For patients undergoing major thoracoabdominal surgery, perioperative nutritional management is essential. Although enteral nutrition is preferred, parenteral nutrition (PN) is needed when oral or enteral intake is inadequate or contraindicated and serves as a key electrolyte source. Electrolytes are crucial for fluid balance, acid-base stability, and metabolic function, and inappropriate supplementation may cause serious disturbances. Real-world evidence on perioperative PN electrolyte use in China remains limited. This multicenter retrospective study included 2018 patients who underwent major thoracoabdominal surgery and received PN between January 1 and December 31, 2024, across 10 medical centers in 8 provinces in China. Daily sodium, potassium, calcium, magnesium, and phosphorus intake and related clinical outcomes were collected from 2 days before to 5 days after surgery. Adequacy was assessed according to current guideline recommendations. Among the 2018 patients included, perioperative electrolyte supplementation showed substantial deviations from guideline recommendations. On the day of surgery, excessive sodium supplementation (>150 mmol) was observed in 73.7% of patients, while insufficient supplementation of potassium, magnesium, and phosphorus occurred in 56.2%, 91.0%, and 94.7%, respectively. Overall, 48.9% of patients experienced at least 1 electrolyte disturbance, with hypocalcemia (30.4%), hypophosphatemia (18.2%), and hyponatremia (17.8%) being the most common abnormalities. Potential PN compatibility risks were identified in 40.4% of prescriptions on the day of surgery and were associated with longer hospital stay. Multivariable analyses showed that supplementation routes were not independently associated with clinical outcomes. In contrast, higher PN volume was independently associated with increased risks of electrolyte disturbances, major complications, and prolonged hospitalization. Phosphate insufficiency was associated with prolonged hospital stay and increased risks of electrolyte disturbance and major complications, particularly on postoperative day 1. Surgical complexity also influenced outcomes, with pancreaticoduodenectomy associated with substantially higher risks of electrolyte disturbances and major complications. Perioperative PN is characterized by sodium overload and multi-electrolyte deficiency. Beyond supplementation routes, PN volume, phosphate insufficiency, and surgical complexity are key independent determinants of adverse clinical outcomes. Optimization of PN dosing strategies and targeted correction of phosphate imbalance may improve postoperative recovery and safety.

Background The role of nutritional management and skeletal muscle mass assessment in the treatment of gastric cancer has received increasing attention. This study aims to investigate the effect of whole-course nutrition management on postoperative skeletal muscle mass, incidence of complications, readmission rate and overall survival in patients with gastric cancer undergoing neoadjuvant treatment. Methods Patients with gastric cancer who underwent radical gastrectomy after neoadjuvant treatment from January 2016 to December 2020 were retrospectively analyzed. The patients were divided into whole-course nutrition management group and control group. Clinical data including demographic information, duration of neoadjuvant chemotherapy regimen, radiotherapy or not, nutritional assessment, nutritional intervention, surgery, and pathology were collected. The primary outcome was skeletal muscle mass measured by computed tomography at 6 months after surgery compared with that before neoadjuvant treatment, which was the cross-sectional area of the third lumbar spine measured by ImageJ software. Results Among 182 initially enrolled patients, propensity score matching yielded 110 patients in the whole-course nutrition management group and 57 in the control group. A statistically significant difference was observed in skeletal muscle area change between the two groups (P = 0.045). However, no significant differences were found in in-hospital complication rates, 90-day readmission rates, overall survival, or disease-free survival. Conclusions In patients with gastric cancer undergoing neoadjuvant treatment, whole-course nutrition management can significantly improve the loss of skeletal muscle mass. Nevertheless, this improvement did not translate into a significant reduction in in-hospital complication rates, readmission rates, or improved survival outcomes.

