Diet has a major influence on the composition and metabolic output of the gut microbiome. Higher-protein diets are often recommended for older consumers; however, the effect of high-protein diets on the gut microbiota and faecal volatile organic compounds (VOC) of elderly participants is unknown. The purpose of the study was to establish if the faecal microbiota composition and VOC in older men are different after a diet containing the recommended dietary intake (RDA) of protein compared with a diet containing twice the RDA (2RDA). Healthy males (74⋅2 (sd 3⋅6) years; n 28) were randomised to consume the RDA of protein (0⋅8 g protein/kg body weight per d) or 2RDA, for 10 weeks. Dietary protein was provided via whole foods rather than supplementation or fortification. The diets were matched for dietary fibre from fruit and vegetables. Faecal samples were collected pre- and post-intervention for microbiota profiling by 16S ribosomal RNA amplicon sequencing and VOC analysis by head space/solid-phase microextraction/GC-MS. After correcting for multiple comparisons, no significant differences in the abundance of faecal microbiota or VOC associated with protein fermentation were evident between the RDA and 2RDA diets. Therefore, in the present study, a twofold difference in dietary protein intake did not alter gut microbiota or VOC indicative of altered protein fermentation.

The aim of the present study was to investigate the associations between the habitual Ca intake and faecal fat and energy excretion as well as blood lipid profile in free-living normal-weight and overweight individuals. The participants were enrolled for an 8-d period where data from a 7-d diet registration (days 1–7), a 5-d faeces collection (days 3–7), a 2-d urine collection (days 5–7), and anthropometric measurements and a fasting blood sample (day 8) were collected. Analyses showed that dietary Ca intake (g/10 MJ per d) was positively associated with excretion of faecal fat (P = 0·004) and energy (P = 0·031) when adjusted for BMI, age, sex and intake of Ca-containing supplements. However, after adjustment for intake of fibre, the effect of Ca intake disappeared. Nevertheless, total cholesterol (CHOL) and LDL-CHOL concentrations were associated negatively with Ca intake (β −0·62 (95 % CI −0·96, −0·28) mmol/l, P < 0·001, and β −0·49 (95 % CI −0·78, −0·20) mmol/l, P = 0·001, respectively, per 1000 mg/10 MJ per d increase in Ca intake). In conclusion, incorporation of Ca-rich food products in a habitual diet was associated with reduced total CHOL and LDL-CHOL concentrations, which may lower the risk of CVD in the long term.

Dietary pattern analysis is an epidemiological method designed to consider the complexity of food preferences and diet patterns of populations. Few studies from South Asia have used this methodology to describe population food intake. Our objective was to identify dietary patterns and understand their associations with sociodemographic, anthropometric and life-style factors among low-income Pakistani urban adults. Dietary information was collected by a thirty-three-item FFQ and dietary patterns were derived by principal component analyses in 5491 subjects enrolled in the Control of Blood Pressure and Risk Attenuation (COBRA) study. Three dietary patterns were identified: a fat and sweet pattern characterised by fried snacks/foods, desserts, organ meats, bakery products, Pakistani bread and food purchased from outside the home; a fruit and vegetable pattern including fruits, juices, raw and cooked vegetables, lean meat and low-fat milk; and a seafood and yogurt pattern identified by prawns, fish, potatoes and yogurt. The fat and sweet pattern scores were low among older subjects, those with high BMI and waist circumference but high among females and physically active participants. The fruit and vegetable pattern was associated with younger age, high BMI, education and non-tobacco use. The seafood and yogurt pattern was associated with high BMI, increased physical activity and non-tobacco use. In conclusion, distinct dietary patterns exist for the Pakistani population that may be related to some of the population characteristics and thus may have importance in suggesting dietary and life-style interventions in the prevention of chronic diseases.

