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Shimizu A, Fujishima I, Maeda K, Murotani K, Kayashita J, Ohno T, Nomoto A, Ueshima J, Ishida Y, Inoue T, Mori N. Texture-Modified Diets are Associated with Poor Appetite in Older Adults who are Admitted to a Post-Acute Rehabilitation Hospital. J Am Med Dir Assoc 2021; 22:1960-1965. [PMID: 34139151 DOI: 10.1016/j.jamda.2021.05.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 05/09/2021] [Accepted: 05/11/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This study aimed to clarify the association between texture-modified diets and poor appetite in older adults, as it is not fully understood. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS We included 208 inpatients who were aged ≥65 years (mean age 78.9 ± 7.6 years, 57.7% female) and admitted to a rehabilitation unit with stroke, musculoskeletal disease, or hospital-associated deconditioning covered by the Japanese insurance system, between January 2019 and January 2020. METHODS Participants were divided into 2 groups according to their food texture level: International Dysphagia Diet Standardization Initiative (IDDSI) levels 3 to 5 for the texture-modified diet group and levels 6 and 7 for the normal diet group. Appetite was assessed using the Simplified Nutritional Appetite Questionnaire for the Japanese elderly, and a score ≤14 was defined as poor appetite. The relationship between IDDSI levels and poor appetite was analyzed using the Cochrane-Armitage trend test. Logistic regression analysis was used to investigate the relationship between the consumption of texture-modified diets and poor appetite. Statistical significance was set at P < .05. RESULTS The numbers of participants on modified diets according to the IDDSI framework were as follows: 4, 11, 41, 76, and 76 in levels 3, 4, 5, 6, and 7, respectively. In total, 152 and 56 patients were classified into the regular diet group and texture-modified diet group, respectively. A significantly higher prevalence of poor appetite was observed with the consumption of texture-modified diets (P < .001 for trend). Logistic regression analysis showed that poor appetite was independently associated with the consumption of texture-modified diets (odds ratio 3.443, P = .011). CONCLUSIONS AND IMPLICATIONS These findings indicate that the consumption of texture-modified diets is associated with poor appetite. Further studies are required to verify whether a multimodal approach involving improvement in the appearance, taste, flavor, and nutrients of the food can improve poor appetite.
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Affiliation(s)
- Akio Shimizu
- Department of Nutrition, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan; Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan; Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Ichiro Fujishima
- Department of Rehabilitation Medicine, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan
| | - Keisuke Maeda
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan; Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Obu, Japan.
| | | | - Jun Kayashita
- Department of Health Sciences, Faculty of Human Culture and Science, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Tomohisa Ohno
- Department of Dentistry, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan
| | - Akiko Nomoto
- Department of Dentistry, Hamamatsu City Rehabilitation Hospital, Hamamatsu, Japan
| | - Junko Ueshima
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan; Department of Clinical Nutrition and Food Service, NTT Medical Center Tokyo, Tokyo, Japan
| | - Yuria Ishida
- Department of Nutrition, Aichi Medical University, Nagakute, Japan
| | - Tatsuro Inoue
- Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Obu, Japan; Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Naoharu Mori
- Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Japan
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Optimizing sensory quality and variety: An effective strategy for increasing meal enjoyment and food intake in older nursing home residents. Appetite 2020; 153:104749. [PMID: 32450092 DOI: 10.1016/j.appet.2020.104749] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/25/2020] [Accepted: 05/18/2020] [Indexed: 01/08/2023]
Abstract
A decline in appetite and consequently in food intake is often observed with ageing, particularly in older adults living in nursing homes. Several strategies have been tested in nursing homes to counter this phenomenon. However, the approaches have rarely focused on food improvement, and most studies have assessed the impact of flavor enhancement on eating behavior. The present experiment aimed to assess the impact of improving sensory quality versus increasing sensory variety on food intake and meal enjoyment in elderly individuals living in a nursing home. Four conditions were compared: control condition, a Quality+ condition (recipes were improved according to sensory preference of the target population), a Variety+ condition (participants were offered a variety of main dishes and several condiments throughout the meal) and a Quality&Variety+ condition combining the two previous conditions. Eighty-two residents (age range: 71-101 years) participated in eight lunchtime sessions (2 replicates × 4 conditions). Compared to control condition, our results showed that improving the sensory quality of the dishes and/or providing variety led to increased meal enjoyment and food intake (energy intake: +5% for Quality+; +7% for Variety+). No additional effect was observed when the two factors were combined (+7% for Quality&Variety+). These results suggest that meal improvement strategies can be used to increase food intake in order to prevent and treat malnutrition in dependent older adults.