This study developed and compared two oral-phase pretreatment strategies, mastication (physiologically realistic) and homogenization (standardized), for in vitro digestion of freshly cooked rice using a combined parallel-sequential kinetics model. Univariate GI prediction models based on AC, rapidly digestible starch weight ( [Formula: see text] ), and 120-min area under the digestion curve (AUC120) were developed from seven rice varieties with contrasting amylose content (AC, 8.1% ~ 31.9%), and were externally validated on four varieties from a separate same-laboratory experiment, while an additional nine varieties were used for extended prediction. The homogenization protocol yielded superior inter-sample discrimination and stronger in vitro-in vivo correlations, and thus was selected for model development. Under homogenization, AC-based eGI achieved the lowest prediction errors (MAE = 1.25, RMSE 1.50) and perfect rank-order preservation (Spearman's ρ=1.0), followed by AUC120 and [Formula: see text] -based eGI. The AC-based eGI was strongly correlated with starch molecular parameters including amylose chain length (p < 0.01), whereas both kinetics-derived predictors lacked significant correlations. Cross-experiment comparison further revealed that identical varieties produced markedly different digestion curves, highlighting the inherent variability of kinetics-based predictors. These findings demonstrate that AC provides a robust and transferable basis for the rapid screening of cooked rice GI.

Time in range (TIR) is a new marker for blood glucose management, but its relationship with sarcopenia and its components requires further investigation. This study aims to investigate the association between TIR and sarcopenia and its components in older patients with type 2 diabetes mellitus (T2DM). This cross-sectional study included 310 hospitalized patients aged ≥ 60 years with T2DM. Continuous glucose monitoring (CGM) was used to assess TIR, and sarcopenia was diagnosed according to the 2019 criteria of the Asian Working Group on Sarcopenia, including indicators such as skeletal muscle mass index (SMI), handgrip strength, and physical performance. The relationships between TIR and sarcopenia and its components were analyzed using a logistic regression model, a linear regression model, and a restricted cubic spline model. The prevalence of sarcopenia was 32.3%. After adjusting for multiple factors, each 10% increase in TIR was associated with a 17% reduction in sarcopenia risk (odds ratio [OR] and 95% confidence interval [CI] = 0.83 [0.74-0.93], P = 0.001). Patients with TIR ≥ 70% had a 62% lower risk of sarcopenia compared to those with TIR < 50% (OR and 95%CI: 0.38 [0.19-0.74], P = 0.005). TIR showed a linear positive correlation with SMI and a nonlinear correlation with handgrip strength; however, it was not significantly associated with physical performance. Higher TIR is associated with higher muscle mass and handgrip strength, as well as a lower incidence of sarcopenia. For older adults with type 2 diabetes who have a low TIR, caution should be exercised regarding their elevated risk of developing sarcopenia.

OBJECTIVES:To evaluate the criterion validity and test-retest reliability of the Chinese version International Physical Activity Questionnaire-Short Form (cIPAQ-SF) for assessing sedentary behaviour and physical activity (PA) in overweight and obese Chinese adults, using activPAL as the reference. METHODS:A cross-sectional study was conducted at a Clinical Nutrition Clinic in China. Participants completed the cIPAQ-SF before and after wearing an activPAL for 7 consecutive days. Criterion validity was assessed using Pearson's/Spearman's correlation coefficients and Bland-Altman plots for sitting time (hours/day), moderate, vigorous and moderate-to-vigorous PA (MVPA) (min/week). Sensitivity and specificity evaluated the IPAQ-SF's accuracy in identifying those not engaging in any PA and those not meeting the PA recommendation (MVPA ≥150 min/week). Test-retest reliability was assessed using intraclass correlation (ICC). RESULTS:Among 80 participants (age 33.9±7.3 years; body mass index 29.1±4.5 kg/m²), the IPAQ-SF demonstrated moderate criterion validity for sitting time (r=0.577 on weekdays, r=0.444 on weekends) and MVPA (ρ=0.451) compared with activPAL. It underestimated sitting time by 3.5 hours/day on weekdays and 2.9 hours/day on weekends. The cIPAQ-SF showed moderate-to-high sensitivity for correctly identifying individuals who were not engaging in any PA (53.6%-85.7%) or not meeting PA recommendations (93.8%), but its specificity was low to moderate (47.8%-73.7%) for PA engagement and meeting guidelines (55.2%). Test-retest reliability was moderate for sitting time (ICC=0.549-0.614) and poor to moderate for PA levels (ICC=0.453-0.592). CONCLUSION:The IPAQ-SF demonstrates moderate validity and reliability in assessing sedentary behaviour and insufficient PA among overweight and obese Chinese adults. It can be used to identify physically inactive individuals for targeted interventions and monitor changes in sedentary behaviour.

