TY - JOUR A1 - Scheffler, Christiane A1 - Hermanussen, Michael T1 - What does stunting tell us? JF - Human biology and public health N2 - Stunting is commonly linked with undernutrition. Yet, already after World War I, German pediatricians questioned this link and stated that no association exists between nutrition and height. Recent analyses within different populations of Low- and middle-income countries with high rates of stunted children failed to support the assumption that stunted children have a low BMI and skinfold sickness as signs of severe caloric deficiency. So, stunting is not a synonym of malnutrition. Parental education level has a positive influence on body height in stunted populations, e.g., in India and in Indonesia. Socially disadvantaged children tend to be shorter and lighter than children from affluent families. Humans are social mammals; they regulate growth similar to other social mammals. Also in humans, body height is strongly associated with the position within the social hierarchy, reflecting the personal and group-specific social, economic, political, and emotional environment. These non-nutritional impact factors on growth are summarized by the concept of SEPE (Social-Economic-Political-Emotional) factors. SEPE reflects on prestige, dominance-subordination, social identity, and ego motivation of individuals and social groups. KW - SEPE Factors KW - physical fitness KW - height in history KW - malnutrition Y1 - 2023 U6 - https://doi.org/10.52905/hbph2022.3.36 SN - 2748-9957 VL - 2022 IS - 3 SP - 1 EP - 15 PB - Universitätsverlag Potsdam CY - Potsdam ER - TY - JOUR A1 - Boeker, Sonja A1 - Hermanussen, Michael A1 - Scheffler, Christiane T1 - Dental age is an independent marker of biological age JF - Human biology and public health N2 - Background: Biological age markers are a crucial indicator whether children are decelerated in growth tempo. Skeletal maturation is the standard measure. Yet, it relies on exposing children to x-radiation. Dental eruption is a potential, but highly debated, radiation free alternative.  Objectives: We assess the interrelationship between dental eruption and other maturational markers. We hypothesize that dental age correlates with body height and skeletal age. We further evaluate how the three different variables behave in cohorts from differing social backgrounds. Sample and Method: Dental, skeletal and height data from the 1970s to 1990s from Guatemalan boys were converted into standard deviation scores, using external references for each measurement. The boys, aged between 7 and 12, derived from different social backgrounds (middle SES (N = 6529), low-middle SES (N = 736), low SES Ladino (N = 3653) and low SES Maya (N = 4587). Results: Dental age shows only a weak correlation with skeletal age (0.18) and height (0.2). The distinction between cohorts differs according to each of the three measurements. All cohorts differ significantly in height. In skeletal maturation, the middle SES cohort is significantly advanced compared to all other cohorts. The periodically malnourished cohorts of low SES Mayas and Ladinos are significantly delayed in dental maturation compared to the well-nourished low-middle and middle class Ladino children. Conclusion: Dental development is an independent system, that is regulated by different mechanisms than skeletal development and growth. Tooth eruption is sensitive to nutritional status, whereas skeletal age is more sensitive to socioeconomic background. KW - dental eruption KW - biological age KW - skeletal age KW - growth tempo KW - maturation KW - malnutrition Y1 - 2022 U6 - https://doi.org/10.52905/hbph2021.3.24 SN - 2748-9957 VL - 2021 IS - 3, Summer School Supplement PB - Universitätsverlag Potsdam CY - Potsdam ER - TY - JOUR A1 - Mumm, Rebekka A1 - Hermanussen, Michael T1 - A short note on the BMI and on secular changes in BMI JF - Human biology and public health N2 - Human size changes over time with worldwide secular trends in height, weight, and body mass index (BMI). There is general agreement to relate the state of nutrition to height and weight, and to ratios of weight-to-height. The BMI is a ratio. It is commonly used to classify underweight, overweight and obesity in adults. Yet, the BMI is inappropriate to provide any immediate information on body composition. It is accepted that the BMI is “a simple index to classify underweight, overweight and obesity in adults”. It is stated that “policies, programmes and investments need to be “nutrition-sensitive”, which means they must have positive impacts on nutrition”. It is also stated that “a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions“. But