The mechanism behind the beneficial effects of enteral nutrition (EN) for patients with acute pancreatitis (AP) is largely unknown. Adipokines, as mediators of metabolism and inflammation, may be a possible mechanism. The study aimed to investigate the effect of EN on adipokines early in the course of AP. Patients with AP were randomised to EN or nil-by-mouth (NBM). Blood samples were taken on the first 4 d of admission and adipokine concentrations for adiponectin, leptin, omentin, resistin and visfatin were determined by ELISA assays. A linear mixed model analysis was run to determine differences in adipokine concentrations between the two study groups. A total of thirty-two patients were included in the study. Omentin concentrations were significantly higher in patients who received EN compared with NBM across the first 4 d of admission (mean difference: 11·6 (95 % CI 1·0, 22·3) ng/ml; P = 0·033). Leptin concentrations were significantly higher in patients who received EN compared with NBM after adjusting for age, sex and BMI (mean difference: 2·3 (95 % CI 0·1, 4·5) ng/ml; P = 0·037). No significant difference in adiponectin, resistin or visfatin concentrations were observed between the two study groups. EN significantly increases omentin and leptin concentrations in AP. Future research should be directed towards understanding whether these adipokines are responsible for the therapeutic benefits of EN.

There is a growing recognition that social support can potentially exert consistent or opposing effects in influencing health behaviours. The present paper presents a cross-sectional study, including 2,064 adults from Italy, Spain and Greece, who were participants in a multi-centre randomised controlled trial (C4H study), aiming to examine whether social support is correlated with adherence to a healthy Mediterranean diet and physical activity. Social support data were available for 1,572 participants. The majority of the sample reported emotional support availability (84·5 %), financial support availability (72·6 %) and having one or more close friends (78·2 %). Mediterranean diet adherence was significantly associated with emotional support (P = 0·009) and social network support (P = 0·021). No statistically significant associations were found between participant physical activity and the social support aspects studied. In conclusion, emotional and social network support may be associated with increased adherence to the Mediterranean diet. However, further research is needed to evaluate the role of social support in adherence to healthy Mediterranean diet.

The present study aimed to assess the prevalence of food insecurity (FI) among college students and explore its association with indicators of mental and psychosocial health. Data were collected using a cross-sectional online survey from college students in different universities in Lebanon during the Spring 2021 semester. FI was assessed using the validated eight-item food insecurity experience scale. The mental health of college students was assessed using validated screening tools for depression, anxiety and well-being, namely the Patient Health Questionnaire (PHQ-9), the General Anxiety Disorder-7 (GAD-7) and the World Health Organization (WHO-5) index, respectively. Multiple linear regression models were conducted to assess the relationship of FI with PHQ-9, GAD-7 and WHO-5 scores. A total of 745 students completed the online survey. Approximately 39 % of students in the sample were experiencing FI of which 27·4, 8·1, and 3·5 % were experiencing mild, moderate and severe FI , respectively. Low maternal education, low household monthly income and high levels of stress were significant correlates of FI among college students (P-trend < 0·001). In addition, 22·6 and 34·4 % of students showed severe symptoms of depression and anxiety, respectively. Regression models showed that FI was associated with higher scores on PHQ-9 and GAD-7 (β = 2·45; 95 % CI [1·41, 3·49]) and (β = 1·4; 95 % CI [1·1, 2·2], respectively) and lower scores on WHO-5 (β = −4·84; 95 % CI [−8·2, −1·5]). In conclusion, a remarkable proportion of college students reported experiencing different forms of FI, which was associated with poorer mental health and well-being outcomes. Public health programmes and interventions are needed to mitigate FI and improve student health-related outcomes.

