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"Malnutrition"

Review Article

Nutritional pathways from treatment to management of sarcopenia in patients with gastric cancer: a narrative review
Swati , Mahak Sharma, Mohit Agarwal, Divya Choudhary
Korean J Fam Med 2026;47(2):97-108.   Published online March 20, 2026
DOI: https://doi.org/10.4082/kjfm.25.0215
Sarcopenia, characterized by the progressive loss of skeletal muscle mass and strength, represents a significant clinical concern among patients undergoing gastric cancer surgery. Postoperative individuals are particularly vulnerable due to gastrointestinal dysfunction, reduced nutrient intake, systemic inflammation, and treatment-induced metabolic stress. This condition is associated with higher complication rates, delayed recovery, chemotherapy intolerance, and decreased survival, underscoring the importance of early detection and effective nutritional management. This narrative review integrates and synthesizes recent evidence from clinical and experimental studies that explore the pathophysiology, diagnosis, and nutritional management of sarcopenia in gastric cancer. The review emphasizes key nutritional risk factors, assessment tools, and intervention strategies applicable to both preoperative and postoperative care. Validated methods such as SARC-F (strength, assistance with walking, rise from a chair, climb stairs, and falls), dual-energy X-ray absorptiometry, and computed tomography imaging play central roles in identifying muscle loss and functional decline. Evidence suggests that protein-enriched diets, branched-chain amino acids, omega-3 fatty acids, and micronutrients such as vitamin D and antioxidants help preserve muscle mass and improve recovery outcomes. Exercise and rehabilitation further enhance these benefits by synergistically promoting muscle protein synthesis and function. Moreover, emerging technologies—including artificial intelligence–assisted nutritional monitoring, nutrigenomics, and biomarker-based personalization—represent promising directions for individualized care. Sarcopenia in gastric cancer is a modifiable and clinically significant condition. Integrating personalized nutrition with structured rehabilitation can markedly enhance functional recovery, treatment tolerance, and quality of life. Future research should aim to develop precision-based nutritional algorithms and standardized diagnostic frameworks to optimize outcomes in this high-risk population.
  • 1,066 View
  • 60 Download
Original Articles
Malnutrition, Its Attributes, and Impact on Quality of Life: An Epidemiological Study among β-Thalassemia Major Children
Bijit Biswas, Narendra Nath Naskar, Keya Basu, Aparajita Dasgupta, Rivu Basu, Bobby Paul
Korean J Fam Med 2021;42(1):66-72.   Published online January 20, 2020
DOI: https://doi.org/10.4082/kjfm.19.0066
Background
India is home to a large number of thalassemic children. Despite malnutrition being an essential determinant of their therapeutic goals and quality of life (QoL), it was hardly ever explored. With this background, this study aimed to estimate the proportion of β-thalassemia major (β-TM) children experiencing malnutrition, its attributes, and impact on their QoL.
Methods
This cross-sectional, hospital-based, analytical observational study was conducted among 328 β-TM children attending the thalassemia day care unit of a medical college from May 2016 to April 2017, with a structured schedule. Data were analyzed following appropriate statistical methods using SPSS statistical package ver. 16.0 (SPSS Inc., Chicago, IL, USA).
Results
Among the study participants, 48.2% were malnourished with a mean body mass index of 13.9 kg/m2 . In the multivariable logistic regression model, participants’ age (adjusted odds ratio [AOR], 1.15; 95% confidence interval [CI], 1.02–1.29), caste (AOR, 2.11; 95% CI, 1.23–3.60), mothers’ educational level (AOR, 2.05; 95% CI, 1.22– 3.44), blood transfusion frequency (AOR, 1.25; 95% CI, 1.16–1.31), and palpable spleen size (AOR, 1.22; 95% CI, 1.08–1.37) were significant predictors of malnutrition after adjusting for pre-transfusion hemoglobin level and hemolytic facies status. In multiple linear regression analysis, malnutrition negatively impacted total QoL (unstandardized beta [standard error], -4.4 [1.7]; P=0.009) and various domains of the study participants except the social and school domains adjusted for age, sex, caste, place of residence, parents’ educational level, and socioeconomic status.
Conclusion
Almost half of the study participants had malnutrition. Malnutrition had a negative impact on their QoL.

