, M.A.E. de van der ; Slotegraaf, A.I. ; Veenhof, C. ; Hoogeboom, T.J. ; Wees, P. Van der ; Oers, S.M.D. van et al. sine al.
2022, Article / Letter to editor (Journal of Rehabilitation Medicine, (2022), pp. jrm00309)OBJECTIVE: To report the study protocol and baseline characteristics of a prospective cohort study to evaluate longitudinal recovery trajectories of patients recovering from COVID-19 who have visited a primary care allied health professional. DESIGN: Prospective cohort study with a mixed-methods approach. PATIENTS: Patients recovering from COVID-19 treated by primary care dietitians, exercise therapists, occupational therapists, physical therapists and/or speech and language therapists in the Netherlands. METHODS: The prospective study will measure primary outcome domains: participation, health-related quality of life, fatigue, physical functioning, and costs, at baseline, 3, 6, 9 and 12 months. Interviews, on the patients' experiences with allied healthcare, will be held with a subsample of patients and allied health professionals. RESULTS: The cohort comprises 1,451 patients (57% female, mean age 49 (standard deviation 13) years). Preliminary results for the study cohort show that 974 (67%) of the participants reported mild/moderate severity symptoms during the infection period and patients reported severe complaints in activities of daily living compared with previous research in other patient populations. Both quantitative and qualitative, will provide insight into the recovery of patients who are treated by allied health professionals. CONCLUSION: This preliminary report describes how the prospective study aims to longitudinally evaluate the recovery trajectories and related costs of patients recovering from COVID-19 who are treated by 1 or more allied health professionals in the Netherlands. In addition, baseline data of patients in the cohort are presented.
Malnutrition risk screening: New insights in a new era.
Schueren, M.A.E. de van der ; Jager-Wittenaar, H
2022, Article / Letter to editor (Clinical Nutrition, vol. 41, iss. 10, (2022), pp. 2163-2168)Twenty years ago, ESPEN published its "Guidelines for nutritional screening 2002", with the note that these guidelines were based on the evidence available until 2002, and that they needed to be updated and adapted to current state of knowledge in the future. Twenty years have passed, and tremendous progress has been made in the field of malnutrition risk screening. Many screening tools have been developed and validated for different patient groups and different health care settings. Some countries even have introduced mandatory screening for malnutrition at admission to hospital. Yet, changes in society and healthcare require a reflection on current practice and policies regarding malnutrition risk screening. In this opinion paper, we share our perspectives on malnutrition risk screening in the twenty-twenties, addressing the changing and varying profile of the malnourished individual, the goals of screening and screening tools (i.e., preventive or reactive), the construct of malnutrition risk (i.e., screening for risk factors or screening for existing malnutrition), and screening alongside a patient's journey.
Mapping ongoing nutrition intervention trials in muscle, sarcopenia, and cachexia: a scoping review of future research.
Orsso, C.E. ; Montes-Ibarra, M. ; Findlay, M ; Meij, B.S. van der ; Schueren, M.A.E. de van der ; Landi, F. ; Laviano, A. ; Prado, C.M.
2022, Article / Letter to editor (Journal of Cachexia Sarcopenia and Muscle, vol. 13, iss. 3, (2022), pp. 1442-1459)Muscle loss alone, or in the context of sarcopenia or cachexia, is a prevalent condition and a predictor of negative outcomes in aging and disease. As adequate nutrition is essential for muscle maintenance, a growing number of studies has been conducted to explore the role of specific nutrients on muscle mass or function. Nonetheless, more research is needed to guide evidence-based recommendations. This scoping review aimed to compile and document ongoing clinical trials investigating nutrition interventions as a strategy to prevent or treat low muscle mass or function (strength and physical performance), sarcopenia, or cachexia. ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform were searched up to 21 April 2021 for planned and ongoing trials. Randomized controlled trials with ≥20 participants per arm were included based on intent to explore the effects of nutrition interventions on muscle-related outcomes (i.e. muscle mass or strength, physical performance, or muscle synthesis rate) in both clinical and non-clinical conditions (i.e. aging). Two reviewers independently screened records for eligibility, and a descriptive synthesis of trials characteristics was conducted. A total of 113 trials were included in the review. Most trials (69.0%) enroll adults with clinical conditions, such as cancer (19.5%), obesity and metabolic diseases (16.8%), and musculoskeletal diseases (10.7%). The effects of nutrition interventions on age-related muscle loss are explored in 31% of trials. Although nutrition interventions of varied types were identified, food supplements alone (48.7%) or combined with dietary advice (11.5%) are most frequently reported. Protein (17.7%), amino acids (10.6%), and β-hydroxy-β-methylbutyrate (HMB, 6.2%) are the top three food supplements' nutrients under investigation. Primary outcome of most trials (54.9%) consists of measures of muscle mass alone or in combination with muscle strength and/or performance (as either primary or secondary outcomes). Muscle strength and physical performance are primary outcomes of 38% and 31.9% of the trials, respectively. These measurements were obtained using a variety of techniques. Only a few trials evaluate muscle synthesis rate either as a primary or secondary outcome (5.3%). Several nutrition studies focusing on muscle, sarcopenia, and cachexia are underway and can inform future research in this area. Although many trials have similar type of interventions, methodological heterogeneity may challenge study comparisons, and future meta-analyses aiming to provide evidence-based recommendations. Upcoming research in this area may benefit from guidelines for the assessment of therapeutic effects of nutrition interventions.
Richtlijn Kwetsbare Ouderen. Praktische handvatten en kwalitatief betere zorg
Vreeken, H. ; Schueren, M.A.E. de van der
2022, Article / Letter to editor (Fysiopraxis, (2022), pp. 38-41)
The association between polypharmacy and malnutrition(risk) in older people: A systematic review.