Estimation of the quality of commercial diets is a topic of interest for the majority of dog owners. Recently, in a French consumer association magazine, an evaluation of eight dog commercial dry diets (from super-premium, basic-nutrition, private-label and economy brands) according to several nutritional criteria was published. The aims of the study were: (1) to evaluate the apparent digestibility of these diets; (2) to score these diets according to digestibility results; and (3) to compare these data with the scoring of the magazine. Six adult Beagle dogs were enrolled for the digestibility trials. Diets were scored according to energy, crude protein and crude fat (CF) apparent digestibility coefficients, digestible protein-to-energy ratios and ash content. Each of the five criteria was scored from 4 to 20 points. The ranges of crude protein, CF, crude fibre and ash content were 20·9–30·6 %, 6·8–19·7 %, 2·2–3·3 % and 4·6–9·7 % on a DM basis, respectively. The ranges of energy, crude protein and CF apparent digestibility coefficients were 72·6–87·7 %, 70·4–82·5 % and 76·1–95·4 %, respectively. The range of the protein-to-energy ratio was 10–14 digestible crude protein per MJ metabolisable energy. Little overlap in the scoring systems was found, but the private-label brand and economy brand diets presented the lowest scores in the two systems. These results showed that the evaluation of commercial diets should take into account multiple nutritional aspects. In particular, analytical and biological (digestibility) criteria should be considered as complementary in the evaluation of dry dog commercial diets.

The purpose of the present study was to compare digestibility of grass hay, faecal and plasma volatile fatty acid (VFA) concentrations, and faecal bacterial abundance in overweight and moderate-condition mares. Five overweight adult mixed-breed mares and five adult mixed-breed mares in moderate condition were housed individually and limit-fed orchard grass (Dactylis glomerata) hay at 20 g/kg body weight (as fed) daily for 14 d. Forage DM and fibre digestibility were determined using AOAC methods; digestible energy was measured using bomb calorimetry; plasma and faecal VFA concentrations were determined by use of GC and MS; faecal Firmicutes, Bacteroidetes, Fibrobacter succinogenes, Ruminococcus flavefaciens and total bacteria abundance was determined by quantitative real-time PCR using previously designed phylum-specific 16S ribosomal RNA gene primers. No differences in hay digestibility, faecal VFA concentrations or faecal bacterial abundance were detected between overweight and moderate-condition mares. Mean plasma acetate concentrations were higher (P = 0·03) in overweight (1·55 (range 1·43–1·65) mmol/l) v. moderate-condition (1·39 (range 1·22–1·47) mmol/l) mares. We conclude that the higher plasma acetate in overweight mares should be further investigated as a potential link between gut microbes and obesity in horses.

Foodbook24 is a self-administered web-based 24-h dietary recall tool developed to assess food and nutrient intakes of Irish adults. This paper describes the first step undertaken in developing Foodbook24 which was to limit participant burden by establishing a concise list of food items for inclusion in the tool. The aim of the present study was to evaluate whether using a concise food list (as opposed to an extensive list) with generic composition data would influence the estimates of nutrient intakes in a nationally representative sample of Irish adults. A 2319-item food list generated from the Irish National Adult Nutrition Survey (NANS) (2008–2010) (n 1500) was used as the basis for a shortened food list for integration into the tool. Foods similar in nutritional composition were recoded with a generic type food code to produce a concise list of 751 food codes. The concise food list was applied to the NANS food consumption dataset and intake estimates of thirty-five nutrients were compared with estimates derived using the original extensive list. Small differences in nutrient intakes (<6 %) with limited effect size (Cohen's d < 0·1) were observed between estimates from both food lists. The concise food list showed strong positive correlations (rs 0·9–1·0, n 1500, P < 0·001) and a high level of agreement with the extensive list (80–97 % of nutrient intakes classified into the same tertile; >90% of intakes similarly categorised according to dietary reference values). This indicates that a concise food list is suitable for use in a web-based 24-h dietary recall tool for Irish adults.

