Showing papers by "John J. Reilly published in 1995"
TL;DR: In this article, the authors validate five currently used equations for this purpose in a sample of 98 healthy prepubertal children (64 boys, 34 girls), mean (SD) age 9.1 (1.7) years by comparison of estimates from each equation with measurements of fatness derived from hydrodensitometry.
Abstract: Measurement of body composition is proving increasingly important in clinical nutrition and research. Skinfold thickness is a simple means of estimating body composition which is widely used in children, but there is little information on its validity. There has been a proliferation of equations for estimation of body composition from skinfolds, but some doubt as to their general applicability. The aim of the present study was to validate five currently used equations for this purpose in a sample of 98 healthy prepubertal children (64 boys, 34 girls), mean (SD) age 9.1 (1.7) years by comparison of estimates from each equation with measurements of fatness derived from hydrodensitometry. Differences between methods were determined by calculation of biases and limits of agreement. Limits of agreement between predicted and measured fatness were wide, particularly in the girls, and some distinct biases were apparent. Choice of prediction equation therefore has a substantial influence on the estimate of fatness obtained when using skinfolds in children. The existing published equations are associated with large random errors or significant systematic errors. For the time being skinfolds might best be regarded as indices (rather than measures) of body fatness in individuals, or means of estimating body fatness of groups. Estimating the total body fatness of individual prepubertal children using skinfolds, on the basis of this evidence, is not advisable at present.
159 citations
TL;DR: It is indicated that severe malnutrition is common in elderly medical admissions, and that it is associated with an increased risk of sepsis.
Abstract: Undernutrition of long-stay hospital patients and those in surgical units is well documented. This study was designed to determine the extent of the problem in elderly people admitted to hospital with acute medical problems and to assess the relationship between nutritional status and course of hospital stay. Sixty-nine patients underwent a nutritional assessment on admission and at intervals throughout their hospital stay and episodes of sepsis were documented. Severely malnourished patients were identified using body mass index, BMI (22%) and corrected arm muscle area, CAMA (26%). Episodes of sepsis occurred significantly more often in the severely undernourished group (p < 0.04). The median length of stay of the group was 16 days (range 2-113): during this time there was no significant change in markers of nutritional status apart from actual muscle circumference (AMC), which showed a reduction in measurement between admission and discharge which was statistically significant (p < 0.0003). This study indicated that severe malnutrition is common in elderly medical admissions, and that it is associated with an increased risk of sepsis. Additional nutritional depletion may occur during hospital stay, and is not easily recognized unless anthropometry is undertaken.
150 citations
TL;DR: It is concluded that moderate negative energy balance is common in elderly patients admitted with acute illness from the community, and that these patients are at risk of undernutrition during their hospital stay.
Abstract: Studies on hospitalized elderly subjects have demonstrated that negative energy balance is common during hospitalization, but have concentrated primarily on long-stay and psychogeriatric patients. There is little information on energy balance in elderly patients admitted with acute illness from the community, despite the importance of this patient group and the presence of a number of factors likely to predispose such patients to negative energy balance. In the present study energy balance was quantified in twenty patients (eight males, mean age 82 (SD 05) years; twelve females, mean age 84 (SD 6) years) admitted from the community with acute illness, and predicted basal metabolic rate (BMR) was compared with measured resting metabolic rate (RMR). Most patients were in negative energy balance during hospitalization, and median measured energy intake (El):measured RMR ratio was 1·0 (range 0·7–1·8). The mean difference between measured El and estimated total energy expenditure was −1·3 MJ/d (range -3·4 to +2·5 MJ/d). Estimated total energy expenditure exceeded measured El in fifteen of the patients and there was a significant decline in mid-arm muscle circumference (paired t, P < 0·05) during hospitalization. We conclude that moderate negative energy balance is common in this patient group, and that these patients are at risk of undernutrition during their hospital stay.
56 citations
TL;DR: Evidence that malnutrition is an adverse prognostic factor in childhood acute lymphoblastic leukaemia (ALL) is reported, and it is suggested that the effect may apply even to moderately undernourished children, and some possible mechanisms are discussed.
Abstract: EDITOR,-Borato Viana et al report evidence that malnutrition is an adverse prognostic factor in childhood acute lymphoblastic leukaemia (ALL), suggest that the effect may apply even to moderately undernourished children, and discuss some possible mechanisms.I While the relevance of severe malnutrition to the developed world may seem limited, our own evidence2 indicates that relatively mild undernutrition (weight for height SD score <-0 5) had adverse prognostic significance for children treated for ALL in Glasgow on the UKALL-X protocol. We would also like to add two possible mechanisms which may be worthy of investigation: impairment of immune function by undernutrition and variability in body composition between patients producing variation in drug pharmacokinetics.3 There are now three studies which indicate the need for further research on the relevance of nutritional status to outcome in ALL, and on the possible mechanisms.' 2 4
6 citations