Kok, W.E. ; Haverkort, E.B. ; Algra, Y.A. ; Mollema, J. ; Hollaar, V.R.Y. ; Naumann, E. ; Schueren, M.A.E. de van der ; Jerković-Ćosić, K
2022, Article / Letter to editor (Clinical nutrition ESPEN, vol. 49, (2022), pp. 163-171)BACKGROUND & AIM: Malnutrition adversely influences a broad range of physical and psychological symptoms. Although polypharmacy is often mentioned to be associated with malnutrition, especially in older people it is unclear to what extent. The aim of this systematic review was to investigate the extent of the association between polypharmacy and malnutrition in older people. METHODS: The methodology followed the guidelines of the Cochrane Collaboration. Literature search was performed in PubMed, CINAHL and Embase. The population of interest for this systematic review were people of 65 years and older with polypharmacy. Because there is ambiguity with regard to the actual definition of malnutrition and polypharmacy, in this systematic review all articles describing malnutrition prevalence rates were included, regardless of the criteria used. Both observational and intervention studies were screened for eligibility. Selection and quality assessment of the included full text studies was assessed by two reviewers independently. A level of evidence and methodological quality score was adjudged to each article based on this assessment. RESULTS: A total of 3126 studies were retrieved by the literature search, of which seven studies were included in this systematic review. There was considerable variation in the definition of polypharmacy between studies. Two studies defined polypharmacy as the use of five or more drugs, two studies as the use of six or more drugs, two studies provided a mean and standard deviation that corresponded to the minimum of five drugs, and one study distinguished between polypharmacy (five or more drugs) and excessive polypharmacy (ten or more drugs). However, all studies showed a statistically significant association between (the risk) of becoming malnourished and polypharmacy regardless the instrument or criterion used to define risk of malnutrition. Studies presented the associations respectively as OR ≥ 1.177, p-value ≤ 0.028, β ≥ -0.62 and r  ≥ -0.31. CONCLUSION: This review demonstrated a statistically significant association between polypharmacy and malnutrition. Further research is required to determine the magnitude of the effect by increased number of drugs in combination with the type of drugs, on the risk of malnutrition.
The protein gap-increasing protein intake in the diet of community-dwelling older adults: a simulation study.
Verwijs, M.H. ; Schueren, M.A.E. de van der ; Ocké, M.C. ; Ditewig, J. ; Linschooten, J.O ; Roodenburg, AJC ; Groot, L.C.P.G.M. de
2022, Article / Letter to editor (Public Health Nutrition, vol. 25, iss. 2, (2022), pp. 248-256)OBJECTIVE: Approximately 50 % of Dutch community-dwelling older adults does not meet protein recommendations. This study assesses the effect of replacing low protein foods with protein-rich alternatives on the protein intake of Dutch community-dwelling older adults. DESIGN: The Dutch National Food Consumption Survey-Older Adults 2010-2012 (DNFCS-OA) was used for scenario modelling. Dietary intake was estimated based on two 24-h recalls. Commonly consumed products were replaced by comparable products rich in protein (scenario 1), foods enriched in protein (scenario 2) and a combination of both (scenario 3). Replacement scenarios were confined to participants whose dietary protein intake was < 1•0 g/kg BW/d (n 391). Habitual protein intake of all older adults was estimated, adjusting for effects of within-person variation in the 2-d intake data. SETTING: A simulation study based on the DNFCS-OA. PARTICIPANTS: 727 Dutch community-dwelling older adults aged 70+. RESULTS: Mean protein intake of the total population increased from 1•0 to 1•2 g/kg BW/d (scenarios 1 and 2) and to 1•3 g/kg BW/d (scenario 3). The percentage of participants with intakes of ≥ 1•0 g/kg BW/d increased from 47•1 % to 91•4 %, 90•2 % and 94•6 %, respectively, in scenarios 1, 2 and 3. The largest increases in protein intake were due to replacements in food groups: yoghurt, cream desserts and pudding, potatoes, vegetables and legumes and non-alcoholic beverages and milk in scenario 1 and bread; yoghurt, cream desserts and pudding and soups in scenario 2. CONCLUSIONS: This simulation model shows that replacing low protein foods with comparable alternatives rich in protein can increase the protein intake of Dutch community-dwelling older adults considerably. Results can be used as a basis for nutritional counselling.
Nutritional problems of patients with COVID-19 receiving dietetic treatment in primary care.
Slotegraaf, A.I. ; Schueren, M.A.E. de van der ; Wierdsma, N.J. ; Weijs, P.J.M. ; Kruizenga, H.M.
2022, Article / Letter to editor (Journal of Human Nutrition and Dietetics, (2022))BACKGROUND: The nutritional problems of patients who are hospitalised for COVID-19 are becoming increasingly clear. However, a large group of patients have never been hospitalised and also appear to experience persistent nutritional problems. The present study describes the nutritional status, risk of sarcopaenia and nutrition-related complaints of patients recovering from COVID-19 receiving dietetic treatment in primary care. METHODS: In this retrospective observational study, data were collected during dietetic treatment by a primary care dietitian between April and December 2020. Both patients who had and had not been admitted to the hospital were included at their first visit to a primary care dietitian. Data on nutritional status, risk of sarcopaenia and nutrition-related complaints were collected longitudinally. RESULTS: Data from 246 patients with COVID-19 were collected. Mean ±SD age was 57 ±16 years and 61% of the patient population was female. At first consultation, two thirds of patients were classified as overweight or obese (body mass index >25nkg m(-2) ). The majority had experienced unintentional weight loss because of COVID-19. Additionally, 55% of hospitalised and 34% of non-hospitalised patients had a high risk of sarcopaenia. Most commonly reported nutrition-related complaints were decreased appetite, shortness of breath, changed or loss of taste and feeling of being full. Nutrition-related complaints decreased after the first consultation, but remained present over time. CONCLUSIONS: In conclusion, weight changes, risk of sarcopaenia and nutrition-related complaints were prevalent in patients with COVID-19, treated by a primary care dietitian. Nutrition-related complaints improved over time, but remained prevalent until several months after infection.
Protein Intake among Community-Dwelling Older Adults: The Influence of (Pre-) Motivational Determinants.
Verwijs, M.H. ; Haveman-Nies, A. ; Borkent, J.W. ; Linschooten, J.O ; Roodenburg, AJC ; Groot, L.C.P.G.M. de ; Schueren, M.A.E. de van der
2022, Article / Letter to editor (Nutrients, vol. 14, iss. 2, (2022))An adequate protein intake is important for healthy ageing, yet nearly 50% of Dutch community-dwelling older adults do not meet protein recommendations. This study explores protein intake in relation to eight behavioral determinants (I-Change model) among Dutch community-dwelling older adults. Data were collected through an online questionnaire from October 2019-October 2020. Protein intake was assessed by the Protein Screener 55+, indicating a high/low chance of a low protein intake (<1.0 g/kg body weight/day). The behavioral determinants of cognizance, knowledge, risk perception, perceived cues, attitude, social support, self-efficacy and intention were assessed by evaluating statements on a 7-point Likert scale. A total of 824 Dutch community-dwelling older adults were included, recruited via online newsletters, newspapers and by personal approach. Poisson regression was performed to calculate quartile-based prevalence ratios (PRs). Almost 40% of 824 respondents had a high chance of a low protein intake. Univariate analyses indicated that lower scores for all different behavioral determinants were associated with a higher chance of a low protein intake. Independent associations were observed for knowledge (Q4 OR = 0.71) and social support (Q4 OR = 0.71). Results of this study can be used in future interventions aiming to increase protein intake in which focus should lie on increasing knowledge and social support.
