Present or absent: risks and protective factors of sudden infant death syndrome (SIDS) in the Zambian context.

Being underweight is an essential problem for Parkinson's disease (PD). Weight loss and being underweight have significant impacts on the disease progression and patient's quality of life, such as increasing risk of malnutrition, muscle wasting and frailty, and even higher risk of complications. Gastrointestinal (GI) dysfunctions are widespread in PD, and PD patients frequently experience dysphagia, constipation, and gastroparesis, all of which worsen as the disease progresses into advanced stages. Dysphagia may pose patients at a serious risk, such as choking, aspiration pneumonia, and malnutrition. Constipation is common and leads to discomfort, bloating, and appetite loss, further reducing dietary intake. Moreover, decreased water intake in PD correlated with greater constipation severity, and may lead to dehydration or serious consequences. Gastroparesis usually contributes to nausea, vomiting, and early satiety, making it difficult for patients to consume adequate nutrition. These several gastrointestinal problems significantly impair a patient's ability to maintain adequate nutrition, leading to reduced intake, malnutrition, and increased aspiration risk. Balancing energy expenditure and dietary energy intake is required to maintain a suitable body weight. Weight loss results from a negative energy balance, in which energy expenditure exceeds energy intake. Occurrence of weight loss in PD has been associated with malnutrition and several issues that can worsen the patient's quality of life, especially in an advanced stage of the disease. PD patients with underweight status, determined using body mass index (BMI < 18.5), often experience more pronounced motor and non-motor symptoms, including severe dysphagia, reduced mobility, fatigue, depression, and cognitive impairment. These patients frequently struggle to maintain adequate nutritional intake due to dysphagia, early satiety, bloating, and gastroparesis. Their restricted dietary intake can lead to malnutrition, muscle wasting, and further deterioration in physical strength and mobility. On the other hand, normal-to-overweight patients (BMI > 18.5) may not face the same immediate risk of malnutrition. However, they may still experience problems with significant gastrointestinal dysfunctions, such as gastrointestinal reflux disease (GERD), dyspepsia, and irritable bowel syndrome. The relationship between body composition and disease progression highlights the need for a deeper understanding of how underweight versus normal-to-overweight PD patients manage their dietary needs. However, few studies have examined the intersection of body weight, dysphagia, and culturally specific dietary patterns in PD. In addition, there is limited targeted research on dietary habits, food preferences, hydration, and nutritional status among PD patients, particularly when comparing different body types. This knowledge gap may contribute to increased risks of malnutrition and aspiration.