Eriocitrin is a citrus flavonoid with a high capacity to reduce the oxidative stress related to metabolic disorders and obesity. We assessed the effects of low doses of eriocitrin on the oxidative stress, inflammation, and metabolism of glucose and lipids of high-fat diet (HFD)-fed obese mice. Fifty male C57BL/6J mice were randomly assigned into five groups (n 10). The mice were fed an HFD (45 % kcal from fat, i.e. lard) for 4 weeks for obesity induction. After this period, the mice continued receiving the same HFD, but supplemented with eriocitrin at 10, 25 or 100 mg/kg body weight (bw) for an additional 4 weeks. Control groups were fed with standard diet (10 % kcal of fat, i.e. soy oil) or with HFD without eriocitrin, for eight consecutive weeks. At the end of the study, mice supplemented with eriocitrin showed lower levels of blood serum glucose and blood and liver triacylglycerols (P < 0⋅05). There was also improved levels of insulin, HOMA-IR, total-cholesterol, resistin and lipid peroxidation in the supplemented mice. It was concluded that the 25 mg dose of eriocitrin improved all the parameters studied and had positive effects on oxidative stress, systemic inflammation and metabolism of lipids and glucose in general.

Introduction: Optimal breast-feeding practices make a major contribution to the promotion of healthy growth and development through much prevention of diarrheal and respiratory diseases which majorly cause morbidity and mortality in under-five children. However, breast-feeding practices remain suboptimality in Ethiopia. Objective: The study objective was to determine the effect of maternal nutrition education on early initiation and exclusive breast-feeding practice in the Hawela Tulla sub-city. Methods: A cluster randomised, parallel-group, single-blinded trial was used. About 310 pregnant women (155 for the intervention group and 155 for the control group) were included. Result: An early initiation of breast-feeding was significantly higher among women who received breast-feeding education than those who did not receive (104(72·7 %) v. 85(59·9 %), P = 0·022) and exclusive breast-feeding practice was also significantly higher among women who received breast-feeding education than those who did not receive (106(74·1 %) v. 86(60·6 %), P = 0·015). Breast-feeding education [AORs 1·55, 95 % CI (1·02, 2·36)], institutional delivery [AOR 2·29, 95 % CI (1·21, 4·35)], vaginal delivery [AOR 2·85, 95 % CI (1·61, 5·41)] and pre-lacteal feeding [AOR 0·47, 95 % CI (0·25, 0·85)] were predictors of early initiation of breast-feeding. Breast-feeding education [AOR 1·72, 95 % CI (1·12, 2·64)] and institutional delivery [AOR 2·36, 95 % CI (1·28, 4·33)] were also determinants of exclusive breast-feeding practices. Conclusion: Breast-feeding education improved early initiation of breast-feeding and exclusive breast-feeding practices. Providing sustained education to women regarding early initiation and exclusive breast-feeding practice should be strengthened.

Key pathophysiology of sickle cell anaemia includes compensatory erythropoiesis, vascular injury and chronic inflammation, which divert amino acids from tissue deposition for growth/weight gain and muscle formation. We hypothesised that sickle mice maintained on an isoenergetic diet with a high percentage of energy derived from protein (35 %), as opposed to a standard diet with 20 % of energy derived from protein, would improve body composition, bone mass and grip strength. Male Berkeley transgenic sickle mice (S; n 8–12) were fed either 20 % (S20) or 35 % (S35) diets for 3 months. Grip strength (BIOSEB meter) and body composition (dual-energy X-ray absorptiometry scan) were measured. After 3 months, control mice had the highest bone mineral density (BMD) and bone mineral content (BMC) (P < 0·005). S35 mice had the largest increase in grip strength. A two-way ANOVA of change in grip strength (P = 0·043) attributed this difference to genotype (P = 0·025) and a trend in type of diet (P = 0·067). l-Arginine (l-Arg) supplementation of the 20 % diet was explored, as a possible mechanism for improvement obtained with the 35 % diet. Townes transgenic sickle mice (TS; n 6–9) received 0·8, 1·6, 3·2 or 6·4 % l-Arg based on the same protocol and outcome measures used for the S mice. TS mice fed 1·6 % l-Arg for 3 months (TS1.6) had the highest weight gain, BMD, BMC and lean body mass compared with other groups. TS3.2 mice showed significantly more improvement in grip strength than TS0·8 and TS1.6 mice (P < 0·05). In conclusion, the high-protein diet improved body composition and grip strength. Outcomes observed with TS1.6 and TS3.2 mice, respectively, confirm the hypothesis and reveal l-Arg as part of the mechanism.

