Aims: This retrospective audit was conducted to investigate the association between outcome and protein-energy malnutrition diagnosed using Subjective Global Assessment (SGA), to evaluate the predictive validity of Subjective Global Assessment in adults admitted to intensive care. Methods:The audit analysed the medical records of 1034 consecutive adult patients who had nutrition assessment on admission to the intensive care unit between January 2017 and July 2018. Extracted data included patient demographics, nutritional status, outcomes, and Acute Physiology and Chronic Health Evaluation II score. Regression was used to explore the association between Subjective Global Assessment and outcomes. Results: The prevalence of protein-energy malnutrition was 39.5% (342 patients SGA-B, and 75 patients SGA-C), and there was a significant independent association between Subjective Global Assessment and outcomes both in surgical and non-surgical patients. Compared with well-nourished patients, mortality was significantly higher in the malnourished, during the intensive care admission (p = 0.007), in hospital (p < 0.0001), at 90 days (p = 0.001) and at 180 days (p = 0.002). Pressure injuries were more common (p = 0.01). Length of stay was longer in intensive care (p = 0.001) and in hospital (p < 0.001), with increased readmission rate (p < 0.001).

Issue AddressedThe diets of Australian children, including their lunch boxes have a disproportionate amount of discretionary foods. Packaged snacks have marketing directed to both children and parents.MethodsPackaged school lunch box snacks were identified on supermarket websites. Nutrition information and child‐directed and parent‐directed marketing on the package were analysed. The “healthiness” of products was analysed using the Health Star Rating (HSR) (presently on packaging in Australia), two criteria designed for assessing food suitable for marketing to children (the Australian Health Council and the World Health Organization Western Pacific region) and Chilean criteria (used for broad food regulation).ResultsThe average HSR of the 135 products was 2.2% and 79% had a HSR <3.5. About 39% of products had child‐directed marketing. Child‐directed marketing would be removed from 89% sweet snacks, and 91% savoury snacks if products with a HSR <3.5 were not allowed to carry that marketing. This is less than the proportion not allowed using criteria from Chile (100%), World Health Organization Western Pacific Region (99%) and the Australian Health Council (93%).ConclusionsA policy that disallows marketing tactics on unhealthy food based on any of the criteria studied would remove most of both child‐directed and parent‐directed marketing on packaged lunch box snacks.So What?Removing child‐directed marketing from unhealthy products would help parents when shopping and contribute to addressing the high proportion of discretionary foods eaten by children at school. Child‐directed marketing on packaging should be a part of comprehensive regulation to protect children from the marketing of unhealthy foods.