• Title/Summary/Keyword: NRI

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The Analysis of Geriatric Nutritional Risk Index (GNRI) for Nutritional Assessment and Health Care in Elderly Women (여자노인의 영양상태 평가 및 건강관리를 위한 Nutritional Risk Index (NRI) 비교 분석)

  • Yang, Eun-Ju
    • Journal of Nutrition and Health
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    • v.42 no.3
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    • pp.234-245
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    • 2009
  • Nutritional assessment for the elderly can identify health status and morbidity. However, development of Nutritional Risk Index (NRI) remains limited for elderly because of difficulties in understanding physiological mechanism of elderly. This study was performed to analyze and develop Nutritional Risk Index for Korean elderly Women (Geriatric Nutritional Risk Index, GNRI). Based on literature review, factors for NRI were identified and indices were assessed by a cross-sectional survey. The survey involved Korean elderly women (${\geq}$60, n = 94) in Gwangju area, and sociodemographics, lifestyle characteristics, health conditions, dietary intakes based on 24h- recall, anthropometric measures (wt, ht, BMI, waist, hip, WHR, body protein, body fat, abdominal fat, and triceps skinfold thickness), and clinical biochemistry parameters (systolic blood pressure, diastolic blood pressure, cholesterol, HDL-cholesterol, triglyceride, total protein, albumin, prealbumin, hemoglobin, hematocrit, fasting blood glucose, HbAlc, ferritin, Zn, Ca, Na, K, Vit E, Vit $B_{12}$, folate, C-reactive protein) were examined relation to nutritional risk index. Based on literature review and data analyses, three NRIs were categorized (NRI I, NRI II, NRI III) and used for further analysis. NRI I was related to having metabolic syndrome, NRI II was related to serum albumin and body weight, and NRI III was related to food habit and health concerns. Abdominal fat (%) of elderly was correlated with each NRIs. NRI II was correlated with nutritional deficiency and higher tendency of inflammatory response, and NRI III was correlated with nutritional status which tend to be lower on aging (protein, folate, Vit $B_{12}$). NRI can serve as a useful tools in assessing health risk and nutritional status. Some modification of items in NRI and validity study are need to apply to Korean elderly.

[Republished study] Assessing Nutritional Status in Outpatients after Gastric Cancer Surgery: A Comparative Study of Five Nutritional Screening Tools ([재출판] 위암 수술 후 외래환자의 영양상태 평가: 5가지 영양검색도구의 비교연구)

  • Cho, Jae Won;Youn, Jiyoung;Choi, Min-Gew;Rha, Mi Young;Lee, Jung Eun
    • Korean Journal of Community Nutrition
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    • v.27 no.3
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    • pp.205-222
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    • 2022
  • Objectives: This study examined the characteristics of patients according to nutritional status assessed by five nutritional screening tools: Patient-Generated Subjective Global Assessment (PG-SGA), NUTRISCORE, Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) and to compare the agreement, sensitivity, and specificity of these tools. Methods: A total of 952 gastric cancer patients who underwent gastrectomy and chemotherapy from January 2009 to December 2012 were included. The patients were categorized into malnutrition and normal status according to five nutritional screening tools one month after surgery. The Spearman partial correlation, Cohen's Kappa coefficient, the area under the curve (AUC), sensitivity, and specificity of each two screening tools were calculated. Results: Malnutrition was observed in 86.24% of patients based on the PG-SGA and 85.82% based on the NUTRISCORE. When NRI or CONUT were applied, the proportions of malnutrition were < 30%. Patients with malnutrition had lower intakes of energy and protein than normal patients when assessed using the PG-SGA, NUTRISCORE, or NRI. Lower levels of albumin, hemoglobin, total lymphocyte count, and total cholesterol and longer postoperative hospital stays were observed among patients with malnutrition compared to normal patients when NRI, PNI, or CONUT were applied. Relatively high agreement for NUTRISCORE relative to PG-SGA was found; the sensitivity was 90.86%, and the AUC was 0.78. When NRI, PNI, and CONUT were compared, the sensitivities were 23.72% for PNI relative to NRI, 44.53% for CONUT relative to NRI, and 90.91% for CONUT relative to PNI. The AUCs were 0.95 for NRI relative to PNI and 0.91 for CONUT relative to PNI. Conclusions: NUTRISCORE had a high sensitivity compared to PG-SGA, and CONUT had a high sensitivity compared to PNI. NRI had a high specificity compared to PNI. This relatively high sensitivity and specificity resulted in 77.00% agreement between PNI and CONUT and 77.94% agreement between NRI and PNI. Further cohort studies will be needed to determine if the nutritional status assessed by PG-SGA, NUTRISCORE, NRI, PNI, and CONUT predicts the gastric cancer prognosis.