Inaugural address (inaugurele rede): The proof of the pudding is in the eating
Schueren, M.A.E. de van der
2021, Inaugural lecture
Interventies voor patiënten met risico op ondervoeding
Berg, G.H. van den ; Schueren, M.A.E. de van der ; Vermeulen, H. ; Huisman - de Waal, G.
2021, Article / Letter to editor (TVZ : verpleegkunde in praktijk en wetenschap, vol. 2021, iss. 4, (2021), pp. 42-43)
ESPEN practical guideline: Clinical Nutrition in cancer
Muscaritoli, M. ; Arends, J ; Bachmann, P ; Baracos, V ; Barthelemy, N ; Bertz, H ; Bozzetti, F ; Hutterer, E ; Isenring, EA ; Kaasa, S ; Krznaric, Z ; Laird, B ; Larsson, M ; Laviano, A. ; Muhlebach, S ; Oldervoll, L ; Ravasco, P ; Solheim, TS ; Strasser, F ; Schueren, M.A.E. de van der ; Preiser, JC ; Bischoff, SC et al. sine al.
2021, Article / Letter to editor (Clinical Nutrition, vol. 40, iss. 5, (2021), pp. 2898-2913)Background: This practical guideline is based on the current scientific ESPEN guidelines on nutrition in cancer patients. Methods: ESPEN guidelines have been shortened and transformed into flow charts for easier use in clinical practice. The practical guideline is dedicated to all professionals including physicians, dieticians, nutritionists and nurses working with patients with cancer. Results: A total of 43 recommendations are presented with short commentaries for the nutritional and metabolic management of patients with neoplastic diseases. The disease-related recommendations are preceded by general recommendations on the diagnostics of nutritional status in cancer patients. Conclusion: This practical guideline gives guidance to health care providers involved in the management of cancer patients to offer optimal nutritional care. (c) 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.
Cachexia and Dietetic Interventions in Patients With Esophagogastric Cancer: A Multicenter Cohort Study
Dijksterhuis, WPM ; Latenstein, AEJ ; Kleef, JJ van ; Verhoeven, RHA ; Vries, JHM de ; Slingerland, M ; Steenhagen, E ; Heisterkamp, J ; Timmermans, LM ; Schueren, M.A.E. de van der ; Oijen, MGH van ; Beijer, S ; Laarhoven, HWM van et al. sine al.
2021, Article / Letter to editor (Journal of the National Comprehensive Cancer Network, vol. 19, iss. 2, (2021), pp. 144-+)Background: Cachexia is common in patients with esophagogastric cancer and is associated with increased mortality. Nutritional screening and dietetic interventions can be helpful in preventing evolvement of cachexia. Our aim was to study the real-world prevalence and prognostic value of pretreatment cachexia on overall survival (OS) using patient-reported weight loss, and to explore dietetic interventions in esophagogastric cancer. Materials and Methods: Patients with esophagogastric cancer (2015-2018), regardless of disease stage, who participated in the Prospective Observational Cohort Study of Esophageal-Gastric Cancer Patients (POCOP) and completed patient-reported outcome measures were included. Data on weight loss and dietetic interventions were retrieved from questionnaires before start of treatment (baseline) and 3 months thereafter. Additional patient data were obtained from the Netherlands Cancer Registry. Cachexia was defined as self-reported >5% half-year body weight loss at baseline or >2% in patients with a body mass index (BMI) <20 kg/m(2) according to the Fearon criteria. The association between cachexia and OS was analyzed using multivariable Cox proportional hazard analyses adjusted for sex, age, performance status, comorbidities, primary tumor location, disease stage, histology, and treatment strategy. Results: Of 406 included patients, 48% had pretreatment cachexia, of whom 65% were referred for dietetic consultation at baseline. The proportion of patients with cachexia was the highest among those who received palliative chemotherapy (59%) or best supportive care (67%). Cachexia was associated with decreased OS (hazard ratio, 1.52; 95% CI, 1.11-2.09). Median weight loss after 3-month follow-up was lower in patients with cachexia who were referred to a dietician at baseline compared with those who were not (0% vs 2%; P=.047). Conclusions: Nearly half of patients with esophagogastric cancer have pretreatment cachexia. Dietetic consultation at baseline was not reported in more than one-third of the patients with cachexia. Because cachexia was independently associated with decreased survival, improving nutritional screening and referral for dietetic consultation are warranted to prevent further deterioration of malnutrition and mortality.
Micronutrient deficiencies and anaemia in patients after pancreatoduodenectomy
Latenstein, AEJ ; Gerven, R van ; Grevers, F ; Pek, CJ ; Koerkamp, BG ; Hartog, H ; Schueren, M.A.E. de van der ; Besselink, MG ; Eijck, CHJ van
2021, Article / Letter to editor (British Journal of Surgery, vol. 108, iss. 2, (2021), pp. E74-E75)
Experts reageren op Voedingsnormen voor eiwitten voor Ouderen
Meij, B.S. van der ; Grootswagers, P. ; Groot, L.C.P.G.M. de ; Schueren, M.A.E. de van der
2021, Article / Letter to editor (Nederlands Tijdschrift voor Voeding & Diëtetiek, vol. 76, (2021), pp. 39-41)
Cachexia, dietetic consultation, and survival in patients with pancreatic and periampullary cancer: A multicenter cohort study
Latenstein, AEJ ; Dijksterhuis, WPM ; Mackay, TM ; Beijer, S ; Eijck, CHJ van ; Hingh, IHJT de ; Molenaar, IQ ; Oijen, MGH van ; Santvoort, HC van ; Schueren, M.A.E. de van der ; Vos-Geelen, J de ; Vries, JHM de ; Wilmink, JW ; Besselink, MG ; Laarhoven, HWM van et al. sine al.
2021, Article / Letter to editor (Cancer Medicine (Malden, Ma), (2021))It is unclear to what extent patients with pancreatic cancer have cachexia and had a dietetic consult for nutritional support. The aim was to assess the prevalence of cachexia, dietitian consultation, and overall survival in these patients. This prospective multicenter cohort study included patients with pancreatic cancer, who participated in the Dutch Pancreatic Cancer Project and completed patient reported outcome measures (2015-2018). Additional data were obtained from the Netherlands Cancer Registry. Cachexia was defined as self-reported >5% body weight loss, or >2% in patients with a BMI <20 kg/m(2) over the past half year. The Kaplan-Meier method was used to analyze overall survival. In total, 202 patients were included from 18 centers. Cachexia was present in 144 patients (71%) and 81 of those patients (56%) had dietetic consultation. Cachexia was present in 63% of 94 patients who underwent surgery, 77% of 70 patients who received palliative chemotherapy and 82% of 38 patients who had best supportive care. Dietitian consultation was reported in 53%, 52%, and 71%, respectively. Median overall survival did not differ between patients with and without cachexia, but decreased in those with severe weight loss (12 months (IQR 7-20) vs. 16 months (IQR 8-31), p = 0.02), as compared to those with <10% weight loss during the past half year. Two-thirds of patients with pancreatic cancer present with cachexia of which nearly half had no dietetic consultation. Survival was comparable in patients with and without cachexia, but decreased in patients with more severe weight loss.