Although obesity has been linked to overactive bladder (OAB), the degree of weight loss needed for meaningful symptom improvement remains unknown. This study aims to evaluate the effects of behavioral weight loss (BWL) on OAB symptoms and to identify predictive threshold for clinically meaningful improvement. Women with concurrent overweight or obesity and OAB were prospectively enrolled in a 6‑month BWL program at our centre from September 2023 to January 2024. The Overactive Bladder Symptom Score (OABSS) was assessed at baseline and at follow-up. A ≥ 3‑point reduction in OABSS defined the effective group; the remaining participants were classified as the ineffective group. The baseline characteristics and the magnitude of weight loss were compared between the two groups. Correlation analysis was performed to examine the relationship between OABSS reduction and both percent weight loss and reduction in fat mass percentage (FM

For patients undergoing major thoracoabdominal surgery, perioperative nutritional management is essential. Although enteral nutrition is preferred, parenteral nutrition (PN) is needed when oral or enteral intake is inadequate or contraindicated and serves as a key electrolyte source. Electrolytes are crucial for fluid balance, acid–base stability, and metabolic function, and inappropriate supplementation may cause serious disturbances. Real-world evidence on perioperative PN electrolyte use in China remains limited. This multicenter retrospective study included 2018 patients who underwent major thoracoabdominal surgery and received PN between January 1 and December 31, 2024, across 10 medical centers in 8 provinces in China. Daily sodium, potassium, calcium, magnesium, and phosphorus intake and related clinical outcomes were collected from 2 days before to 5 days after surgery. Adequacy was assessed according to current guideline recommendations. Among the 2018 patients included, perioperative electrolyte supplementation showed substantial deviations from guideline recommendations. On the day of surgery, excessive sodium supplementation (>150 mmol) was observed in 73.7% of patients, while insufficient supplementation of potassium, magnesium, and phosphorus occurred in 56.2%, 91.0%, and 94.7%, respectively. Overall, 48.9% of patients experienced at least 1 electrolyte disturbance, with hypocalcemia (30.4%), hypophosphatemia (18.2%), and hyponatremia (17.8%) being the most common abnormalities. Potential PN compatibility risks were identified in 40.4% of prescriptions on the day of surgery and were associated with longer hospital stay. Multivariable analyses showed that supplementation routes were not independently associated with clinical outcomes. In contrast, higher PN volume was independently associated with increased risks of electrolyte disturbances, major complications, and prolonged hospitalization. Phosphate insufficiency was associated with prolonged hospital stay and increased risks of electrolyte disturbance and major complications, particularly on postoperative day 1. Surgical complexity also influenced outcomes, with pancreaticoduodenectomy associated with substantially higher risks of electrolyte disturbances and major complications. Perioperative PN is characterized by sodium overload and multi-electrolyte deficiency. Beyond supplementation routes, PN volume, phosphate insufficiency, and surgical complexity are key independent determinants of adverse clinical outcomes. Optimization of PN dosing strategies and targeted correction of phosphate imbalance may improve postoperative recovery and safety.