these statements are neither warranted by arithmetic considerations, nor by historic evidence. Measuring the BMI is an appropriate screening tool for detecting an unusual weight-to-height ratio, but the BMI is an inappropriate tool for estimating body composition, or suggesting medical and health policy decisions. KW - body mass index KW - secular trend KW - weight-to-height ratio KW - malnutrition KW - obesity Y1 - 2021 U6 - https://doi.org/10.52905/hbph.v2.17 SN - 2748-9957 IS - 2 PB - Universitätsverlag Potsdam CY - Potsdam ER - TY - JOUR A1 - Volkert, Dorothee A1 - Kiesswetter, Eva A1 - Cederholm, Tommy A1 - Donini, Lorenzo M. A1 - Egiseer, Doris A1 - Norman, Kristina A1 - Schneider, Stephane M. A1 - Stroebele-Benschop, Nanette A1 - Torbahn, Gabriel A1 - Wirth, Rainer A1 - Visser, Marjolein T1 - Development of a Model on Determinants of Malnutrition in Aged Persons BT - A MaNuEL Project JF - Gerontology and Geriatric Medicine N2 - In older persons, the origin of malnutrition is often multifactorial with a multitude of factors involved. Presently, a common understanding about potential causes and their mode of action is lacking, and a consensus on the theoretical framework on the etiology of malnutrition does not exist. Within the European Knowledge Hub "Malnutrition in the Elderly (MaNuEL)," a model of "Determinants of Malnutrition in Aged Persons" (DoMAP) was developed in a multistage consensus process with live meetings and written feedback (modified Delphi process) by a multiprofessional group of 33 experts in geriatric nutrition. DoMAP consists of three triangle-shaped levels with malnutrition in the center, surrounded by the three principal conditions through which malnutrition develops in the innermost level: low intake, high requirements, and impaired nutrient bioavailability. The middle level consists of factors directly causing one of these conditions, and the outermost level contains factors indirectly causing one of the three conditions through the direct factors. The DoMAP model may contribute to a common understanding about the multitude of factors involved in the etiology of malnutrition, and about potential causative mechanisms. It may serve as basis for future research and may also be helpful in clinical routine to identify persons at increased risk of malnutrition. KW - older persons KW - malnutrition KW - determinants KW - etiology KW - model Y1 - 2019 U6 - https://doi.org/10.1177/2333721419858438 SN - 2333-7214 VL - 5 PB - Sage Publ. CY - Thousand Oaks ER - TY - JOUR A1 - Volkert, Dorothee A1 - Beck, Anne Marie A1 - Cederholm, Tommy A1 - Cereda, Emanuele A1 - Cruz-Jentoft, Alfonso J. A1 - Goisser, Sabine A1 - de Groot, Lisette A1 - Grosshauser, Franz A1 - Kiesswetter, Eva A1 - Norman, Kristina A1 - Pourhassan, Maryam A1 - Reinders, Ilse A1 - Roberts, Helen C. A1 - Rolland, Yves A1 - Schneider, Stéphane M. A1 - Sieber, Cornel A1 - Thiem, Ulrich A1 - Visser, Marjolein A1 - Wijnhoven, Hanneke A1 - Wirth, Rainer T1 - Management of malnutrition in older patients BT - Current approaches, evidence and open questions JF - Journal of Clinical Medicine : open access journal N2 - Malnutrition is widespread in older people and represents a major geriatric syndrome with multifactorial etiology and severe consequences for health outcomes and quality of life. The aim of the present paper is to describe current approaches and evidence regarding malnutrition treatment and to highlight relevant knowledge gaps that need to be addressed. Recently published guidelines of the European Society for Clinical Nutrition and Metabolism (ESPEN) provide a summary of the available evidence and highlight the wide range of different measures that can be taken—from the identification and elimination of potential causes to enteral and parenteral nutrition—depending on the patient’s abilities and needs. However, more than half of the recommendations therein are based on expert consensus because of a lack of evidence, and only three are concern patient-centred outcomes. Future research should further clarify the etiology of malnutrition and identify the most relevant causes in order to prevent malnutrition. Based on limited and partly conflicting evidence and the limitations of existing studies, it remains unclear which interventions are most effective in which patient groups, and if specific situations, diseases or etiologies of malnutrition require specific approaches. Patient-relevant outcomes such as functionality and quality of life need more attention, and research methodology should be harmonised to allow for the comparability of studies. KW - Geriatric patients KW - older persons