Citations

Citations to this article as recorded by  
  • Health-related quality of life and associated factors in Chinese pediatric patients with β-thalassemia major receiving transfusion and iron chelation therapy: a cross-sectional study
    Haiyan Liang, Yang Yang, Lin Pan, Yanni Xie, Yongrong Lai
    Expert Review of Hematology.2026; : 1.     CrossRef
  • Dietary Patterns Among Patients With Beta‐Thalassemia Major in Vietnam
    Thi Ngoc Anh Hoang, Ha‐Linh Quach
    Journal of Human Nutrition and Dietetics.2025;[Epub]     CrossRef
  • Health‐related quality of life with standard and curative therapies in thalassemia: A narrative literature review
    Richa Shah, Sherif M. Badawy
    Annals of the New York Academy of Sciences.2024; 1532(1): 50.     CrossRef
  • Comparison of Yearly Cost Related to Complications Between Deferasirox and Deferiprone Monotherapy in Thalassemia
    Teny Tjitra Sari, Pustika Amalia Wahidiyat, Ludi Dhyani Rahmartani, Stephen Diah Iskandar, Isyanaditta Agung Putri
    Journal of Pediatric Hematology/Oncology.2024; 46(6): e402.     CrossRef
  • Quality of life and thalassemia in India: A scoping review
    Saravanan Chinnaiyan, Jenifer Sylvia, Sowmiya Kothandaraman, Bharathi Palanisamy
    Journal of Family Medicine and Primary Care.2024; 13(4): 1183.     CrossRef
  • Association of age to nutritional status and muscle mass in children with transfusion-dependent β-thalassemia: a cross-sectional study
    Li Wang, Luyang Zhang, Yanlan Yang, Yuan Luo, Lei Wang, Sandip Patil
    Frontiers in Nutrition.2024;[Epub]     CrossRef
  • Premature Atherosclerosis in Children With Transfusion-Dependent Thalassemia
    Rajesh Kulkarni, B. Rameshbabu
    Indian Pediatrics.2023; 60(3): 239.     CrossRef
  • Detection of endocrine disorders in young children with multi-transfused thalassemia major
    Ramadan A. Mahmoud, Ashraf Khodeary, Marwa S. Farhan
    Italian Journal of Pediatrics.2021;[Epub]     CrossRef
  • 8,254 View
  • 186 Download
  • 10 Web of Science
  • 8 Crossref
Background

Microalbuminuria and obesity markers are known risk factors for cardiovascular or renal disease. This study aimed to evaluate the prevalence of microalbuminuria according to body mass index (BMI) and abdominal obesity criteria.

Methods

The study subjects included 3,979 individuals aged 30 years or older who did not have diabetes, hypertension, renal failure, or overt proteinuria, from among those who participated in The Korean National Health and Nutrition Examination Survey in 2013, a cross-sectional, nationally representative, stratified survey. Microalbuminuria was defined as a urinary albumin to creatinine ratio of 30 to 300 mg/g. BMI and waist circumference were classified according to the Asia-Pacific criteria.

Results

The prevalence of microalbuminuria was found to be 5.1%. In the normoalbuminuria group, 3.4%, 41.7%, 24%, 27.6%, and 3.2% of participants were included in the underweight, normal, overweight, obesity 1, and obesity 2 groups, respectively. These percentages in the microalbuminuria group were 7.1%, 34.5%, 19.2%, 28.6%, and 10.6%, respectively (P<0.001). The waist circumference in men was 21.4% in the normoalbuminuria group and 36.5% in the microalbuminuria group (P=0.004). Logistic regression analyses were performed to evaluate the relationship between the presence of microalbuminuria and BMI or waist circumference groups. The risk of microalbuminuria was significant only in the underweight group (odds ratio, 13.22; 95% confidence interval, 2.55–68.63; P=0.002) after adjusting for confounding factors, abdominal obesity was not significantly associated with microalbuminuria.

Conclusion

The prevalence of microalbuminuria in a general population in Korea was associated with underweight in men and was not associated with waist circumference in either men or women.