The Association between Malnutrition and Oral Health in Older People: A Systematic Review
Algra, Y. ; Haverkort, L. ; Kok, W. ; Etten-Jamaludin, F van ; Schoot, L. ; Hollaar, V.R.Y. ; Naumann, E. ; Schueren, M.A.E. de van der ; Jerković-Ćosić, K
2021, Article / Letter to editor (Nutrients, vol. 13, (2021))
Senioren onderschatten het belang van adequate eiwitinname
Linschooten, J. ; Verwijs, M. ; Schueren, M.A.E. de van der ; Roodenburg, A.
2021, Article / Letter to editor (Voeding Magazine, iss. 2, (2021), pp. 20-23)
Malnutrition in patients with COVID-19: assessment and consequences
Meij, B.S. van der ; Ligthart-Melis, GC ; Schueren, M.A.E. de van der
2021, Article / Letter to editor (Current Opinion in Clinical Nutrition and Metabolic Care, vol. 24, iss. 6, (2021), pp. 543-554)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. 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.
The effect of oral omega-3 polyunsaturated fatty acid supplementation on muscle maintenance and quality of life in patients with cancer: A systematic review and meta-analysis
Lam, CN ; Watt, AE ; Isenring, EA ; Schueren, M.A.E. de van der ; Meij, B.S. van der
2021, Article / Letter to editor (Clinical Nutrition, vol. 40, iss. 6, (2021), pp. 3815-3826)Background & aims: Omega-3 polyunsaturated fatty acid (PUFA) supplementation has been proposed as a potential therapy for cancer-related malnutrition, which affects up to 70% of patients with cancer. The aim of this systematic review and meta-analysis was to examine the effects of oral omega-3 PUFA supplementation on muscle maintenance, quality of life, body weight and treatment-related toxicities in patients with cancer. Methods: Randomised controlled trials in patients with cancer aged 18 years were retrieved from 5 electronic databases: MEDLINE (via PubMed), EMBASE, CENTRAL, CINAHL (via EBSCOhost), and Web of Science, from database inception until 31st of December 2019. The quality of included studies was assessed using the Cochrane risk of bias tool. Trials supplementing >600 mg/d omega-3 PUFA (oral capsules, pure fish oil or oral nutritional supplements) compared with a control intervention for >3 weeks were included. Meta-analyses were performed in RevMan to determine the mean differences (MD) in muscle mass, quality of life and body weight, and odds ratio (OR) for the incidence of treatmentrelated toxicities between omega-3 PUFA and control groups with 95% confidence intervals (CI) and I2 for heterogeneity. Results: We included 31 publications in patients with various types of cancers and degrees of malnutrition. The Cochrane risk of bias tool graded most trials as 'unclear' or 'high' risk of bias. Meta-analyses showed no significant difference between omega-3 PUFA supplements and control intervention on muscle mass, quality of life and body weight. Oral omega-3 PUFA supplements reduced the likelihood of developing chemotherapy-induced peripheral neuropathy (OR: 0.20; 95% CI: 0.10-0.40; p < 0.001; I2 1/4 0%). Conclusion: This systematic review and meta-analysis indicates that oral omega-3 PUFA supplementation does not improve muscle maintenance, quality of life or body weight in patients with cancer, but may reduce the incidence of chemotherapy-induced peripheral neuropathy. Well-designed large-scale randomised controlled trials in homogenous patient cohorts are required to confirm these findings. (c) 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Cancer cachexia in adult patients: ESMO Clinical Practice Guidelines
Arends, J ; Strasser, F ; Gonella, S ; Solheim, TS ; Madeddu, C ; Ravasco, P ; Buonaccorso, L ; Schueren, M.A.E. de van der ; Baldwin, C ; Chasen, M ; Ripamonti, CI et al. sine al.
2021, Article / Letter to editor (Esmo Open, vol. 6, iss. 3, (2021))
Malnutrition Prevalence Rates among Dutch Nursing Home Residents: What Has Changed over One Decade? A Comparison of the Years 2009, 2013 and 2018
Everink, IHJ ; Haastregt, JCM van ; Manders, M ; Schueren, M.A.E. de van der ; Schols, JMGA
2021, Article / Letter to editor (Journal of Nutrition, Health & Aging, vol. 25, iss. 8, (2021), pp. 999-1005)Objectives To assess changes in prevalence of malnutrition and its associated factors among people living in Dutch nursing homes in 2009, 2013 and 2018. Design Secondary data analysis of the International Prevalence Measurement of Care Quality (LPZ) study. Setting Dutch nursing homes. Participants Residents living at a psychogeriatric or somatic ward in Dutch nursing homes in 2009, 2013 or 2018. Measurements weight and height, unintentional weight loss over the last month and last six months, age, sex, length of stay up to the measurement day, care dependency, and the presence of various diseases (dementia, diabetes mellitus, stroke, diseases of the respiratory system, respiratory diseases and pressure ulcers). Results In total, 14,317 residents were included in this study with a mean age of 82.2, 70.9 female and 66.8% was living on a psychogeriatric ward. Results of this study show relative stability in background characteristics of the nursing home population over the last decade. In the total sample, 16.7% was malnourished and these percentages were 16.6% in 2009, 17.5% in 2013 and 16.3% in 2018. Multiple binary logistic regression analyses revealed having a pressure ulcer, female sex and living on a psychogeriatric department to be positively associated and having diabetes mellitus to be negatively associated with malnutrition throughout the years. These associations were strong and similar across years. Conclusion Even though much attention has been paid to prevent malnutrition in Dutch nursing homes over the last decades, results show a relatively stable malnutrition prevalence rate of around 16%. This leads to the question if nursing staff is able to sufficiently recognize residents with (a risk of) malnutrition, and if they are aware of interventions they could perform to decrease this rate.
Cancer-associated anorexia: Validity and performance overtime of different appetite tools among patients at their first cancer diagnosis
Molfino, A ; Schueren, M.A.E. de van der ; Sanchez-Lara, K ; Milke, P ; Amabile, MI ; Imbimbo, G ; Lazzaro, L Di ; Cavuto, S ; Ronzani, G ; Snegovoy, A ; Gioulbasanis, I ; Laviano, A. et al. sine al.