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Zanfirescu A, Ungurianu A, Tsatsakis AM, Nițulescu GM, Kouretas D, Veskoukis A, Tsoukalas D, Engin AB, Aschner M, Margină D. A review of the alleged health hazards of monosodium glutamate. Compr Rev Food Sci Food Saf 2019; 18:1111-1134. [PMID: 31920467 PMCID: PMC6952072 DOI: 10.1111/1541-4337.12448] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 03/15/2019] [Indexed: 12/11/2022]
Abstract
Monosodium glutamate (MSG) is an umami substance widely used as flavor enhancer. Although it is generally recognized as being safe by food safety regulatory agencies, several studies have questioned its long-term safety. The purpose of this review was to survey the available literature on preclinical studies and clinical trials regarding the alleged adverse effects of MSG. Here, we aim to provide a comprehensive overview of the reported possible risks that may potentially arise following chronic exposure. Furthermore, we intend to critically evaluate the relevance of this data for dietary human intake. Preclinical studies have associated MSG administration with cardiotoxicity, hepatotoxicity, neurotoxicity, low-grade inflammation, metabolic disarray and premalignant alterations, along with behavioral changes. Moreover, links between MSG consumption and tumorigenesis, increased oxidative stress and apoptosis in thymocytes, as well as genotoxic effects in lymphocytes have been reported. However, in reviewing the available literature, we detected several methodological flaws, which led us to conclude that these studies have limited relevance for extrapolation to dietary human intakes of MSG risk exposure. Clinical trials have focused mainly on the effects of MSG on food intake and energy expenditure. Besides its well-known impact on food palatability, MSG enhances salivary secretion and interferes with carbohydrate metabolism, while the impact on satiety and post-meal recovery of hunger varied in relation to meal composition. Reports on MSG hypersensitivity, also known as 'Chinese restaurant syndrome', or links of its use to increased pain sensitivity and atopic dermatitis were found to have little supporting evidence. Based on the available literature, we conclude that further clinical and epidemiological studies are needed, with an appropriate design, accounting for both added and naturally occurring dietary MSG. Critical analysis of existing literature, establishes that many of the reported negative health effects of MSG have little relevance for chronic human exposure and are poorly informative as they are based on excessive dosing that does not meet with levels normally consumed in food products.
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Affiliation(s)
- Anca Zanfirescu
- Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, Traian Vuia 6, Bucharest 020956, Romania
| | - Anca Ungurianu
- Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, Traian Vuia 6, Bucharest 020956, Romania
| | - Aristides M. Tsatsakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, Heraklion 71409, Crete, Greece
| | - George M. Nițulescu
- Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, Traian Vuia 6, Bucharest 020956, Romania
| | - Demetrios Kouretas
- Department of Biochemistry and Biotechnology, University of Thessaly, Larissa 41500, Greece
| | - Aris Veskoukis
- Department of Biochemistry and Biotechnology, University of Thessaly, Larissa 41500, Greece
| | - Dimitrios Tsoukalas
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, Heraklion 71409, Crete, Greece
- Metabolomic Medicine Clinic, Athens 10674, Greece
| | - Ayse B. Engin
- Gazi University, Faculty of Pharmacy, Department of Toxicology, Ankara 06330, Turkey
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx NY 10463, USA
| | - Denisa Margină
- Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, Traian Vuia 6, Bucharest 020956, Romania
