Malnutrition is common in stroke patients, as it is associated with neurological and cognitive impairment as well as clinical outcomes. Nutritional screening is a process with which to categorize the risk of malnutrition (i.e., nutritional risk) based on validated tools/procedures, which need to be rapid, simple, cost-effective, and reliable in the clinical setting. This review focuses on the tools/procedures used in stroke patients to assess nutritional risk, with a particular focus on their relationships with patients’ clinical characteristics and outcomes. Different screening tools/procedures have been used in stroke patients, which have shown varying prevalence in terms of nutritional risk (higher in rehabilitation units) and significant relationships with clinical outcomes in the short- and long term, such as infection, disability, and mortality. Indeed, there have been few attempts to compare the usefulness and reliability of the different tools/procedures. More evidence is needed to identify appropriate approaches to assessing nutritional risk among stroke patients in the acute and sub-acute phase of disease or during rehabilitation; to evaluate the impact of nutritional treatment on the risk of malnutrition during hospital stay or rehabilitation unit; and to include nutritional screening in well-defined nutritional care protocols.

Background: In previous pilot studies we have demonstrated that the Treatment Motivation and Readiness Test (TRE-MORE) is capable of predicting the outcome of obesity therapy and that a higher muscle mass (MM) is associated with a greater weight loss. Purposes of the present study were: to confirm the predictive value of TRE-MORE scores and MM, using a standardized non-pharmacologic intervention for weight loss; to explore the relationship between TRE-MORE and MM; to discriminate predictors of attendance from predictors of final therapeutic success. Methods: A consecutive series of 331 patients was enrolled and addressed to a standardized treatment protocol. Results: Mean weight loss at 6 months was -5.03%. Among participants, 48.7% lost at least 5% initial body weight after 6 months and had significantly higher TRE-MORE total scores and MM. Weight loss was significantly associated with baseline MM, TRE-MORE-3, and a lower number of previous diets. Significantly lower TRE-MORE-3 scores were associated with drop-out. Conclusion: The present study confirms that therapeutic success is predicted by TRE-MORE scores and, independently from these, by estimated MM (after adjustment for BMI). TRE-MORE total score is a predictor of failure, but not of attendance, whereas drop-out patients showed a lower score only in TREMORE-3 subscale which investigates lifestyle habits.

Preliminary evidence in the literature suggests a high prevalence of malnutrition (undernutrition) in patients with severe acquired brain injuries (sABI), with an expected negative impact on clinical outcomes and pressure ulcers (PUs) in particular. In a retrospective cohort study on patients discharged from intensive care units (ICU) and admitted to an intensive rehabilitation unit (IRU), the risk of malnutrition was systematically assessed, in addition to standard clinical procedures (including PUs evaluation), using two different tools: the Malnutrition Universal Screening Tool (MUST) and the Controlling Nutritional Status (CONUT) tool. Eighty-eight patients were included in the analysis. A high proportion (79.5%) of patients with sABI suffered from PUs, being older and more frequently men, with a longer ICU stay between the event and admission to IRU, and a greater MUST score. At discharge, when compared to patients whose PUs had healed, those with persisting PUs were more often men and had the worst cognitive performance at admission. As for nutritional risk, the baseline CONUT score was identified as an independent negative predictor of PUs at discharge by the logistic regression model. In conclusion, the assessment of nutritional risk using simple standard tools may be useful in the clinical evaluation of sABI patients with PUs.

Aim: Malnutrition is an often underestimated, worldwide, frequent problem with a high prevalence among inpatients, especially the elderly ones. Undernourished patients have an increased risk of comorbidities, complications and a decreased quality of life. Malnutrition is associated with longer hospital stay, increased care needs and costs for the National Health Service (NHS). We describe the protocol of a study conducted to evaluate the impact of specialized nutritional care on 3-month outcomes of patients at high risk of malnutrition at admission and to describe the actual nutritional practice in a rehabilitation setting. Methods: In this single-center, prospective, observational study patients at high risk of malnutrition who received standard nutritional care (Group 1) were compared with patients at high risk of malnutrition who received a specialized nutritional care (Group 2). Three months after discharge (follow-up), patients of both groups were interviewed by telephone to collect data regarding number of hospital readmission, emergency department admission, general practitioner (GP) and outpatient visits, diagnostic tests, daily medication use and survival. Conclusion: Our study could help to support clinical choices for personalized nutritional interventions to improve rehabilitation outcomes and to decrease the costs for the NHS. This protocol is registered at ClinicalTrials.gov (NCT07183098) under the title “A Prospective Observational Study on the Prevalence of Malnutrition and Clinical-Economic Aspects of the Impact of Specialized Nutritional care on the 3-month Outcomes of Patients at high Risk of malnutrition Admitted to a Rehabilitation Hospital”.

Whey protein (WP) supplementation could affect low-grade inflammation (inflammaging) and gut microbiome dysbiosis, both of which play key roles in non-communicable diseases (NCDs). Twenty-seven cardiac rehabilitation patients were randomly allocated to two groups: the case group (CA) (n = 14) received 80 g/die vitamin D and leucine-enriched WP supplement, combined with a standard hospital diet, while the control group (CO, n = 13) received the standard hospital diet alone. Blood and stool samples were collected at baseline (T0) and after two weeks (T1). At T1, serum levels of interleukin 6 (IL-6) and C-reactive protein (CRP) significantly decreased in the CA group. Ferritin levels significantly decreased within both groups and between the two groups. No significant differences were observed for IL-1β, tumor necrosis factor-α (TNF-α), or IL-10. A clear difference in the bacterial intestinal microbiome composition between the case group at T1 (CAT1) and at T0 (CAT0), and control group at T0 (COT0) and at T1 (COT1), was observed. The eubacterial rpoB copy number, which was quantified by qPCR, significantly increased between CAT0 and CAT1, in contrast to the Lactobacillus spp. rpoB copy number. Our exploratory results showed that vitamin D and leucine-enriched WP supplementation could have a potential effect on chronic inflammation and gut microbiota composition in cardiac rehabilitation patients.

Introduction: Nutritional literacy enables the proper management of information about food and diet, promoting adequate nutritional habits. Diet plays a central role in the prevention and management of cardiovascular diseases. In centres dedicated to cardiovascular prevention and cardiac rehabilitation, dietitian-led nutritional care is essential, but all team members contribute to patient education, requiring continuous knowledge updates. The DEMETRA survey assessed the nutritional knowledge of the cardiology teams members, their adherence to the Mediterranean Diet, and the relationship between knowledge and adherence. Methods: The DEMETRA survey, promoted by ASAND and ITACARE-P, involved healthcare professionals of cardiovascular prevention and rehabilitation teams (cardiologists, resident physicians, psychologists, nurses, and physiotherapists), excluding dietitians. The online questionnaire collected demographic data, presence of a dietitian in the team, nutritional knowledge (Moynihan questionnaire), and adherence to the Mediterranean Diet (QueMD questionnaire). Results: A total of 153 healthcare professionals participated. Nutritional knowledge and Mediterranean Diet adherence were similar between medical and non-medical professionals ( p > 0.05). Higher knowledge did not consistently correspond to greater dietary adherence. Only participants with high adherence to the Mediterranean model reported a mean score consistent with high nutritional knowledge. Conclusions: Nutritional knowledge and Mediterranean Diet adherence were moderate but below optimal levels. A possible positive relationship emerged between high adherence to the Mediterranean model and greater nutritional knowledge. These findings highlight the need for targeted educational strategies and reinforce the strategic role of dietitians in strengthening nutrition competencies within multidisciplinary cardiovascular teams.