The prevalence of sarcopenia (loss of muscle strength, mass and function) in individuals with heart failure (HF) stands at a considerable level (approximately 20%), contributing to heightened mortality rates and diminished quality of life. The underlying pathophysiological mechanisms involve the presence of low-grade inflammation and a disturbance of the anabolic–catabolic protein balance. The nutritional assessment of patients with HF is a key aspect, and diverse diagnostic tools are employed based on patient profiles (outpatient, inpatient and nursing home). The Global Leadership Initiative on Malnutrition (GLIM) criteria serves as a consensus for diagnosing malnutrition. Given that edema can impact body mass index (BMI) in patients with HF, alternative body assessment technical methods, such as bioelectrical vector impedance (BiVA), BIA (without vector mode), computer tomography (CT) or clinical ultrasound (US), are useful. Scientific evidence supports the efficacy of both aerobic and resistance physical exercises in ameliorating and preventing muscle wasting associated with HF. Dietary strategies emphasize the importance of protein intake, while certain micronutrients like coenzyme Q10 or intravenous iron may offer benefits. This narrative review aims to present the current understanding of the pathogenesis, diagnosis and treatment of muscle loss in individuals with heart failure and its consequential impact on prognosis.
Background: Malnutrition or its risk is common among patients with cancer (from 15% to 90%) and can negatively impact treatment outcomes and quality of life. Early detection and nutritional intervention are essential to improve clinical, health, and economic outcomes. This study evaluates the PRONTO (PROtocol for NuTritional risk in Oncology), a novel tool designed for the early identification of nutritional risk in patients with cancer. Objectives: To assess the feasibility of the PRONTO in detecting nutritional risk among newly diagnosed oncology patients. Methods: This cross-sectional, observational pilot study included 200 patients from two oncology centers in Madrid, Spain. The PRONTO was applied during the first oncology visit. Nutritional risk was assessed using PRONTO and nutritional status was evaluated with the Global Leadership Initiative on Malnutrition (GLIM) criteria. Tool acceptability was measured using the System Usability Scale (SUS) and Net Promoter Score (NPS) among participating oncologists. Results: The PRONTO identified 62.0% of patients at nutritional risk, while malnutrition was confirmed in 57.0% of patients using GLIM criteria. The PRONTO demonstrated high sensitivity (90.4%) and specificity (75.6%) compared to the GLIM. Oncologists rated the PRONTO highly, with a SUS score of 87.9 and an NPS of 9.1, indicating strong usability and recommendation potential. Conclusions: The PRONTO is a feasible and practical tool for early nutritional risk screening in oncology settings. Its simplicity and efficiency support its integration into routine clinical practice. The high prevalence of nutritional risk underscores the need for early screening to guide timely nutrition care. Further research with larger and diverse groups of patients and oncologists is needed to validate scalability and assess the impact of nutritional interventions on patient outcomes.