2021, Article / Letter to editor (Clinical Nutrition, vol. 40, iss. 6, (2021), pp. 4037-4042)Background & aims: Anorexia is a frequent symptom in cancer and we aimed to assess its prevalence among patients at their first cancer diagnosis by different appetite tools and the relationship between each tool with self-reports of food intake. We also tested whether cancer anorexia influences outcomes independently of reduced food intake or body weight loss (BWL) overtime and whether BWL was associated with complications during anticancer-therapy. Methods: Functional Assessment of Anorexia/Cachexia Therapy (FAACT) score, self-assessment of appetite, Anorexia Questionnaire (AQ) and Visual Analog Scale (VAS) were administered. Percent of food intake was used as a criterion measure of anorexia. We registered BWL and anticancer-therapy complications over 3-month-follow-up. Results: 438 cancer patients from 7 cancer-centers worldwide were included. The prevalence of anorexia was 39.9% by FAACT score, 40.2% by VAS, 40.6% by the self-assessment of appetite and 65.4% by AQ. Low food intake (<50%) was reported in 28% of patients. All appetite tools correlated with food intake percent (P < 0.0001). We documented a correlation between self-assessment of appetite, FAACT score, VAS and BWL overtime (P < 0.04). The self-assessment of appetite (P = 0.0152) and the FAACT score (P = 0.043) were associated with BWL independently of anticancer therapies. Among patients with BWL, the risk to develop complications was greater with respect to those who maintained a stable or gained body weight (P = 0.03). Conclusions: In our sample of cancer patients, FAACT score and self-assessment of appetite performed well when low food intake was used as a criterion measure, and revealed an association of anorexia with BWL, which was, in turn, related to the development of anticancer-therapy complications. (c) 2021 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Decision-making regarding oral nutritional supplements for nursing home residents with advanced dementia: A cross-sectional pilot study
Hamersveld-Kramer, M van ; Perry, SIB ; Lodewijks, E ; Vasse, E. ; Schueren, M.A.E. de van der
2021, Article / Letter to editor (Journal of Human Nutrition and Dietetics, (2021))Background Surrogate decision-making regarding oral nutritional supplements (ONS) for nursing home residents with advanced dementia is a complex process. In this cross-sectional study, we assessed whether Dutch dietitians, elderly care physicians (physicians) and surrogate decision-makers (SDMs) differ in the factors that they regard important when considering ONS. We also investigated differences in opinion regarding whether or not ONS is a life-prolonging measure. Methods Through an online survey, 90 dietitians, 53 physicians and 70 SDMs of nursing home residents (all aged >= 65 years old with advanced dementia) rated the level of perceived influence of 11 pre-defined factors on their decision-making, ranked factors in order of importance and stated whether they considered ONS a life-prolonging measure or not. By statistical analysis, we tested differences in the mean sum of ranks for perceived influence differing between groups. We also tested differences in proportions between groups of those who considered ONS a life-prolonging measure. Results Rating of perceived influence significantly differed for six factors. Quality of life was ranked as the most influential factor by all groups. Dietitians significantly differed in their opinion on the life-prolonging effect of ONS from physicians (odds ratio = 0.29, 95% confidence interval = 0.13-0.65), as well as from SDMs (odds ratio = 0.22, 95% confidence interval = 0.10-0.45). Conclusions Although all groups proclaimed quality of life to be first priority in decision-making, we found that Dutch dietitians, physicians and SDMs differed in what they regarded important when considering ONS for nursing home residents with advanced dementia. Regarding the life-prolonging effect of ONS, dietitians differed in opinion from physicians, as well as from SDMs.
The centenary of the Harris-Benedict equations: How to assess energy requirements best? Recommendations from the ESPEN expert group
Bendavid, I ; Lobo, DN ; Barazzoni, R. ; Cederholm, T. ; Coeffier, M ; Schueren, M.A.E. de van der ; Fontaine, E ; Hiesmayr, M. ; Laviano, A. ; Pichard, C ; Singer, P. et al. sine al.
2021, Article / Letter to editor (Clinical Nutrition, vol. 40, iss. 3, (2021), pp. 690-701)Background & aims: The year 2019 marked the centenary of the publication of the Harris and Benedict equations for estimation of energy expenditure. In October 2019 a Scientific Symposium was organized by the European Society for Clinical Nutrition and Metabolism (ESPEN) in Vienna, Austria, to celebrate this historical landmark, looking at what is currently known about the estimation and measurement of energy expenditure. Methods: Current evidence was discussed during the symposium, including the scientific basis and clinical knowledge, and is summarized here to assist with the estimation and measurement of energy requirements that later translate into energy prescription. Results: In most clinical settings, the majority of predictive equations have low to moderate performance, with the best generally reaching an accuracy of no more than 70%, and often lead to large errors in estimating the true needs of patients. Generally speaking, the addition of body composition measurements did not add to the accuracy of predictive equations. Indirect calorimetry is the most reliable method to measure energy expenditure and guide energy prescription, but carries inherent limitations, greatly restricting its use in real life clinical practice. Conclusions: While the limitations of predictive equations are clear, their use is still the mainstay in clinical practice. It is imperative to recognize specific patient populations for whom a specific equation should be preferred. When available, the use of indirect calorimetry is advised in a variety of clinical settings, aiming to avoid under-as well as overfeeding. (C)2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Effects of nursing nutrition interventions on outcomes in malnourished hospital inpatients and nursing home residents: A systematic review
Berg, G.H. van den ; Huisman - de Waal, G. ; Vermeulen, H. ; Schueren, M.A.E. de van der
2021, Article / Letter to editor (International Journal of Nursing Studies, vol. 117, (2021))Context: Malnutrition in institutionalized patients is associated with adverse outcomes and increased costs. Nurses have a crucial role in the recognition and treatment of malnutrition and empowering patients in nutritional care. Objective: This systematic review provides an overview of the effectiveness of nursing nutritional interventions to counteract malnutrition. Data sources: Data were obtained through a systematic search in MEDLINE/PubMed, Cochrane, CINAHL, EMBASE and ISI Web of Science databases from inception to February 15th 2018. Data extraction: Studies were eligible for inclusion when published in English, Spanish or German. Primary outcome parameters were nutritional status and dietary intake. Data analysis: The Evidence analysis checklist from the American Dietetic Association and GRADE were used to evaluate the methodological quality of the studies. Results: Out of 8162 studies, fifteen studies were included in the study, representing nine hospitals and six long-term care facilities. Two main categories of nursing nutrition interventions were identified; the implementation of 1) a nursing nutrition plan focusing on nursing actions in nutritional care or 2) nursing assistance in feeding support, mostly during mealtimes. Studies were heterogeneous and of most of them of low quality. This hampered drawing conclusions on effectiveness of nursing nutrition interventions on malnutrition related outcomes in clinical care. Nevertheless, six out of 15 studies reported a slightly improved nutritional status and/or clinical outcomes as a result of the interventions. Conclusion: This review identified two categories of nursing nutrition interventions to counteract malnutrition. Their effectiveness needs to be further evaluated in future studies. Tweetable abstract: Systematic review of effective Nursing Nutrition Interventions in the management of malnutrition in hospital and nursing home care. (C) 2021 The Author(s). Published by Elsevier Ltd.