BACKGROUND:Phase angle serves as a robust indicator of cellular integrity and overall health status. However, reference values for phase angle among healthy Chinese adults remain poorly defined. METHODS:We performed a multicenter descriptive cross-sectional study in healthy Chinese adults from 2021 to 2024. Our primary outcome was phase angle, calculated from the relationship between resistance and reactance measured directly by bioelectrical impedance analysis. Standardized anthropometric and bioelectrical impedance analysis assessments were conducted. We examined associations of phase angle with age, sex, and body mass index using multivariable linear regression and generated sex-, age-, and body mass index-stratified percentiles. RESULTS:We analyzed 40,074 healthy adults (46.9% men; mean ± SD age 42.8 ± 12.9 years; mean ± SD body mass index 24.2 ± 3.5 kg/m²) who attended routine health examinations at three hospitals in Northern, Eastern, and Southwestern China. The mean ± SD phase angle was 5.52 ± 0.79°, with significantly higher values in men compared with women (5.95° vs 5.14°, P < 0.001). Phase angle positively correlated with body mass index (r = 0.35) and negatively with age (r = -0.20) (both P < 0.001). Peak phase angle values were observed in individuals aged 30-39 years and declined thereafter. Device type showed no significant effect on phase angle measurements. CONCLUSION:We established the first large-scale, sex-, age-, and bioelectrical impedance analysis-specific phase angle reference ranges for healthy Chinese adults. These normative values provide an essential foundation for clinical application of phase angle in health assessment, early disease screening, and individualized nutrition and medical interventions.

ObjectivesTo evaluate the relationship between single- and multiple-mineral deficiencies and malnutrition, as defined by the Global Leadership Initiative on Malnutrition (GLIM) criteria among Chinese inpatients.MethodsA multicenter cross-sectional study of hospitalized patients in hospitals was conducted in China. Information on the inpatients’ social demographic characteristics, physical examination, and laboratory test results was collected. Malnutrition was defined on the GLIM criteria. Multivariable logistic regression and restricted cubic spline were used to examine the relationship between individual serum minerals and their counts and malnutrition.ResultsA total of 3,433 hospitalized adults were included in the study. Compared to those with normal mineral levels, patients with serum mineral deficiencies had a 1.43- to 2.31-fold higher likelihood of prevalent GLIM-based malnutrition. After stratifying by age, significant associations were observed only among middle-aged and elderly inpatients. For individuals aged 45 and older, low mineral levels were associated with a higher likelihood of malnutrition compared to normal levels; the ORs (95% CIs) ranged from 1.56 (1.01, 2.39) to 2.96 (1.71, 5.70). Furthermore, inpatients with one, two, and three or more minerals below the normal level had a respective 1.33-, 2.15-, and 2.95-fold higher likelihood of prevalent malnutrition, respectively.ConclusionOur study found that serum mineral deficiencies—particularly potassium, sodium, chloride, and phosphorus—are significantly associated with prevalent malnutrition, with this association more pronounced among middle-aged and elderly patients. Moreover, the cumulative burden of mineral deficiencies showed a graded association with the likelihood of prevalent malnutrition, though this association requires further validation in prospective studies.

BackgroundChina’s healthcare system is confronting a rising burden of antimicrobial resistance, chronic complex diseases, and an aging population requiring long-term, post-acute care. As a value-based care model in the USA for over 50 years, home infusion therapy (HIT), combined with home health services (HHS), presents a sustainable alternative to prolonged hospitalization for intravenous medication administration. In this two-part narrative review, Part 1 provides a needs assessment describing the demographic, clinical, and public health factors driving the demand for HIT and HHS in China.MethodsWe conducted a literature search up to January 2026 using MEDLINE, EMBASE, PubMed, Web of Science, and China National Knowledge Infrastructure.ResultsIn Part 1, we present the impact of the aging population and chronic conditions requiring prolonged infusion therapy (including cancer, malnutrition and infections like osteomyelitis, endocarditis, and bacteremia) on the rising antimicrobial resistance, hospital burden and healthcare expenditures. Through the patient-centric solution of HIT and HHS, patients can receive intravenous medications and nutrition in the comfort of their homes, enabling the continuity of care beyond the hospital. Services include outpatient parenteral antibiotic therapy, hospice and palliative care in patients with cancer, and management of nutritional needs through total parenteral nutrition. Under this care model, reimbursement is tied to success in improved patient outcomes and reduced hospital readmissions. A detailed reimbursement and cost-effectiveness considerations are addressed in Part 2 of this review.ConclusionWith proper infrastructure development and reimbursement mechanisms that align payment with value, HIT and HHS could mitigate antimicrobial resistance, and transform and sustain affordable care delivery in China, especially for older adults and those with chronic conditions.Part 2 is available at https://doi.org/10.3389/fpubh.2026.1761870.