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Perna S, Rondanelli M, Spadaccini D, Lenzi A, Donini LM, Poggiogalle E. Are the therapeutic strategies in anorexia of ageing effective on nutritional status? A systematic review with meta-analysis. J Hum Nutr Diet 2018; 32:128-138. [PMID: 30159922 DOI: 10.1111/jhn.12594] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Anorexia of ageing (AA) may be considered as a risk factor for frailty and has an important impact on quality of life, morbidity and mortality. METHODS A systematic review and a meta-analysis were performed to summarise the results from several trials on the effectiveness of treatments in AA, as associated with depression, sensory impairment of taste and smell, decreased appetite or early satiety, and disability. Eligible studies were required to report baseline and follow-up values, the mean change (∆-change) from baseline, and/or the mean difference among intervention groups versus control group, concerning food intake (kcal/daily) and/or nutritional outcomes, such as body weight, body mass index, albumin and Mini Nutritional Assessment. RESULTS The systematic review included 20 papers based on different therapeutic approaches concerning food intake and/or nutritional outcomes. The results of the meta-analysis indicate that the interventions for AA have an important impact on body weight [+1.59 kg; 95% confidence interval (CI) = 1.48-+1.71 kg; P < 0.001) and on energy intake (+56.09 kcal; 95% CI = -54.05 to +166.25 kcal; P = 0.32). Regarding secondary outcomes, it was not possible to meta-analyse the limited amount of data availab le. CONCLUSIONS The different variants of AA need to be defined because diverse therapeutic approaches are available. A more precise definition of the functional impairments associated with AA may allow a more correct decision about the most appropriate therapy to be prescribed. Moreover, this may allow for a more effective performance of the different therapeutic approaches once they are better targeted to the different scenarios of AA.
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Affiliation(s)
- S Perna
- Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, University of Pavia, Pavia, Italy
| | - M Rondanelli
- Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, University of Pavia, Pavia, Italy.,IRCCS Mondino Foundation, Pavia, Department of Public Health, Experimental and Forensic Medicine, Unit of Human and Clinical Nutrition, University of Pavia, Italy
| | - D Spadaccini
- Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona, University of Pavia, Pavia, Italy
| | - A Lenzi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - L M Donini
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - E Poggiogalle
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
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Appetite, Metabolism and Hormonal Regulation in Normal Ageing and Dementia. Diseases 2018; 6:diseases6030066. [PMID: 30036957 PMCID: PMC6164971 DOI: 10.3390/diseases6030066] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 07/17/2018] [Accepted: 07/19/2018] [Indexed: 12/12/2022] Open
Abstract
Feeding and nutrition follow the growth trajectory of the course of life. The profound physiological changes that human body experiences during ageing affect separate aspects of food intake, from tastant perception to satiety. Concurrent morbidities, such as neurodegeneration, as seen in dementia, and metabolic syndrome, may further shape nutritional behaviours, status and adequacy. In an effort to fill the gap between the exhausting basic research and the actual needs of professionals caring for the exponentially expanding ageing population, the current review addresses major factors relevant to appetite and eating disturbances. Does age alter the perception of food modalities? Is food generally still perceived as alluring and delicious with age? Is there an interplay between ageing, cognitive decline, and malnutrition? What tools can we adopt for proper and timely monitoring? Finally, what anatomical and pathophysiological evidence exists to support a hypothesis of central regulation of metabolic perturbations in normal and accelerated cognitive impairment, and how can we benefit from it in health practice?