American Television: A Source of Nutrition Education and Information

  • Bredbenner, Carol-Byrd
    • Journal of Community Nutrition
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    • v.5 no.4
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    • pp.230-238
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    • 2003
  • Television is a powerful and persuasive teacher. It has the potential to influence perceptions, knowledge, beliefs, and behaviors, thus nutritionists need to be aware of the nutrition-related information (NRI) in television programming and the effect this information has on viewers. The purpose of this article was to review research published in peer-reviewed journals between 1988 and 2003 that examined the NRI embedded in American television programming, which is exported to over 125 nations, and its impact on nutrition knowledge, attitudes, and/or behaviors. This review revealed that, for the past 15 years, NRI was commonly included in both television advertisements and shows. Advertised foods were mainly high in fat, sodium, and/or sugar. In addition, the NRI embedded in food advertisements tended to be misleading or inaccurate. Prime-time television shows included numerous NRI containing scenes every hour, with situation comedies having the most and real-life re-enactment shows the least. Overall, low nutrient density foods accounted for approximately 40 percent or more of all food references on prime-time television shows. In television shows, foods were mostly consumed as snacks rather than meals and children often ate more nutritious foods than adults. Although relatively few studies have examined the impact of television programming on viewers, those that do exist indicate that as children watch more television, nutrition knowledge and understanding declines while misconceptions about nutrition increase. Advertising influences children's food purchase requests and subsequent purchases by adults, with the most requested and purchased foods being high in sugar, fat, and/or salt foods. Existing research indicates that television must be acknowledged as a major source of NRI and a potentially powerful influence on dietary practices.

The Health and Nutritional Status of Low-Income, Alone-Living Elderly (일부지역 저소득층 독거노인의 건강 및 영양불량 위험도 조사연구)

  • 이기완;이영미;김정현
    • Korean Journal of Community Nutrition
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    • v.5 no.1
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    • pp.3-12
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    • 2000
  • The nutritional and health status of low-income alone-living elderly(ALE) was assessed in relation to the activity of daily living (ADL) and nutritional risk factors. One hundred and eighty five ALE over 65 years old, living in the Sungnam area, were interviewed in their homes through questionnaires. The results were as follows : 63.6% of the subjects considered themselves in poor the health and only 4.3% of them considered thermselves healthy. 89.7% of the subjects answered that they were suffering from illness and 29.7% were taking medication. The ADL was assessed through 10 checklist items and the average score of the ADL was $84.78{\pm}11.11$(maximum :100) The nutritional risk index(NRI) was evaluated by 12 risk factors and the average score of the NRI was $4.43{\pm}1.38$ (maximumː12) The scores of the ADL were positively correlated with the scored of the instrumental activities of daily living (IADL)(r=0.7523, p<0.001) and negatively correlated with NRI(r= -0.2694, p<0.001) When subjects were divided into nutritionally high risk group(HNARI: TEX>$NRI{\geq}5$) and nutritionally low risk group(LNRI : NRI<5) according to the USA screening basis, 48.9% of the subjects belonged to the HNRI, But 16.9% of the HNRI and 34.4% of the LNRI belonged to the fourth quartile($Q_{0.75}$) of the ADL, the distribution of which showed significant differences(p<0.05) We suggest that the application of the ADL as a screening tool for nutrition intervention programs for the elderly. Oncemore, further research is needed to develop appropriate checklist items for the ADL and NRI along with the screening basis for the NRI 새 diagnose the adverse nutritional status of the Korean elderly.

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Selection and optimization of nutritional risk screening tools for esophageal cancer patients in China

  • Dong, Wen;Liu, Xiguang;Zhu, Shunfang;Lu, Di;Cai, Kaican;Cai, Ruijun;Li, Qing;Zeng, Jingjing;Li, Mei
    • Nutrition Research and Practice
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    • v.14 no.1
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    • pp.20-24
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    • 2020
  • BACKGROUND/OBJECTIVES: Malnutrition has multiple impacts on surgical success, postoperative complications, duration of hospital stay, and costs, particularly for cancer patients. There are various nutrition risk screening tools available for clinical use. Herein, we aim to determine the most appropriate nutritional risk screening system for esophageal cancer (EC) patients in China. SUBJECTS/METHODS: In total, 138 EC patients were enrolled in this study and evaluated by experienced nurses using three different nutritional screening tools, the Nutrition Risk Screening 2002 tool (NRS2002), the Patient-generated Subjective Globe Assessment (PG-SGA), and the Nutrition Risk Index (NRI).We compared sensitivity, specificity, positive and negative likelihood ratios, and Youden index generated by each of the three screening tools. Finally, cut-off points for all three tools were re-defined to optimize and validate the best nutritional risk screening tool for assessing EC patients. RESULTS: Our data suggested that all three screening tools were 100% sensitive for EC patients, while the specificities were 44.4%, 2.96%, and 59.26% for NRS 2002, PG-SGA, and NRI, respectively. NRI had a higher positive likelihood ratio as well as a higher area under the receiver operating characteristic curve compared to those of NRS 2002 and PG-SGA; although, all three tools had null negative likelihood ratios. After adjusting the cut-off points, the specificity and accuracy for all tools were significantly improved, however, the NRI remained the most appropriate nutritional risk screening system for EC patients. CONCLUSIONS: The NRI is the most suitable (highest sensitivity and accuracy) nutritional risk screening tool for EC patients. The performance of the NRI can be significantly improved if the cut-off point is modified according to the results obtained using MedCalc software.