BACKGROUND AND OBJECTIVES:This study aimed to evaluate the safety and efficacy of a fish oil-enriched food for special medical purposes (FSMP, ProSure) compared to an oncology-specific enteral nutrition product (TPF-T). METHODS AND STUDY DESIGN:This multicenter, randomized, open-label, non-inferiority phase III trial (NCT05301556) included patients with gastrointestinal tumors scheduled for surgery and at high risk for malnutrition. Participants were randomized 1:1 to receive either FSMP or TPF-T as a sole nutritional source from 4±2 days before surgery to 9±3 days postoperatively. The primary endpoint was the change in serum pre-albumin levels from baseline to 9±3 days post-surgery (non-inferiority margin: 20.807 mg/L). RESULTS:Of the 325 patients randomized (FSMP: n = 162; TPF-T: n = 163), FSMP demonstrated non-inferiority to TPF-T in maintaining serum pre-albumin levels in the perioperative patients (least square [LS] mean differ-ence: 6.9 mg/L, 95% CI: -5.0 to 18.8). FSMP showed a greater reduction in serum triglycerides (LS mean difference: -0.133 mmol/L, 95% CI: -0.239 to -0.027, p = 0.014), while comparable changes in other lipid parameters, serum albumin, body weight, or grip strength from baseline to 9±3 days post-surgery, and the length of hospital stay were observed between groups (all p >0.05). The most common treatment-emergent adverse events were gastrointestinal disorders, including abdominal distension (FSMP: 17.3% vs. TPF-T: 18.4%), di-arrhea (21.0% vs. 11.0%), and nausea (6.8% vs. 5.5%). CONCLUSIONS:ProSure, an FSMP, when used as a sole nutritional source, is not inferior to TPF-T in maintaining perioperative nutritional status in patients with gastrointestinal tumors, demonstrating comparable efficacy and safety.

BackgroundChina's healthcare system may benefit from the integration of home infusion therapy (HIT) combined with home health services (HHS) to address the urgent need for a sustainable long-term, post-acute care model for the aging population and those with chronic complex diseases. In this Part 2, we presented the current landscape of home- and community-based care models in China and formulated recommendations for successful implementation of HIT and HHS.MethodsWe conducted a literature search up to October 2025 using MEDLINE, EMBASE, PubMed, Web of Science, and China National Knowledge Infrastructure.ResultsTo address the urgent need to support aging at home, China has initiated home- and community-based services nationwide. Despite these services, including a pilot of hospital-at-home, utilization remains low due to limited facilities, suboptimal service quality, and inadequate promotion. Notably, HIT and HHS that provide outpatient parenteral antibiotic therapy and total parenteral nutrition at home, and chemotherapy at infusion centers have not been adopted in China; yet this value-based modality has existed in western countries (including the United States, the United Kingdom, Australia, Canada, France, among others) for decades to provide patient-centric care that is safe and cost-effective. Implementing HIT requires a robust accreditation system, sterile compounding standards, technological integration, and professional training to ensure patient safety and quality of care.ConclusionThe shift of care from hospitals to homes through HIT supported by HHS holds great potential to alleviate healthcare costs, reduce hospital burden, and enhance patient comfort and dignity in China.Part 1 is available at https://doi.org/10.3389/fpubh.2026.1761871.

