Modified Mininutritional Assessment Can Effectively Assess the Nutritional Status of Patients on Hemodialysis.

[[abstract]]"Objective: We sought to determine whether the MNA (Mininutritional Assessment) would be an effective tool for assessing the nutritional status of patients undergoing hemodialysis. Design: Purposive sampling. Setting: Two hospital-managed hemodialysis centers in central Taiwan. Patients:Subjects were 95 ambulatory patients older than 40 years without acute diseases or infections who had received hemodialysis treatment at the center for longer than 30 days. Methods: Each subject was interviewed with a structured questionnaire to elicit basic personal data and healthand lifestyle-related information and answered questions on the Council on Nutrition Appetite Questionnaire and MNA. Serum biochemical data were obtained from their routine measurement. The nutritional status of each subject was graded with two modified MNA versions. MNA-TI adopted population-specific anthropometric cut-points, and MNA-TII further had the body mass index question deleted from the scale and question scores adjusted but maintained the same 30 total points. Results:Based on the strength of correlation with the key nutrition-related parameters including appetite status, serum creatinine, percent weight loss, hospital length of stay, number of prescribed drugs, and hemodialysis time, both modified MNA versions reflected the nutritional status of Taiwanese hemodialysis patients better than the Council on Nutrition Appetite Questionnaire. Serum albumin did not reflect nutritional status well in these hemodialysis patients. MNA-TI predicted 26.4% and MNA-TII predicted 29.5% of hemodialysis patients were either malnourished or at risk of malnutrition. Conclusions: Both versions of the modified MNA are effective in assessing the nutritional status of hemodialysis patients. MNA-TII without body mass index is a significant improvement for hemodialysis patients because body weights fluctuate significantly between dialysis sessions

Sex and ethnic disparities in weight and height among children of transnational couple, aborigines, and Han Chinese in Taiwan.

[[abstract]]In this study, we examined sex and ethnic disparities in growth and body mass index (BMI) status among schoolchildren of transnational families, the aborigines and Han Taiwanese in Nantou, Taiwan. We tested the hypothesis that cultural and social factors of the transnational couples could impact the growth status of their children. The study also determined the factors associated with the growth status of schoolchildren. A total of 1674 school age children in the county were cluster sampled, and their weight and height data were statistically analyzed by 1-way analysis of variance, χ2 test, and linear regression analysis according to sex, ethnicity, and residential locations. The institutional review board of Asia University, Taiwan, ROC, approved the study protocol. Results showed that aboriginal boys were significantly shorter in stature than sons of the transnational couples and Han Taiwanese. However, weight and BMI were not different among the 3 groups. Daughters of the transnational couples were significantly shorter and lighter, whereas the aboriginal girls were shorter but not lighter and had significantly greater BMI compared with their Han Taiwanese counterparts. Regression analysis revealed significant associations of weight and BMI with sex and ethnicity. Results suggest that culture plays a role in sex disparity. Ethnic and sex disparities in growth status exist in Taiwan. Aboriginal boys and girls are shorter but not lighter compared with their Han Taiwanese counterparts, whereas daughters but not sons of transnational couples are shorter and lighter compared with Han Taiwanese counterparts. These findings are useful information for the educators and healthcare policy makers for improving diet and health

Population-specific modifications of the short-form Mini Nutritional Assessment and Malnutrition Universal Screening Tool for elderly Taiwanese.

[[abstract]]"Background The Mini Nutritional Assessment (MNA) and the Malnutrition Universal Screening Tool (MUST) are two widely used malnutrition screening scales. Objective The study was to compare the grading ability of the two scales, and to determine whether adoption of population-specific anthropometric cut-points could improve the grading ability of these tools and whether calf circumference (CC) could be an acceptable alternative to BMI in these scales. Design Purposive sampling. Settings Outpatients receiving annual physical examination at an area hospital. Participants Community-living elderly who were 65 years or older, able to communicate orally, without acute health conditions and willing to sign a study-consent. Methods Subjects were measured for anthropometrics and blood biochemical indicators, and interviewed for personal data and answers to the MNA and MUST. The risk of malnutrition was evaluated with the short-form MNA (MNA-SF) and the MUST, each in three versions (the original, Taiwan version-1 (T1) which adopted population-specific anthropometric cut-points, and Taiwan version-2 (T2) which replaced BMI with CC). Long-form (LF) MNA versions served as references. Results Results showed that (a) in both scales, patterns of nutritional status rated with the original versions were different from those rated with respective modified versions but ratings made with two modified versions were the same, (b) the T2 versions showed the best grading ability based on agreement with the reference (MNA-LF), and (c) MNA-SF versions rated greater proportions of subjects at risk of malnutrition than the respective MUST versions. Conclusions (a) Adoption of population-specific anthropometric cut-points improves the grading ability of the MNA-SF and the MUST in community-living Taiwanese, (b) CC is an acceptable alternative to BMI for both MNA-SF and MUST, and (c) nutritional assessment tools should be as much population or ethnically specific as possible to account for cultural and anthropometric differences across populations.