Bovine colostrum is well known for its beneficial properties on health and development. It contains a wide variety of bioactive ingredients that are known to promote a number of cellular processes. Therefore the use of colostrum whey as a feed additive to promote intestinal health has been proposed, yet little is known about mechanisms implicated in its beneficial properties on intestinal epithelial cells. In the present paper, casein were removed from bovine colostrum and the remaining liquid, rich in bioactive compounds, was evaluated for its capacity to modulate cellular processes in porcine intestinal epithelial cell line IPEC-J2 and human colon adenocarcinoma cell line Caco-2/15. First, we verified the effect of colostrum whey and cheese whey on processes involved in intestinal wound healing, including cell proliferation, attachment, morphology and migration. Our results showed that colostrum whey promoted proliferation and migration, and decreased specifically the attachment of Caco-2/15 cells on the culture dish. On the other hand, cheese whey induced proliferation and morphological changes in IPEC-J2 cells, but failed to induce migration. The gene expression profile of IPEC-J2 cells following colostrum whey treatment was evaluated by microarray analysis. Results revealed that the expression of a significant number of genes involved in cell migration, adhesion and proliferation was indeed affected in colostrum whey-treated cells. In conclusion, colostrum specific bioactive content could be beneficial for intestinal epithelial cell homoeostasis by controlling biological processes implicated in wound healing through a precise gene expression programme.

The risk of undernutrition in older community-dwelling adults increases when they are no longer able to shop or cook themselves. Home-delivered products could then possibly prevent them from becoming undernourished. This single-blind randomised trial tested the effectiveness of home-delivered protein-rich ready-made meals and dairy products in reaching the recommended intake of 1·2 g protein/kg body weight (BW) per d and ≥25 g of protein per meal. Community-dwelling older adults (n 98; mean age 80·4 (sd 6·8) years) switched from self-prepared to home-delivered hot meals and dairy products for 28 d. The intervention group received ready-made meals and dairy products high in protein; the control group received products lower in protein. Dietary intake was measured at baseline, after 2 weeks (T1), and after 4 weeks (T2). Multilevel analyses (providing one combined outcome for T1 and T2) and logistic regressions were performed. Average baseline protein intake was 1·09 (se 0·05) g protein/kg BW per d in the intervention group and 0·99 (se 0·05) g protein/kg BW per d in the control group. During the trial, protein intake of the intervention group was 1·12 (se 0·05) g protein/kg BW per d compared with 0·87 (se 0·03) g protein/kg BW per d in the control group (between-group differences P < 0·05). More participants of the intervention group reached the threshold of ≥25 g protein at dinner compared with the control group (intervention T1: 84·8 %, T2: 88·4 % v. control T1: 42·9 %, T2: 40·5 %; P < 0·05), but not at breakfast and lunch. Our findings suggest that switching from self-prepared meals to ready-made meals carries the risk of a decreasing protein intake, unless extra attention is given to protein-rich choices.

Neutering is a risk factor for obesity in companion animals. In a study to determine the total energy requirements of kittens (15–52 weeks) the impact of neutering and age when neutered on intake and body weight (BW) was investigated. Females (n 14), neutered when 19 (early neuter; EN) or 31 (conventional neuter; CN) weeks old (n 7/group), were individually fed to maintain an ideal body condition score (BCS). EN kittens gained weight gradually whilst CN kittens’ BW gain slowed from week 24, weighing less than EN kittens from week 30 with a reduced energy intake (kcal/kg BW0·67) in weeks 24–32 (P < 0·05). Following neutering, CN cats’ BW and energy intake increased rapidly (energy intake CN > EN in weeks 36–40). Although EN required earlier diet restriction, acute hyperphagia and increased rate of BW gain following neutering were not observed. Earlier neutering may aid healthy weight management through growth when regulating intake to maintain an ideal BCS.