Citations

Citations to this article as recorded by  
  • Microalbuminuria in normotensive nondiabetic overweight and obese versus nonobese adults
    Kiran, Madhubala Negi
    Journal of Family Medicine and Primary Care.2025; 14(8): 3199.     CrossRef
  • Obesity related alterations in kidney function and plasma cytokines: Impact of sibutramine and diet in male Wistar rats
    Uchenna AGU Francis, Uche ELENDU Melford, Kelechi OKECHUKWU Hope, Adolphus MBAH Chikodili, Chinonye OBIOHA Kennedy, Orji ABALI Isaiah, Edorisiagbon IYARE Eghosa, Daniel Chukwu NWACHUKWU and
    African Journal of Pharmacy and Pharmacology.2022; 16(10): 161.     CrossRef
  • Association between obesity and urinary albumin-creatinine ratio in the middle-aged and elderly population of Southern and Northern China: a cross-sectional study
    Shan Qin, Anping Wang, Shi Gu, Weiqing Wang, Zhengnan Gao, Xulei Tang, Li Yan, Qin Wan, Zuojie Luo, Guijun Qin, Lulu Chen, Guang Ning, Yiming Mu
    BMJ Open.2021; 11(1): e040214.     CrossRef
  • Association between body mass index and fragility fracture in postmenopausal women: a cross-sectional study using Korean National Health and Nutrition Examination Survey 2008–2009 (KNHANES IV)
    Jihan Kim, Sami Lee, Sung Soo Kim, Jong-Pyo Lee, Jong Sung Kim, Jin Gyu Jung, Seok Jun Yoon, Kyu Pil Kim, Chan-Keol Park, Yong-Hwan Kim
    BMC Women's Health.2021;[Epub]     CrossRef
  • The Association Between Serum Magnesium Level and Microalbuminuria in Type 2 Diabetes Mellitus Patients
    Masoud Mohebbi, Katayoun Samadi, Nazafarin Navari, Melika Ziafati-fahmideh-sani, Golshid Nourihosseini, Negin Ershad, Milad Bahrami, Ali Rezaeizadeh, Amirhossein Taheri, Mohammad-taha Akbari-javar, Mohammad Zamiri Bidary, Ali Kabirian, Amirhossein Hessami
    Nephro-Urology Monthly.2021;[Epub]     CrossRef
  • The Effect of Bariatric Surgery versus Intensive Medical Care on Prevention of Microalbuminuria in Patients with Type 2 Diabetes: 3 Year Experience of a Prospective Study
    Amin Soliman, Haythum Soliman, Mervat Naguib
    Open Access Macedonian Journal of Medical Sciences.2021; 9(B): 202.     CrossRef
  • Cross-sectional associations between central and general adiposity with albuminuria: observations from 400,000 people in UK Biobank
    Pengfei Zhu, Sarah Lewington, Richard Haynes, Jonathan Emberson, Martin J. Landray, David Cherney, Mark Woodward, Colin Baigent, William G. Herrington, Natalie Staplin
    International Journal of Obesity.2020; 44(11): 2256.     CrossRef
  • Prevalence of microalbuminuria and associated factors among HIV − infected ART naïve patients at Mulago hospital: a cross-sectional study in Uganda
    Thomas Kiggundu, Robert Kalyesubula, Irene Andia-Biraro, Gyaviira Makanga, Pauline Byakika-Kibwika
    BMC Nephrology.2020;[Epub]     CrossRef
  • Albuminuria in Patients with Morbid Obesity and the Effect of Weight Loss Following Bariatric Surgery
    Johanna Maria Brix, Carsten Thilo Herz, Hans Peter Kopp, Astrid Feder, Eva-Christina Krzizek, Christoph Sperker, Gerit-Holger Schernthaner, Guntram Schernthaner, Bernhard Ludvik
    Obesity Surgery.2019; 29(11): 3581.     CrossRef
  • Is there a J-shaped relationship between the fatty liver index and risk of microalbuminuria in the general population?
    Jong Wook Choi, Il Hwan Oh, Chang Hwa Lee, Joon-Sung Park
    Clinica Chimica Acta.2018; 481: 231.     CrossRef
  • Prevalence of microalbuminuria and its associated cardiometabolic risk factors in Korean youth: Data from the Korea National Health and Nutrition Examination Survey
    Heeyeon Cho, Jae Hyun Kim, Gianpaolo Reboldi
    PLOS ONE.2017; 12(6): e0178716.     CrossRef
  • 7,628 View
  • 47 Download
  • 11 Web of Science
  • 11 Crossref
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