KW - malnutrition KW - therapy KW - interventions Y1 - 2019 U6 - https://doi.org/10.3390/jcm8070974 SN - 2077-0383 VL - 8 IS - 7 PB - MDPI CY - Basel ER - TY - JOUR A1 - Franz, Kristina A1 - Otten, Lindsey A1 - Müller-Werdan, Ursula A1 - Döhner, Wolfram A1 - Norman, Kristina T1 - Severe Weight Loss and Its Association with Fatigue in Old Patients at Discharge from a Geriatric Hospital JF - Nutrients N2 - Although malnutrition is frequent in the old, little is known about its association with fatigue. We evaluated the relation of self-reported severe weight loss with fatigue and the predictors for fatigue in old patients at hospital discharge. Severe weight loss was defined according to involuntary weight loss >= 5% in the last three months. We determined fatigue with the validated Brief Fatigue Inventory questionnaire. The regression analyses were adjusted for age, sex, number of comorbidities, medications/day, and BMI. Of 424 patients aged between 61 and 98 y, 34.1% had severe weight loss. Fatigue was higher in patients with severe weight loss (3.7 +/- 2.3 vs. 3.2 +/- 2.3 points, p = 0.021). In a multinomial regression model, weight loss was independently associated with higher risk for moderate fatigue (OR:1.172, CI:1.026-1.338, p = 0.019) and with increased risk for severe fatigue (OR:1.209, CI:1.047-1.395, p = 0.010) together with the number of medications/day (OR:1.220, CI:1.023-1.455, p = 0.027). In a binary regression model, severe weight loss predicted moderate-to-severe fatigue in the study population (OR:1.651, CI:1.052-2.590, p = 0.029). In summary, patients with self-reported severe weight loss at hospital discharge exhibited higher fatigue levels and severe weight loss was an independent predictor of moderate and severe fatigue, placing these patients at risk for impaired outcome in the post-hospital period. KW - malnutrition KW - involuntary weight loss KW - post-hospital syndrome KW - fatigue KW - old adults Y1 - 2019 U6 - https://doi.org/10.3390/nu11102415 SN - 2072-6643 VL - 11 IS - 10 PB - MDPI CY - Basel ER - TY - JOUR A1 - Baldermann, Susanne A1 - Blagojevic, Lara A1 - Frede, Katja A1 - Klopsch, R. A1 - Neugart, Susanne A1 - Neumann, A. A1 - Ngwene, Benard A1 - Norkeweit, Jessica A1 - Schroeter, D. A1 - Schroeter, A. A1 - Schweigert, Florian J. A1 - Wiesner, M. A1 - Schreiner, Monika T1 - Are Neglected Plants the Food for the Future? JF - Critical reviews in plant sciences N2 - Malnutrition, poor health, hunger, and even starvation are still the world's greatest challenges. Malnutrition is defined as deficiency of nutrition due to not ingesting the proper amounts of nutrients by simply not eating enough food and/or by consuming nutrient-poor food in respect to the daily nutritional requirements. Moreover, malnutrition and disease are closely associated and incidences of such diet-related diseases increase particularly in low- and middle-income states. While foods of animal origin are often unaffordable to low-income families, various neglected crops can offer an alternative source of micronutrients, vitamins, as well as health-promoting secondary plant metabolites. Therefore, agricultural and horticultural research should develop strategies not only to produce more food, but also to improve access to more nutritious food. In this context, one promising approach is to promote biodiversity in the dietary pattern of low-income people by getting access to nutritional as well as affordable food and providing recommendations for food selection and preparation. Worldwide, a multitude of various plant species are assigned to be consumed as grains, vegetables, and fruits, but only a limited number of these species are used as commercial cash crops. Consequently, numerous neglected and underutilized species offer the potential to diversify not only the human diet, but also increase food production levels, and, thus, enable more sustainable and resilient agro- and horti-food systems. To exploit the potential of neglected plant (NP) species, coordinated approaches on the local, regional, and international level have to be integrated that consequently demand the involvement of numerous multi-stakeholders. Thus, the objective of the present review is to evaluate whether NP species are important as “Future Food” for improving the nutritional status of humans as well as increasing resilience of agro- and horti-food systems. KW - Fruits KW - malnutrition KW - orphan crops KW - underutilized species KW - vegetables Y1 - 2016 U6 - https://doi.org/10.1080/07352689.2016.1201399 SN - 0735-2689 SN - 1549-7836 VL - 35 SP - 106 EP - 119 PB - Institut d'Estudis Catalans CY - Philadelphia ER -