The Importance of Developing A Brief User-Friendly Tool to Assess Patients’ Nutritional Status, Dietary Patterns and Exercise Patterns in Sri Lanka
Faculty of Livestock, Department of Applied Nutrition, Sri Lanka
Submission: May 16, 2019;Published: June 19, 2019
*Corresponding author: Adikari AMNT, Faculty of Livestock, Department of Applied Nutrition, Fisheries and Nutrition, Sri Lanka
How to cite this article: Adikari AMNT. The Importance of Developing A Brief User-Friendly Tool to Assess Patients’ Nutritional Status, Dietary Patterns and Exercise Patterns in Sri Lanka. J of Pharmacol & Clin Res. 2019; 7(3): 555713. DOI: 10.19080/JPCR.2019.07.555713
Medication and Nutrition therapy are two types of treatments for hospitalized as well as non-hospitalized patients. Nutrition therapy combines science (biochemistry and nutrition) with naturopathy (natural, drug-free medicine) in order to return the patient to a state of good health. Nutritional therapy is holistic because it is designed to treat the body as a whole - curing the causes of problems, not just the symptoms as is too often the case in conventional medicine . Nutrition needs to maintain the body’s functions, growth, and the protection from most of the diseases. Nutrients including carbohydrates, proteins, fats, vitamins and minerals can be obtained through diets.
The diet and the physical activity play a major role in management of non-communicable diseases such as cardiovascular diseases, stock, hypertension, type 2 diabetes mellitus and certain types of cancers . These diseases are global burden and they lead to increased morbidity and mortality. Therefore, the proper nutrition and regular physical activity are important for maintaining the healthy life.
Under-nutrition and nutritional risk are common problems among hospitalized patients [3,4]. Undernourished patients who do not obtain adequate calories and protein are unable to fully utilize the food due to the illness. A large number of hospitalized patients are undernourished when admitted to the hospital, majority of them become further undernourished during hospitalized period. Since malnutrition is not recognized and not frequently identify in hospitalized patients  these patients are at high risk for infection, organ failure, decreased wound healing, and suboptimal response to regular medical treatments.
Other than the malnutrition, nutrition depletion is common incidence among hospitalized patients. Because patients have dietary restrictions, changes in eating and dietary patterns during the hospitalization, altered body sensations and experiences, shifting body image, new cognitions and feelings, and changing lifestyle . Therefore, early identification of patients who are in poor nutritional status and consuming inadequate nutrients is essential. Abnormalities of nutritional status or food intake are often not considered in hospital settings. As a result, the poor nutritional status is a common occurrence in hospitalized patients . Furthermore, inadequacies in nutrients intake eventually alter the functional capacity of the body, which results in many adverse health outcomes that distinguishes the expressions of different severity levels of malnutrition. Therefore, nutritional supports as well as nutritional advices are important for the hospitalized patients.
Nutrition is not a single factor for the healthy life. Other than nutrition doing regular exercise enhances the healthy life. Regular physical activity induces multiple adaptations within skeletal muscles and the cardio respiratory system, all of which providing positive outcomes for the prevention and treatment of many metabolic disorders [8,9]. But the modern lifestyle factors promote comfort and well- being which gives less energy demand environment. It leads to sedentary lifestyle of people. Therefore, promoting regular exercise habits are also important for the healthy life.
Nutrition management, nutrition counseling and education involve in dietary modifications and physical activity recommendations. But there are several barriers for nutritional management and counseling including lack of resources, lack of time, uncertainty about the effectiveness of nutritional interventions, concerns about patient response and lack of knowledge about nutrition and nutritional risk factor of healthcare professionals due to less priority for nutritional management and less training opportunities in nutritional field .