The nutrition environment, including food store type, may influence dietary choices, which in turn can affect risk of obesity and related chronic diseases such as CHD, diabetes and cancer. The objective of the present study was to elucidate the extent to which healthy foods are available and affordable in various rural food outlets. A subset of the nutrition environment was assessed using the Nutrition Environment Measures Survey in Stores (NEMS-S). The NEMS-S instrument assessed the availability and price of healthy foods (e.g. low-fat/non-fat milk, lean meats and reduced-fat dinner entrées) compared with less healthy counterparts (e.g. whole milk, non-lean meats and regular dinner entrées). The NEMS-S also assessed the quality of fresh fruits and vegetables. Availability, prices and quality of healthy foods were compared between grocery stores (n 24) and convenience stores (n 67) in nine rural counties in Alabama. Mean availability subscale score (possible range 0 to 30; higher score indicates a greater number of healthier foods were available) for grocery stores was 22·6 (sd 8·1), compared with 6·6 (sd 5·2) in convenience stores (P < 0·0001); and mean price subscale score (possible range −9 to 18; higher score indicates that healthier options were less expensive than the less healthy options) for grocery stores was 2·4 (sd 2·7), compared with 0·7 (sd 1·2) in convenience stores (P = 0·0080). Mean total NEMS-S score (possible range −9 to 54) in grocery stores was 29·8 (sd 10·9) compared with 7·3 (sd 7·1) in convenience stores (P < 0·0001). Both grocery and convenience stores could be strategic points of intervention to improve the nutrition environment in the counties that were surveyed.

It was examined whether the physiological effects of high-amylose maize starch (HAMS) are influenced by hydroxypropylation. Rats were fed one of the following three diets: an AIN-93-based diet with waxy maize starch (WMS) as a starch source, or this diet with 150 g of WMS replaced by either HAMS or hydroxypropylated HAMS (HP-HAMS). The activities of amylase in bile-pancreatic juice and sucrose, maltase and isomaltase of the jejunum and ileum were not affected by diet, but the digestibility of HAMS was decreased by hydroxypropylation. The amounts of SCFA in caecal content and H2 excreted in the breath and flatus for HAMS were decreased by hydroxypropylation. Plasma glucagon-like peptide-1 (GLP-1), glucose and insulin concentrations were not affected by diet. On the basis of PCR-denaturing gradient gel electrophoresis (DGGE) profiles, the similarity in caecal bacteria population of the HP-HAMS group and HAMS group was low, but that of the HP-HAMS and WMS groups was high. The amount of caecal IgA was not affected by hydroxypropylation, but those in the HAMS and HP-HAMS groups were greater than that in the WMS group. Plasma and liver concentrations of TAG and cholesterol for HAMS were not affected by hydroxypropylation. These results show that the small intestinal digestibility and fermentation-dependent parameters such as caecal SCFA and H2 productions and caecal bacterial profile of HAMS were affected by hydroxypropylation, but parameters of glucose metabolism such as GLP-1 and insulin, those of lipid metabolism such as plasma TAG and cholesterol and the amount of caecal IgA were not.

