Pre-post Analysis of Medical Nutrition Therapy on Nutritional Status among Patients with Obesity in Metabolic Obesity Clinic, Hospital Pengajar Universiti Putra Malaysia

Karuppan, Kumuthini (2022) Pre-post Analysis of Medical Nutrition Therapy on Nutritional Status among Patients with Obesity in Metabolic Obesity Clinic, Hospital Pengajar Universiti Putra Malaysia. [Project Paper] (Submitted)

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Abstract

Obesity is a chronic disease that has been increasing in Malaysia for the past few years. The current primary treatment for obesity is Medical Nutrition Therapy (MNT). However, there is scarce data on the changes in nutritional status post-MNT among patients with obesity and limited studies conducting retrospective analysis utilising real-life clinical practice data. Thus, this retrospective pre-post analysis was conducted to determine the pre-post changes in nutritional status among patients with obesity following MNT. Medical records of the patients with obesity were used to obtain the sociodemographic, clinical characteristics, anthropometric measurements, dietary intake and metabolic parameters at baseline (before MNT) and first follow-up visit (after MNT). A total of 57 subjects (41 females, 16 males) with a mean age of 41 ± 11 years and an average gap between visits of 3 ± 2 months were analysed. The majority of the participants had 2 comorbidities with Type 2 Diabetes Mellitus being the commonest comorbidities (42.1%). Before MNT, about 50.9% of subjects had BMI >40 kg/m2 (morbidly obese) and an average weight of 110 ± 21 kg. Mean metabolic parameters showed that subjects had not optimal fasting blood glucose (6.32 mmol/L), total cholesterol (5.16 mmol/L) and low-density lipoprotein cholesterol (LDL-C) (3.23 mmol/L). The mean energy intake was 1946 kcal/day. The carbohydrate and protein intake were within recommendation, but fat intake exceeded the recommendation. After MNT, there was a significant reduction in weight (110.14 ± 21.17 to 108.41 ± 20.89 kg, p<0.001) with about 2% weight loss from initial weight, BMI (41.55 ± 7.20 to 40.89 ± 7.18 kg/m2, p<0.001), fasting blood glucose (5.6 to 5.1 mmol/L, p=0.002), total cholesterol (5.4 to 4.5 mmol/L, p=0.014) and LDL-C (3.3 to 2.7 mmol/L, p=0.018). As for dietary intake, calories dropped significantly by almost 600 kcal/day. Protein from %TEI had significantly increased (13.8 to 15%, p=0.005), and fat intake remained above the recommendations after the MNT. This retrospective analysis found significant improvement in nutritional status post-MNT, which proven the benefits of MNT provided by a dietitian in managing obesity. Nonetheless, weight loss of 2% within 3 months is not clinically optimal, which could be related to a shorter duration of observation. Thus, the findings warrant further investigations, including barriers and challenges of MNT for morbid obesity management.

Item Type:	Project Paper
Faculty:	Faculty of Medicine and Health Science
Depositing User:	Mr Khoirul Asrimi Md Nor
Date Deposited:	15 Aug 2023 03:22
Last Modified:	15 Aug 2023 03:22
URI:	http://psaspb.upm.edu.my/id/eprint/993

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