A modified Mini Nutritional Assessment without BMI predicts nutritional status of community-living elderly in Taiwan.

[[abstract]]"Objective: The study was to determine whether a modified MNA (Mini Nutritional Assessment) which adopted population-specific anthropometric cut-points but without BMI could maintain its predicting ability in community-living elderly in Taiwan. Design: Purposive sampling. Setting: Community-living elderly. Participants: Three hundred and one (138 male and 163 female) >65-year-old outpatients seeking free annual health examination at an area hospital in central Taiwan. Measurements: A structured questionnaire elicited personal data, lifestyle information and answers to the MNA. Laboratory results from health checkup provided the needed biochemical data. Each subject's nutritional status was assessed with the MNA in three versions: the original, the MNA-TI (with population-specific cut-points), and the MNA-TII (further eliminated the BMI question and redistributed its score to the MAC and CC questions). Results: All three versions identified the same 0.7% elderly malnourished. The proportions predicted at risk of malnutrition were 16.6, 12.0 and 10% according to the original, MNA-TI and MNA-TII, respectively. Friedman Test and post hoc analysis indicated that the pattern predicted by the original MNA was different from that predicted by the two modified versions whereas the patterns predicted by the two modified versions were not different from each other. Conclusion: Adoption of population-specific anthropometric cut-points improves the predicting ability of the MNA in Taiwanese elderly, and the improved functionality is maintained in a version without BMI (but with adjusted MAC and CC scores). A MNA without BMI has greater applicability and can enhance professional efficiency of healthcare workers.

Population-specific anthropometric cutoff standards improve the functionality of the Mini Nutritional Assessment without BMI in institutionalized elderly in Taiwan.

[[abstract]]"To assess the nutritional status of institutionalized Taiwanese elderly with the Mini Nutritional Assessment (MNA) without BMI and to determine whether the application of population-specific MAC and CC cutoff standards would improve the functionality of the tool. Purposive sampling. A long-term care facility in central Taiwan. Two hundred and eight > 65 y residents who were free of acute infection/diseases and were able to communicate. A questionnaire survey to elicit personal data and administer the MNA and measurements of anthropometric and blood biochemical indicators. The MNA, without BMI, predicted 22.1% of participants malnourished and 61.1% at risk of malnutrition among residents of a long-term care facility in Taiwan. Replacing the population-specific cutoff standards of MAC and CC for the original cutoff standards in the MNA and increasing the weighted score of MAC and CC to replace for the weighted score of BMI preserved and improved the predicting ability of the MNA. The improvement was evidenced by the increase in the correlationships between the MNA scores and the anthropometric, biochemical or health status indicators. The MNA predicted nutritional risk status of the institutionalized elderly Taiwanese. The study suggests that whenever possible population-specific anthropometric cutoff standards should be applied to improve the functionality of the MNA. It also appears possible to preserve or even improve the functionality of the MNA without BMI. The modifications indicate an improvement in the application of the MNA in long-term care patients.

A population-specific Mini Nutritional Assessment can effectively grade the nutritional status of stroke rehabilitation patients in Taiwan.

[[abstract]]"Aims and objectives. To determine whether a modified version of the Mini-Nutritional Assessment without body mass index could effectively assess the nutritional risk status of stroke rehabilitation patients in Taiwan. Background. The Mini-Nutritional Assessment was developed on the basis of clinical data of Western populations. Although widely used, its application to assess stroke rehabilitation patients has been limited. Further, to get best results, population-specific modifications to address anthropometric and lifestyle differences have been suggested, especially for non-Caucasian populations. Design. The study assessed the nutritional status of stroke rehabilitation patients who enrolled in the Long-term Care Service of Taipei. Strokes who were >40 years old, in the program for >1 month and cognitively able to answer the questions were recruited to participate in the study. Methods. An on-site in-person interview with structured questionnaire elicited information on personal data, disease history and healthcare use and answers to the Mini-Mental State Examination, the Activities of Daily Living and the Mini-Nutritional Assessment. Patient’s nutritional status was assessed with the Mini-Nutritional Assessment in three versions: the original, population-specific (MNA-TI) and population-specific, without body mass index (MNA-TII). Results. The original Mini-Nutritional Assessment rated 24% of patients malnourished and 57% at risk of malnutrition. Similar results, 14 and 64%, respectively, for MNA-TI; and 19 and 57%, respectively, for MNA-TII were observed. Conclusion. Both the original and the modified versions of the Mini-Nutritional Assessment can effectively rate the nutritional risk status of stroke rehabilitation patients in Taiwan. Version MNA-TII that adopted population-specific anthropometric cut-values but without body mass index can effectively predict the nutritional status of stroke patients. Relevance to clinical practice. The modified scale (MNA-TII) can enhance the application of the tool and timely detection and intervention of undernutrition among stroke rehabilitation patients. It can also help to improve job efficiency of the primary care professionals.[ABSTRACT FROM AUTHOR] Copyright of Journal of Clinical Nursing is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.Copyright applies to all Abstracts.