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Toyama K, Kuranuki S, Nakamura T, Yoshitake Y. Effect of Monosodium Glutamate on the Thermic Effect of Food and Body Surface Temperature in Young Women. J JPN SOC FOOD SCI 2018. [DOI: 10.3136/nskkk.65.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Kenji Toyama
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University ofHuman Services
- Graduate School of Physical Education, National Institute of Fitness and Sports in Kanoya
| | - Sachi Kuranuki
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University ofHuman Services
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van der Meij BS, Wijnhoven HAH, Lee JS, Houston DK, Hue T, Harris TB, Kritchevsky SB, Newman AB, Visser M. Poor Appetite and Dietary Intake in Community-Dwelling Older Adults. J Am Geriatr Soc 2017; 65:2190-2197. [PMID: 28744853 DOI: 10.1111/jgs.15017] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND/OBJECTIVES Poor appetite in older adults leads to sub-optimal food intake and increases the risk of undernutrition. The impact of poor appetite on food intake in older adults is unknown. The aim of this study was to examine the differences in food intake among older community-dwelling adults with different reported appetite levels. DESIGN Cross-sectional analysis of data from a longitudinal prospective study. SETTING Health, aging, and body composition study performed in the USA. PARTICIPANTS 2,597 community-dwelling adults aged 70-79. MEASUREMENTS A semi-quantitative, interviewer-administered, 108-item food frequency questionnaire designed to estimate dietary intake. Poor appetite was defined as the report of a moderate, poor, or very poor appetite in the past month and was compared with good or very good appetite. RESULTS The mean age of the study sample was 74.5 ± 2.8 years; 48.2% were men, 37.7% were black, and 21.8% reported a poor appetite. After adjustment for total energy intake and potential confounders (including biting/chewing problems), participants with a poor appetite had a significantly lower consumption of protein and dietary fiber, solid foods, protein rich foods, whole grains, fruits, and vegetables, but a higher consumption of dairy foods, fats, oils, sweets, and sodas compared to participants with very good appetite. In addition, they were less likely to report consumption of significant larger portion sizes. CONCLUSION Older adults reporting a poor appetite showed a different dietary intake pattern compared to those with (very) good appetite. Better understanding of the specific dietary intake pattern related to a poor appetite in older adults can be used for nutrition interventions to enhance food intake, diet variety, and diet quality.
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Affiliation(s)
- Barbara S van der Meij
- Department of Health Sciences and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands.,Department of Nutrition and Dietetics, VU University Medical Center, Amsterdam, The Netherlands.,Faculty of Health Sciences and Medicine, Bond University, Robina, Australia.,Department of Nutrition and Dietetics, Mater Health Services, Brisbane, Australia
| | - Hanneke A H Wijnhoven
- Department of Health Sciences and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - Jung S Lee
- Department of Foods and Nutrition, University of Georgia, Athens, GA, USA
| | - Denise K Houston
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Trisha Hue
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, National Institute of Aging, National Institutes of Health, Baltimore, MD, USA
| | - Stephen B Kritchevsky
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Anne B Newman
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, SA
| | - Marjolein Visser
- Department of Health Sciences and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, Amsterdam, The Netherlands.,Department of Nutrition and Dietetics, VU University Medical Center, Amsterdam, The Netherlands.,Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
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Does acute or habitual protein deprivation influence liking for monosodium glutamate? Physiol Behav 2017; 171:79-86. [DOI: 10.1016/j.physbeh.2017.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 01/04/2017] [Accepted: 01/05/2017] [Indexed: 11/21/2022]
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Baldwin C, Kimber KL, Gibbs M, Weekes CE. Supportive interventions for enhancing dietary intake in malnourished or nutritionally at-risk adults. Cochrane Database Syst Rev 2016; 12:CD009840. [PMID: 27996085 PMCID: PMC6463805 DOI: 10.1002/14651858.cd009840.pub2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Supportive interventions such as serving meals in a dining room environment or the use of assistants to feed patients are frequently recommended for the management of nutritionally vulnerable groups. Such interventions are included in many policy and guideline documents and have implications for staff time but may incur additional costs, yet there appears to be a lack of evidence for their efficacy. OBJECTIVES To assess the effects of supportive interventions for enhancing dietary intake in malnourished or nutritionally at-risk adults. SEARCH METHODS We identified publications from comprehensive searches of the Cochrane Library, MEDLINE, Embase, AMED, British Nursing