BACKGROUND & AIMS:Frailty has been linked to an increased risk of mental disorders. However, little is known about the impact of nutritional frailty, a crucial phenotype of frailty, on depression and anxiety. We aimed to examine the prospective associations between nutritional frailty and the incidence and progression of depression and anxiety among middle-aged and older adults. METHODS:Data were obtained from a large prospective cohort study with over 500,000 participants. Nutritional frailty was defined as the copresence of physical frailty (assessed by weight loss, exhaustion, low physical activity level, slowness, and weakness) and nutritional imbalance (assessed by body mass index, skeletal muscle index, and sodium, potassium, and iron intake). Depression, anxiety, and their comorbidity were identified via the International Statistical Classification of Diseases and Related Health Problems, Ninth Revision and Tenth Revision, on the basis of the primary or secondary diagnosis. We performed Cox proportional hazards models to investigate the associations between nutritional frailty and incident depression, anxiety, and their comorbidity. Multistate models were used to examine how nutritional frailty influences transitions from a baseline state to single mental disorders, their comorbidity, and mortality. RESULTS:We included 176,987 participants with a mean age of 56.1 years (SD 8.0), of whom 2648 (1.5%) had nutritional frailty at baseline. During a median follow-up of 12.2 years, 4794 (2.7%) developed depression, 6081 (3.4%) developed anxiety, and 1610 (0.9%) developed both conditions. Individuals with nutritional frailty had a significantly greater risk of developing depression, anxiety, and their comorbidity than robust individuals and those with physical frailty and nutritional imbalance (depression: nutritional frailty HR 3.21 [95% CI 2.77-3.73]; physical frailty 3.11 [2.70-3.58]; nutritional imbalance 1.19 [1.11-1.28]; anxiety: 2.25 [1.93-2.63], 2.17 [1.87-2.51], 1.20 [1.13-1.28]; comorbidity: 3.69 [2.92-4.66], 3.43 [2.74-4.28], 1.31 [1.15-1.50]), even after multivariable adjustment. Baseline nutritional frailty adversely impacts transitions from a baseline state to single mental disorders (depression: 2.89 [2.49-3.36], anxiety: 1.82 [1.54-2.16]) and death (1.95 [1.71-2.22]), from single mental disorders to their comorbidity (depression: 1.96 [1.32-2.89]; anxiety 1.78 [1.17-2.71]), and from comorbidity to death (2.04 [1.07-3.91]). CONCLUSIONS:Nutritional frailty is an independent risk factor for incident depression, anxiety, and their comorbidity and adversely influences the progression of these conditions among middle-aged and older adults.

BACKGROUND & AIMS:Malnutrition is a significant health issue in hospital settings, with persistent diagnostic challenges. Despite the Global Leadership Initiative on Malnutrition (GLIM) criteria providing a standardised approach, nationwide validation and implementation remain limited. We aimed to estimate the national prevalence of GLIM-defined malnutrition among Chinese adult inpatients and assess the predictive value of the GLIM criteria for short-term clinical outcomes. METHODS:We conducted the China Nutrition Fundamental Data 2022 project among adult inpatients from 322 sites across 31 provinces in China between February and October 2023. Malnutrition was defined using the GLIM criteria through a standardised two-step process. The clinical outcomes included discharge outcomes, length of stay, hospitalisation costs, and 30-day mortality. We used logistic and multiple linear regression analyses to examine the association between malnutrition severity and clinical outcomes. RESULTS:The final analysis included 61,283 individuals. Malnutrition was prevalent in 24.6 % of the inpatients (moderate malnutrition: 13.8 %; severe malnutrition: 10.8 %). A dose-response relationship was observed between malnutrition severity and adverse clinical outcomes: moderate and severe malnutrition increased the risk of ineffective discharge outcomes by 1.533 (95 % CI: 1.362-1.725) and 2.200 (1.958-2.473) times, respectively, and 30-day mortality by 1.875 times (1.408-2.496) and 3.065 (2.332-4.028) times, respectively. Additionally, moderate and severe malnutrition were linked to a 0.97-day and 1.20-day increases in hospital stays, respectively. CONCLUSIONS:Malnutrition is prevalent among adult Chinese inpatients and strongly associated with adverse clinical outcomes. GLIM-based assessments and interventions are essential to reduce the burden of malnutrition.