De essentiële rol van voeding en beweging bij patiënten met kanker. De laatste stand van zaken vanuit de wetenschap
Schueren, M.A.E. de van der
2021, Article in monograph or in proceedings (Congres Kanker en Leven)
Wetenschappelijk bewijzen dat diëtetiek essentieel is, ook bij herstelzorg na Covid-19
Schueren, M.A.E. de van der
2021, Article / Letter to editor (Voeding Magazine, iss. 1, (2021))
Campagne Eiwitwijs: gezond en fit met eiwit
Linschooten, J. ; Doedée, C. ; Mieghem, N. van ; Verwijs, M. ; Roodenburg, A. ; Schueren, M.A.E. de van der
2021, Article / Letter to editor (Nederlands Tijdschrift voor Voeding & Diëtetiek, vol. 76, iss. 2, (2021), pp. 40-41)
Foodsampler: zijn diëtisten klaar voor nieuwe concepten?
Maassen, F. ; Blokland, F. ; Schueren, M.A.E. de van der ; Oers, S.M.D. van
2021, Article / Letter to editor (Nederlands Tijdschrift voor Voeding & Diëtetiek, vol. 76, iss. 2, (2021), pp. 26-27)
Mineralen tegen long Covid? Een Loppersumse patiënt zweert erbij.
Schueren, M.A.E. de van der
2021, Contribution for newspaper or weekly magazine (Trouw, 3 juni 2021)
Inventarisatie van risicofactoren voor een verminderde voedingstoestand bij thuiswonende Nederlandse ouderen: uitkomsten van zelfscreening
Borkent, J.W. ; Naumann, E. ; Vasse, E. ; Heijden, E.H.A. van der ; Schueren, M.A.E. de van der
2020, Article / Letter to editor (Nederlands Tijdschrift voor Voeding & Diëtetiek, vol. 75, iss. 1, (2020), pp. 19-28)
Eerste hoogleraar Diëtetiek. Eindelijk....het is zover!
Schueren, M.A.E. de van der
2020, Article / Letter to editor (Nederlands Tijdschrift voor Voeding & Diëtetiek, vol. 75, iss. 3, (2020), pp. 6-9)
Global Leadership Initiative on Malnutrition (GLIM): Guidance on Validation of the Operational Criteria for the Diagnosis of Protein-Energy Malnutrition in Adults
Keller, H. ; Schueren, M.A.E. de van der ; Jensen, G.L. ; Barazzoni, R. ; Compher, C. ; Correia, M.I.T.D. ; Gonzalez, M.C. ; Jager-Wittenaar, H ; Pirlich, M. ; Steiber, A ; Waitzberg, D. ; Cederholm, T. et al. sine al.
2020, Article / Letter to editor (Jpen, Journal of Parenteral and Enteral Nutrition, vol. 44, iss. 6, (2020), pp. 992-1003)Background The Global Leadership Initiative on Malnutrition (GLIM) created a consensus-based framework consisting of phenotypic and etiologic criteria to record the occurrence of malnutrition in adults. This is a minimum set of practicable indicators for use in characterizing a patient/client as malnourished, considering the global variations in screening and nutrition assessment, and to be used across different healthcare settings. As with other consensus-based frameworks for diagnosing disease states, these operational criteria require validation and reliability testing, as they are currently based solely on expert opinion. Methods Several forms of validation and reliability are reviewed in the context of GLIM, providing guidance on how to conduct retrospective and prospective studies for criterion and construct validity. Results There are some aspects of GLIM that require refinement; research using large databases can be employed to reach this goal. Machine learning is also introduced as a potential method to support identification of the best cut points and combinations of indicators for use with the different forms of malnutrition, which the GLIM criteria were created to denote. It is noted as well that validation and reliability testing need to occur in a variety of sectors and populations and with diverse persons using GLIM criteria. Conclusion The guidance presented supports the conduct and publication of quality validation and reliability studies for GLIM.
Global Leadership Initiative on Malnutrition (GLIM): Guidance on validation of the operational criteria for the diagnosis of protein-energy malnutrition in adults
Schueren, M.A.E. de van der ; Keller, H. ; Cederholm, T. ; Barazzoni, R. ; Compher, C. ; Correia, M.I.T.D. ; Gonzalez, M.C. ; Jager-Wittenaar, H ; Pirlich, M. ; Steiber, A ; Waitzberg, D. ; Jensen, G.L. et al. sine al.
2020, Article / Letter to editor (Clinical Nutrition, vol. 39, iss. 9, (2020), pp. 2872-2880)Background: The Global Leadership Initiative on Malnutrition (GLIM) created a consensus-based framework consisting of phenotypic and etiologic criteria to record the occurrence of malnutrition in adults. This is a minimum set of practicable indicators for use in characterizing a patient/client as malnourished, considering the global variations in screening and nutrition assessment, and to be used across different health care settings. As with other consensus-based frameworks for diagnosing disease states, these operational criteria require validation and reliability testing as they are currently based solely on expert opinion. Methods: Several forms of validation and reliability are reviewed in the context of GLIM, providing guidance on how to conduct retrospective and prospective studies for criterion and construct validity. Findings: There are some aspects of GLIM criteria which require refinement; research using large data bases can be employed to reach this goal. Machine learning is also introduced as a potential method to support identification of the best cut-points and combinations of operational criteria for use with the different forms of malnutrition, which the GLIM criteria were created to denote. It is noted as well that the validation and reliability testing need to occur in a variety of sectors, populations and with diverse persons completing the criteria. Conclusion: The guidance presented supports the conduct and publication of quality validation and reliability studies for GLIM. (c) 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism and American Society for Parenteral and Enteral Nutrition [Published by Wiley]. All rights reserved.
