Anthropometric, Biochemical, and Food Consumption Parameters are Associated with Venous Leg Ulcer Area and Duration

Abstract

OBJECTIVE To describe the dietary habits and anthropometric and biochemical parameters of patients with active venous leg ulcers and to verify the association of these variables with wound duration and area. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional study conducted with 33 participants diagnosed with venous leg ulcers in outpatient care. MAIN OUTCOME MEASURES Socioeconomic data, anthropometric parameters, biochemical parameters, food consumption, and wound characteristics were analyzed by an interprofessional team. MAIN RESULTS Participants were an average of 58 ± 13 years, 57.6% women, 84.8% overweight, and had a median wound duration of 10 months (range, 1–192 months) and an average wound area of 5 cm2 (range, 0.22–61.1 cm2). Diets were typically hypocaloric and hypoproteic, with a low amount of vitamin A and magnesium. Wound duration was negatively associated with polyunsaturated fat intake (P = .032), whereas wound area was significantly associated with lipid intake (P = .002) and C-reactive protein (P = .040). CONCLUSIONS Patients with active venous leg ulcers were overweight (leading to systemic inflammation) and had low consumption of calories, protein, and micronutrients that could support cicatrization. Wound area was associated with a high-fat diet, whereas wound duration was negatively associated with polyunsaturated fat intake.

Influence of Nutrition Status and Compression Therapy on Venous Ulcer Healing: A Systematic Review

“…In the analysis, significantly lower mean values for several parameters were detected in the study group versus the control group, including vitamin B 6 (4.2 vs 9 ng/mL; P < .0005), vitamin B 9 (5.19 vs 9.4 ng/mL; P < .0005), vitamin C (3 vs 5.2 mg/mL; P < .007), zinc (69 vs 87 μg/dL; P < .006), and albumin (34.5 vs 40.7 g/L; P < .000006). Homocysteine levels were elevated in the study group but in the normal range in the In the study by Melo et al, 23 ulcers averaged 32.5 cm 2 in size, and mean BMI was 30.93 kg/m 2 . Patients' nutrient intake was collected using 24-hour records.…”

“…Of the 11 studies included in the review, 63.6% were conducted in Europe, [16][17][18][19][20][21][22] and the remainder were conducted in the US (18.2%) 23,24 and Australia (18.2%). 25,26 The European studies were conducted in the UK, 16,21 Germany, 22 Poland, 17 Italy, 18 and France.…”

“…In the management of VUs, nutrition status and deficiencies that may affect the evolution of the wound should be considered. In this study, the authors found four articles [22][23][24]26 that investigated the nutrition status of patients with VUs.…”

“…Low values of vitamins B 6 , B 9 , C, D, and A predominate in patients with VUs. [22][23][24] Whereas deficits of vitamins B 6 , B 9 , and C are observed in patients with vascular ulcers, deficits of vitamins D and A are detected in all patients, although more pronounced in patients with VUs. Vitamin D deficiency is associated with age, low sun exposure, or obesity, whereas vitamin deficiency is due to a higher metabolic demand (as in the case of a chronic wound) and not only to insufficient intake.…”

“…[22][23][24] Some of the studies also describe ulcer assessment or development. 22,23 Renner et al 22 studied two groups of patients: patients with venous ulceration and a control group of patients who had a postsurgical wound following skin cancer removal. The mean size of VUs was 32.5 cm 2 , and BMI was higher in the study group than the control group (31.5 vs 27.1 kg/m 2 ).…”