BACKGROUND & AIMS:Nutrition screening is a fundamental step to ensure appropriate intervention in patients with malnutrition. An automatic tool of nutritional risk screening based on electronic health records will improve efficiency and elevate the malnutrition diagnosis rate. We aimed to develop an artificial intelligence (AI) malnutrition screening tool based on electronic medical records and compare it with the patient interview-based tool. METHODS:We conducted a cross-sectional study at a comprehensive tertiary hospital in China. Data of malnutrition information were extracted from electronic health records (EHR) and were used to train and test an AI tool for the malnutritional risk screening. We adopted the GLIM framework as a reference standard for assessing malnutrition. Six widely used machine learning algorithms for auxiliary diagnosis prediction, including Support Vector Machine, Random Forest, extreme gradient boosting (XGBoost), Logistic Regression, AdaBoost, and Gradient Boosting were compared and visualized using SHapley Additive exPlanations (SHAP). After feature screening, simplified algoritms were cross validated at an independent data set. RESULTS:495 inpatients enrolled were randomly divided into training and validation groups for algorithm development. 10 features annotated manually from free texts and 32 features selected from structured EHRs entered the models. XGBoost had the highest area under the receiver operating characteristic curve (AUC) and the top six features were weight loss, decreased food intake, prealbmine, white cell, BMI group, and percent of neutrophils. In simplified models, Random Forest acquired the highest AUC of 0.97 based on first sources data from interviews and 0.87 based on EHR data. CONCLUSIONS:Inpatients' EHR data could be integrated by AI to detect the risk of malnutrition. This AI-enabled tool may hold promise for timely and efficient nutrition screening in newly admitted inpatients.

Malnutrition substantially contributes to adverse clinical outcomes. However, no national survey has been conducted to characterize its epidemiology in hospital settings in China. We conducted the China Nutrition Fundamental Data 2020 project among a multistage stratified cluster sample of adult inpatients from 291 study sites across 30 provinces, autonomous regions and municipalities (except for Hong Kong, Macao, Taiwan Province, and the Xizang Autonomous Region, please see MATERIALS AND METHODS for details of the causes) of China to generate reliable data on the prevalence of malnutrition and explore the associated risk factors. We collected information on participants’ sociodemographic characteristics, physical examinations, and laboratory test results. Malnutrition was defined according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. The standardized prevalence of malnutrition was calculated, and factors associated with malnutrition were examined using logistic regression analyses. We included 54,652 individuals with seven systemic diseases who completed all the survey documents in the final analysis. The overall prevalence of malnutrition was 12.5

As the population ages, the prevalence of sarcopenia, particularly in nursing homes, becomes increasingly significant. This muscle degeneration condition commonly affects older adults, but aerobic and resistance exercises have been shown to effectively counteract it. Despite this, there is a notable gap in research focusing on enhancing exercise participation and muscle health among nursing home residents. Furthermore, understanding and improving residents' perceptions and acceptance of these exercise regimens is crucial to foster long-term engagement in physical activity. This pilot study employs a quasi-experimental cluster-controlled trial design to assess the feasibility of an integrated intervention that combines square dancing with progressive elastic band training for elderly residents in nursing homes who have sarcopenia or possible sarcopenia. Participants are assigned to either an intervention group or a control group at the nursing home cluster level. The intervention consists of a 12-week program conducted 3 times per week, followed by a 12-week observation period. Primary outcome measures include the intervention’s feasibility and acceptability, with secondary outcomes encompassing appendicular skeletal muscle mass, muscle strength, physical function, cognitive function, depressive symptoms, balance stability, and falls risk. The study aims to recruit 68 participants based on power analysis calculations to detect significant intervention effects. The study investigated a frequently neglected and under-researched group of nursing home residents displaying symptoms of sarcopenia or possible sarcopenia. The findings are expected to lay the groundwork for developing sustainable and effective exercise programs that can markedly improve geriatric care practices and the treatment of sarcopenia.