Ik wil de diëtetiek op een hoger plan brengen
Schueren, M.A.E. de van der
2020, Article / Letter to editor (Suiker in perspectief, vol. 49, (2020), pp. 12)
Interdisciplinary communication and collaboration as key to improved nutritional care of malnourished older adults across health-care settings - A qualitative study
Verwijs, M.H. ; Puijk-Hekman, S. ; Heijden, E. van der ; Vasse, E. ; Groot, L.C.P.G.M. de ; Schueren, M.A.E. de van der
2020, Article / Letter to editor (Health Expectations, (2020))Background Malnutrition is a risk factor for impaired functionality and independence. For optimal treatment of malnourished older adults (OA), close collaboration and communication between all stakeholders involved (OA, their caregivers and health-care and welfare professionals) is important. This qualitative study assesses current collaboration and communication in nutritional care over the continuum of health-care settings and provides recommendations for improvement. Methods Eleven structured focus group interviews and five individual interviews took place in three regions across the Netherlands from November 2017 until February 2018, including OA, caregivers and health-care and welfare professionals. Various aspects of collaboration and communication between all stakeholders were discussed. Interviews were transcribed and analysed using a thematic approach. Results Six main themes emerged: causes of malnutrition, knowledge and awareness, recognition and diagnosis of malnutrition, communication, accountability and food preparation and supply. Physical and social aspects were recognized as important risk factors for malnutrition. Knowledge and awareness regarding malnutrition were acknowledged as being insufficient among all involved. This may impair timely recognition and diagnosis. Responsibility for nutritional care and its communication to other disciplines are low. Food preparation and supply in hospitals, rehabilitation centres and home care are below expected standards. Conclusion Many stakeholders are involved in nutritional care of OA, and lack of communication and collaboration hinders continuity of nutritional care over health-care settings. Lack of knowledge is an important risk factor. Establishing one coordinator of nutritional care is suggested to improve collaboration and communication across health-care settings.
Effectiveness and acceptance of commercially available protein-rich meals and dairy products in increasing protein intake of community-dwelling older adults
Linschooten, J.O ; Beelen, J. ; Schueren, M.A.E. de van der ; Roodenburg, AJC ; Borkent, J.W.
2020, Article / Letter to editor (Proceedings of the Nutrition Society, vol. 79, iss. OCE2, (2020), pp. E482)
Olfactory and gustatory functioning and food preferences of patients with Alzheimer's disease and mild cognitive impairment compared to controls: the NUDAD project
Doorduijn, A.S. ; Schueren, M.A.E. de van der ; Rest, O. van de ; Leeuw, F.A. de ; Fieldhouse, J.L.P. ; Kester, M.I. ; Teunissen, C.E. ; Scheltens, P. ; Flier, W.M. van der ; Visser, M. ; Boesveldt, S. et al. sine al.
2020, Article / Letter to editor (Journal of Neurology, vol. 267, iss. 1, (2020), pp. 144-152)Our aim is to compare olfactory and gustatory function and food preferences of patients with Mild Cognitive Impairment (MCI) and Alzheimer's disease (AD) with controls. We included 22 patients with MCI, 30 patients with AD and 40 controls and assessed olfactory threshold, odor discrimination and odor identification (Sniffin' Sticks), gustatory functioning (Taste Strips), and food preferences (Macronutrient and Taste Preference Ranking Task). Linear regression analyses were used to study associations of five cognitive domains or AD biomarkers with olfactory functioning. Groups did not differ in olfactory threshold, gustatory function and food preferences. Patients with MCI and AD scored lower on odor discrimination and identification than controls. Poorer memory, but no other cognitive domain, was associated with poorer odor discrimination and odor identification, but not with odor threshold. No associations with AD biomarkers were found. In conclusion, patients with MCI and AD have poorer odor discrimination and identification ability than controls, but similar detection thresholds. This is likely a consequence of poorer memory rather than directly caused by AD pathology.
The effect of nutritional counseling on muscle mass and treatment outcome in patients with metastatic colorectal cancer undergoing chemotherapy: A randomized controlled trial
Werf, A. van der ; Langius, J.A.E. ; Beeker, A ; Tije, AJ ten ; Vulink, AJ ; Haringhuizen, A ; Berkhof, J ; Vliet, HJ van der ; Verheul, H.M.W. ; Schueren, M.A.E. de van der
2020, Article / Letter to editor (Clinical Nutrition, vol. 39, iss. 10, (2020), pp. 3005-3013)Background & aims: A low muscle mass before start of treatment and loss of muscle mass during chemotherapy is related to adverse outcomes in patients with cancer. In this randomized controlled trial, the effect of nutritional counseling on change in muscle mass and treatment outcome in patients with metastatic colorectal cancer during first-line chemotherapy was studied. Methods: Patients scheduled for first-line chemotherapy (n = 107) were randomly assigned to individualized nutritional counseling by a dietitian (NC) or usual care (UC). NC was aimed at sufficient protein-and energy intake, supported by oral supplements or enteral feeding if indicated. Furthermore, physical activity was encouraged. Outcomes were assessed at baseline (T0) and the time of the first (T1) and second (T2) regular follow-up computed tomography scans. The proportion of patients with a clinically relevant decrease in skeletal muscle area of >6.0 cm(2), measured by computed tomography, was the primary outcome. Secondary outcomes included body weight, quality of life, treatment toxicity and progression free and overall survival. Results: A total of 107 patients were enrolled (mean age, 65 years (SD, 11 years), 63% male). Mean change in skeletal muscle area from T0 till T1 was -2.5 (SD, 9.5) cm(2), with no difference between NC versus UC (p = 0.891). The proportion of patients with a clinically relevant decrease in skeletal muscle area of >= 6.0 cm(2) did not differ (NC 30% versus UC 31%, p = 0.467). NC compared with UC had a significant positive effect on body weight (B coefficient 1.7, p = 0.045), progression free survival (p = 0.039) and overall survival (p = 0.046). Conclusions: NC of patients undergoing chemotherapy for metastatic colorectal cancer had no effect on muscle mass. However, we found that NC may increase body weight and improve progression free survival and overall survival compared to UC in this group of patients. These findings need further evaluation in future clinical trials. (C) 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Verschillende onderzoekslijnen, gedeelde missie
Schueren, M.A.E. de van der
2020, Article / Letter to editor (MedNet Oncologie, vol. 11, (2020), pp. 10-11)
Wetenschapper weegt effect van de strijd tegen de kilo's
Schueren, M.A.E. de van der
2020, Contribution for newspaper or weekly magazine (De Gelderlander, , pp. 10)
What do screening tools measure? Lessons learned from SCREEN II and SNAQ(65+)
Borkent, J.W. ; Schuurman, LT ; Beelen, J. ; Linschooten, J.O ; Keller, HH ; Roodenburg, AJC ; Schueren, M.A.E. de van der
2020, Article / Letter to editor (Clinical nutrition ESPEN, vol. 38, (2020), pp. 172-177)Background: Over the last decade, different screening tools for malnutrition have been developed. Within these tools, a distinction can be made between tools that assess nutritional risk and tools that assess protein energy malnutrition. Insights in differences in characteristics of participants at risk and in differences in prevalence rates will aid in deciding which tool(s) to use in daily practice. Methods: Dutch community-dwelling older adults (n = 200, 78.2 +/- 6.9 years), not known to have specific nutrition problems, were recruited to participate in this cross-sectional study. SNAQ(65+) (low risk vs moderate/high risk) was used to assess risk of protein energy malnutrition and SCREEN II was used to assess nutrition risk (score <54 out of 64). Chi-square tests were used to test associations between demographic, health, physical and social factors and outcome of SNAQ(65+) and SCREEN II. Results: Of all participants 69.0% were at nutrition risk (SCREEN II), while 13.5% were at risk of protein energy malnutrition (SNAQ(65+)). Agreement between the two tools was poor (kappa < 0.20). Gender, BMI, living status, income, activity level and protein/energy intake were associated with SCREEN II; age, BMI, comorbidities, medication use, help at home, activity level and low basic mobility were associated with SNAQ(65+). Conclusion: SCREEN II and SNAQ(65+) measure different concepts of malnutrition and therefore identify different persons at risk. SCREEN II is more inclusive and comprises both undernutrition and overnutrition as well as different determinants that can impact on food intake, while SNAQ(65+) is solely focused on protein-energy malnutrition. (C) 2020 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.