Portion size images are advantageous in dietary assessment. The aim of the present study was to develop and validate new culturally specific image-series for portion size estimation to be used in a new Norwegian version of a British web-based dietary assessment tool (myfood24). Twenty-three image-series of different foods, each containing seven portion size images, were created and validated in a group of adults (n 41, 58 % female) aged 19–44 (median 23), out of which 63 % had higher (tertiary) education. The participants compared 46 portions of pre-weighed foods to the portion size images (1886 comparisons in total). Portion size estimations were either classified as correct, adjacent or misclassified. The weight discrepancy in percentage between the chosen and the correct portion size image was also calculated. Mann–Whitney U tests were used to explore if portion size estimation accuracy differed across sample characteristics, or if it depended on how the foods were presented. For thirty-eight of the forty-six presented food items, the participants selected the correct or adjacent portion size image 98 % on average. The remaining eight food items were on average misclassified by 27 % of the participants. Overall, a mean weight discrepancy of 2⋅5 % was observed between the chosen and the correct portion size images. Females estimated portion size more accurately than males (P = 0⋅019). No other significant differences in estimation accuracy were observed. In conclusion, the new image-series performed satisfactorily, except for the image-series depicting bread, caviar spread and marzipan cake, which will be altered. The present study demonstrates the importance of validating portion size estimation tools.

Neutering is a common veterinary recommendation and is often associated with obesity development. Thus, the aim of the present study was to evaluate the effects of two different amounts of protein intake by neutered dogs regarding maintenance energy requirement (MER), body composition, and biochemical and hormonal parameters. A total of fourteen healthy adult dogs were fed either a diet containing 59·7 g protein/1000 kcal (4184 kJ) (P60) or a diet with 94·0 g protein/1000 kcal (4184 kJ) (P94) for 26 weeks after neutering to maintain their body weight prior to neutering. A mixed model was fitted to verify diet, time and diet × time interaction effects on biochemical parameters, serum concentrations of insulin, glucagon, leptin and insulin-like growth factor-1 (IGF-1). MER and the body composition data were evaluated within diets (paired t test) and within times (unpaired t test). A time effect was found for fructosamine, TAG, total lipids and IGF-1 serum concentrations. The diet × time interaction was significant for glucagon (P < 0·05). No differences between diets in the MER within each time were found. However, there was a reduction in the MER of dogs fed the P60 diet 26 weeks after neutering (P = 0·042). The fat body mass of dogs fed the P60 diet increased (P < 0·05) after neutering, even without a body-weight change. Some of the biochemical parameters changed over time, but all remained within the normal range. For the period evaluated in the present study, a diet with 94·0 g of protein/1000 kcal (4184 kJ) metabolisable energy seems to be a beneficial nutritional strategy to maintain the MER and the body composition of dogs after neutering.

Cancer is the third leading cause of death in Kenya. However, there is scarce information on the nutritional status of cancer patients to guide in decision making. The present study sought to assess the risk of malnutrition, and factors associated with malnutrition and cachexia, among cancer out-patients, with the aim of informing nutrition programmes for cancer management in Kenya and beyond. This was a facility-based cross-sectional study performed at Kenyatta National Hospital and Texas Cancer Centre in Nairobi, Kenya. The risk of malnutrition was assessed using the Malnutrition Universal Screening Tool (MUST). Diagnoses of malnutrition and cachexia were done using the European Society of Clinical Nutrition and Metabolism (ESPEN) and Fearon criteria, respectively. A total of 512 participants were assessed. Those at risk of malnutrition were 33·1 % (12·5 % at medium risk, 20·6 % at high risk). Prevalence of malnutrition was 13·4 %. The overall weight loss >5 % over 3 months was 18·2 % and low fat-free mass index was 43·1 %. Prevalence of cachexia was 14·1 % compared with 8·5 % obtained using the local criteria. Only 18·6 % participants had received any form of nutrition services. Age was a predictor of malnutrition and cachexia in addition to site of cancer for malnutrition and cigarette smoking for cachexia. The use of the MUST as a screening tool at the first point of care should be explored. The predictive value of current nutrition assessment tools, and the local diagnostic criteria for malnutrition and cachexia should be reassessed to inform the development of appropriate clinical guidelines and future capacity-building initiatives that will ensure the correct identification of patients at risk for timely care.