Only few hospitals and healthcare providers have a specific set of protocols or screening tools for identifying patients at nutritional risk who need appropriate nutritional care plan. Globally there are a few numbers of nutritional screening tools available such as mini nutritional assessment tool, nutritional risk screening- 2002 tool, malnutrition universal screening tool, Weight, Activity, Variety & Excess tool and Rapid Eating & Activity Assessment for Patients tool. These tools are established for different purposes and used to assess different stages of nutritional status of hospitalized patients. For example, mini nutritional assessment tool is developed to identify the malnutrition status of elderly people and malnutrition universal screening tool is used for identifying malnutrition status of adult patients. However, hospitals and other healthcare providing organizations in Sri Lanka have a limited number of nutritional screening and/or assessment tools. Available tools which include anthropometric assessments, information on family background, dietary patterns and other related information are developed by the dieticians or nutritionists. It is mostly used in private hospitals and they have personnel/own nutritional screening tool, which is different from the hospital to hospital. But these tools have a number of drawbacks; consuming more time, only used by dieticians, does not used by other healthcare professionals, sometimes makes burden for patients and those tools only used for the patients who are referred to the dieticians in hospitals. Therefore, it is essential to develop a brief user-friendly tool to assess patients’ nutritional status, dietary patterns and exercise patterns at hospital settings.
In Sri Lanka, only few government permanent carders have for dieticians’ posts for hospitals. These nutritionists cannot cater all hospitalized patients who need nutritional care. Other important problem is that the majority of Sri Lankan physicians do not like to get the services of nutritionists for their healthcare process and they pay less attention for the nutritional management of the patients. Even though, nutrition plays a vital role in the healthcare process of the patients; poor involvement of nutritional management is observed. It may be due to limited time spending for a patients and inadequate nutrition knowledge and nutritional training among healthcare professionals and lack of dietitians & nutritionists in almost all the government hospitals in Sri Lanka. Therefore, the development of a brief, user- friendly tool to assess the patients’ nutritional status, diets and exercise patterns by providing information on healthy dietary patterns and physical activity patterns are important for healthcare professionals.
- Krauss RM, Eckel B, Howard LJ, Appel LJ, Daniels SR (2000) AHA Dietary Guidelines Revision 2000: a statement for healthcare professionals from the Nutrition Committee of the American Heart Association. Circulation 102(18): 2284-2299.
- Allison DB, Fontaine KR, Manson JE, Stevens J, VanItallie TB (1999) Annual deaths attributable to obesity in the United States. J Am Med Assoc 282(16): 1530-1538.
- Fettes SB, Davidson HIM, Richardoson RA, Pennington CR (2002) Nutritional status of elective gastrointestinal surgery patients pre- and post-operatively. Clinical Nutrition 21(3): 249-254.
- Kruizenga HM, Wierdsma NJ, Van Bokhorst MAE, Haollander HJ, Jonker Schuitema CF, et al. (2003) Screening of nutritional status in the Netherlands. Clin Nutr 22(2): 147-152.
- Middleton MH, Nazarenko G, Nivison Smith I, Smerdely P (2001) Prevalence of malnutrition and 12-month incidence of mortality in two Sydney teaching hospitals. Intern Med J 31(8): 455-461.
- Le Mont D, Fountain Valley CA, Melodie K, Moorehead FL, Michael S, et al. (2004) American Society for Bariatric Surgery. Allied Health Sciences Section Ad hoc Behavioral Health Committee.
- Burke BS (1947) The dietary history as a tool in research. J Am Diet Assoc 23: 1041-1046.
- Hawley JA (2004) Exercise as a therapeutic intervention for the prevention and treatment of insulin resistance. Diabetes/Metabolism Research and Reviews 20(5): 383-393.
- Tremblay A, Therrien F (2006) Physical activity and body functionality: implications for obesity prevention and treatment. Canadian Journal of Physiology and Pharmacology 84(2): 149-156.
- Wolinsky FD, Coe RM, McIntosh WA, Kubena KS, Prendergast JM, et al. (1990) Progress in the development of a nutrition risk index. Journal of Nutrition 120(11): 1549-1553.