Associations Between Nutrient Intake and Corresponding Nutritional Biomarker Levels in Blood in a Memory Clinic Cohort: The NUDAD Project
Leeuw, F.A. de ; Rest, O. van de ; Doorduijn, A.S. ; Fieldhouse, J.L.P. ; Schueren, M.A.E. de van der ; Visser, M. ; Heuvel, E.G.H.M. van den ; Scheltens, P. ; Teunissen, C.E. ; Kester, M.I. ; Flier, W.M. van der et al. sine al.
2020, Article / Letter to editor (Journal of the American Medical Directors Association, vol. 21, iss. 10, (2020), pp. 1436-1438)
Cross-Country Differences and Similarities in Undernutrition Prevalence and Risk as Measured by SCREEN II in Community-Dwelling Older Adults
Borkent, J.W. ; Keller, H. ; Wham, C ; Wijers, F ; Schueren, M.A.E. de van der
2020, Article / Letter to editor (Healthcare, vol. 8, iss. 2, (2020))Undernutrition is highly prevalent among community-dwelling older adults. Early identification of nutrition risk is important to prevent or treat undernutrition. This study describes the prevalence rates of nutrition risk in community-dwelling older adults (aged >= 65) using the same validated tool across different countries and aims to identify differences in nutritional risk factors. Cross-sectional data was obtained from three datasets including participants from the Netherlands (NL), Canada (CA) and New Zealand (NZ). Seniors in the Community Risk Evaluation for Eating and Nutrition II (SCREEN II) was used to assess nutritional risk factors and prevalence of risk. Differences between countries were tested with logistic and linear regression. Sensitivity analyses were conducted to test the influence of sampling strategy. A total of 13,340 participants were included, and 66.3% were found to be at high nutrition risk. After stratifying the data for method of data sampling, prevalence rates showed some differences across countries (NL: 61.5%, NZ: 68.2%, CA: 70.1%). Risk factor items that contributed to nutrition risk also differed among countries: NZ and CA participants scored higher for weight change, skipping meals, problems with meal preparation, use of meal replacements, problems with biting and chewing, low fluid intake and problems with doing groceries, as compared to participants in NL. Low intake of fruits and vegetables and meat were more prevalent in NL. In conclusion: nutrition risk is a worldwide, highly prevalent problem among community-dwelling older adults, but risk factors contributing to nutrition risk differ by country.
Diet in the palliative phase
Beuken-van Everdingen, M. van den ; Schueren, M.A.E. de van der ; Zeegers, M.
2020, Part of book or chapter of book (Diet and fighting bladder cancer, pp. 103-108)
Energy intake and expenditure in patients with Alzheimer's disease and mild cognitive impairment: the NUDAD project
Doorduijn, A.S. ; Schueren, M.A.E. de van der ; Rest, O. van de ; Leeuw, F.A. de ; Hendriksen, HMA ; Teunissen, C.E. ; Scheltens, P. ; Flier, W.M. van der ; Visser, M.
2020, Article / Letter to editor (ALZHEIMERS RESEARCH & THERAPY, vol. 12, iss. 1, (2020))Background Malnutrition is common in patients with Alzheimer's disease (AD) dementia and mild cognitive impairment (MCI) and is associated with institutionalization and increased mortality. Malnutrition is the result of a negative energy balance, which could be due to reduced dietary intake and/or higher energy expenditure. To study underlying mechanisms for malnutrition, we investigated dietary intake and resting energy expenditure (REE) of patients with AD dementia, MCI, and controls. In addition, we studied associations of global cognition (Mini-Mental State Examination (MMSE)) and AD biomarkers with dietary intake and REE. Methods We included 219 participants from the NUDAD project, 71 patients with AD dementia (age 68 +/- 8 years, 58% female, MMSE 24 +/- 3), 52 with MCI (67 +/- 8 years, 42% female, MMSE 26 +/- 2), and 96 controls (62 +/- 7 years, 52% female, MMSE 28 +/- 2). We used a 238-item food frequency questionnaire to assess dietary intake (energy, protein, carbohydrate, and fat). In a subgroup of 92 participants (30 patients with AD dementia, 22 with MCI, and 40 controls) we measured REE with indirect calorimetry. Between-group differences in dietary intake and REE were tested with ANOVAs. In the total sample, linear regression analyses were used to explore potential associations of MMSE score and AD biomarkers with dietary intake and REE. All analyses were adjusted for age, sex, education, and body mass index or fat-free mass. Results Patients with AD dementia and MCI did not differ from controls in total energy intake (1991 +/- 71 and 2172 +/- 80 vs 2022 +/- 61 kcal/day,p > 0.05) nor in protein, carbohydrate, or fat intake. Patients with AD dementia and MCI had a higher REE than controls (1704 +/- 41 and 1754 +/- 47 vs 1569 +/- 34 kcal/day,p < 0.05). We did not find any association of MMSE score or AD biomarkers with dietary intake or REE. Conclusions We found a higher REE, despite similar energy intake in patients with AD and MCI compared to controls. These findings suggest that elevated metabolism rather than reduced energy intake explains malnutrition in AD. These results could be useful to optimize dietary advice for patients with AD dementia and MCI.

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