Effects of overnight fasting on handgrip strength in inpatients

Abstract

Objective:To investigate the effects of overnight fasting on handgrip strength of adult inpatients.Methods:A prospective clinical study enrolling 221 adult patients. The endpoints were handgrip strength obtained by dynamometry in three time points (morning after an overnight fasting, after breakfast and after lunch) and the cumulative handgrip strength (mean of handgrip strength after breakfast and lunch) in the same day. The mean of three handgrip strength measures was considered to represent each time point. A cut-off for the mean overnight fasting handgrip strength at the 50th percentile (35.5kg for males and 27.7kg for females) was used for comparisons. We registered the age, sex, current and usual weight (kg), weight loss (kg), diagnosis of cancer, nutritional status, elderly frequency, digestive tract symptoms, type of oral diet, and the amount of dinner ingested the night before handgrip strength (zero intake, until 50%, <100% and 100%).Results:Handgrip strength evaluated after an overnight fasting (31.2±8.7kg) was lesser when compared with handgrip strength after breakfast (31.6±8.8kg; p=0.01), and with cumulative handgrip strength (31.7±8.8kg; p<0.001). Handgrip strength was greater in patients who ingested 100% (33.2±9.1kg versus 30.4±8.4kg; p=0.03) and above 50% of dinner (32.1±8.4kg versus 28.6±8.8kg; p=0.006). Multivariate analysis showed that ingesting below 50% of dinner, severe malnutrition, and elderly were independent factors for handgrip strength reduction after overnight fasting.Conclusion:The muscular function was impaired after an overnight fasting of adult patients hospitalized for medical treatment, especially for those with low ingestion, malnourished and elderly.

Risco Nutricional versus Risco de Sarcopenia Associado a Complicações Pós-Operatórias e Mortalidade em Pacientes Oncológicos Submetidos a Cirurgias de Grande Porte

“…Portanto, o SARC-F parece ser uma ferramenta eficaz para selecionar pacientes que devem ser submetidos a mais testes para confirmar o diagnóstico de sarcopenia 26 . Neste estudo, esse resultado foi uma surpresa, uma vez que o SARC-F avalia as condições relacionadas à capacidade funcional e à performance muscular 11,19,26,27 , que se modificam rapidamente antecedendo às alterações antropométricas [28][29][30][31] , o que permite diagnosticar mais precocemente os prejuízos na condição do paciente 11,12 e, ainda, a associação com piores desfechos. Por outro lado, o NRS-2002 é um instrumento preconizado pela Sociedade Europeia de Nutrição Clínica e Metabolismo (ESPEN) para triagem nutricional, e tem sido empregado com frequência para associar o risco nutricional e as complicações pós-operatórias 9,10 .…”

Association between preoperative potential sarcopenia and survival of cancer patients undergoing major surgical procedures

“…We considered patients who achieved a SARC F ≥ 4 as in risk of sarcopenia 17,18 . We assessed muscle strength by the handgrip strength (HGS; Kgf), measured in the dominant hand with the aid of a hydraulic dynamometer (Saehan Corporation, Masan, Corea®) 19 . We classified patients as having low muscle strength according to the cutoffs of < 27 Kgf and < 16 Kgf, for men and women, respectively 7 .…”

“…An ally of the SARC-F, and indicated by it, is the measuring of muscle strength for the diagnosis of SP 7 . The muscle strength changes rapidly and precedes the anthropometric changes, which allows more sensitive and rapid detection of sarcopenia [17][18][19][20] .…”

Is muscular strength compromised by overnight fasting or food ingestion in hospital settings?

“…The article “Effects of overnight fasting on handgrip strength in inpatients” 1 is relevant and has practical application in the hospital environment. Nevertheless, a few methodological issues need to be clarified:…”

“…O artigo “Efeitos do jejum noturno sobre a força muscular em pacientes internados” 1 é relevante e de aplicação prática no ambiente hospitalar. Porém, algumas questões metodológicas merecem ser esclarecidas:…”