Index, CINAHL, SCOPUS, ISI Web of Science databases, scrutiny of the reference lists of included trials and related systematic reviews and handsearching the abstracts of relevant meetings. The date of the last search for all databases was 31 March 2013. Additional searches of CENTRAL, MEDLINE, ClinicalTrials.gov and WHO ICTRP were undertaken to September 2016. The date of the last search for these databases was 14 September 2016. SELECTION CRITERIA Randomised controlled trials of supportive interventions given with the aim of enhancing dietary intake in nutritionally vulnerable adults compared with usual care. DATA COLLECTION AND ANALYSIS Three review authors and for the final search, the editor, selected trials from titles and abstracts and independently assessed eligibility of selected trials. Two review authors independently extracted data and assessed risk of bias, as well as evaluating overall quality of the evidence utilising the GRADE instrument, and then agreed as they entered data into the review. The likelihood of clinical heterogeneity amongst trials was judged to be high as trials were in populations with widely different clinical backgrounds, conducted in different healthcare settings and despite some grouping of similar interventions, involved interventions that varied considerably. We were only able, therefore, to conduct meta-analyses for the outcome measures, 'all-cause mortality', 'hospitalisation' and 'nutritional status (weight change)'. MAIN RESULTS Forty-one trials (10,681 participants) met the inclusion criteria. Trials were grouped according to similar interventions (changes to organisation of nutritional care (N = 13; 3456 participants), changes to the feeding environment (N = 5; 351 participants), modification of meal profile or pattern (N = 12; 649 participants), additional supplementation of meals (N = 10; 6022 participants) and home meal delivery systems (N = 1; 203 participants). Follow-up ranged from 'duration of hospital stay' to 12 months.The overall quality of evidence was moderate to very low, with the majority of trials judged to be at an unclear risk of bias in several risk of bias domains. The risk ratio (RR) for all-cause mortality was 0.78 (95% confidence interval (CI) 0.66 to 0.92); P = 0.004; 12 trials; 6683 participants; moderate-quality evidence. This translates into 26 (95% CI 9 to 41) fewer cases of death per 1000 participants in favour of supportive interventions. The RR for number of participants with any medical complication ranged from 1.42 in favour of control compared with 0.59 in favour of supportive interventions (very low-quality evidence). Only five trials (4451 participants) investigated health-related quality of life showing no substantial differences between intervention and comparator groups. Information on patient satisfaction was unreliable. The effects of supportive interventions versus comparators on hospitalisation showed a mean difference (MD) of -0.5 days (95% CI -2.6 to 1.6); P = 0.65; 5 trials; 667 participants; very low-quality evidence. Only three of 41 included trials (4108 participants; very low-quality evidence) reported on adverse events, describing intolerance to the supplement (diarrhoea, vomiting; 5/34 participants) and discontinuation of oral nutritional supplements because of refusal or dislike of taste (567/2017 participants). Meta-analysis across 17 trials with adequate data on weight change revealed an overall improvement in weight in favour of supportive interventions versus control: MD 0.6 kg (95% CI 0.21 to 1.02); 2024 participants; moderate-quality evidence. A total of 27 trials investigated nutritional intake with a majority of trials not finding marked differences in energy intake between intervention and comparator groups. Only three trials (1152 participants) reported some data on economic costs but did not use accepted health economic methods (very low-quality evidence). AUTHORS' CONCLUSIONS There is evidence of moderate to very low quality to suggest that supportive interventions to improve nutritional care results in minimal weight gain. Most of the evidence for the lower risk of all-cause mortality for supportive interventions comes from hospital-based trials and more research is needed to confirm this effect. There is very low-quality evidence regarding adverse effects; therefore whilst some of these interventions are advocated at a national level clinicians should recognise the lack of clear evidence to support their role. This review highlights the importance of assessing patient-important outcomes in future research.
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Affiliation(s)
- Christine Baldwin
- King's College LondonDiabetes & Nutritional Sciences Division, School of MedicineFranklin Wilkins Building150 Stamford StreetLondonUKSE1 9NH
| | - Katherine L Kimber
- School of Medicine, King's College LondonDiabetes & Nutritional Sciences DivisionFranklin Wilkin’s Building, Stamford StreetLondonUKSE1 9NH
| | - Michelle Gibbs
- King's College LondonDiabetes & Nutritional Sciences Division, School of MedicineFranklin Wilkins Building150 Stamford StreetLondonUKSE1 9NH
| | - Christine Elizabeth Weekes
- Guy's & St Thomas NHS Foundation TrustDepartment of Nutrition & DieteticsLambeth Palace RoadLondonUKSE1 7EH
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Greisinger S, Jovanovski S, Buchbauer G. An Interesting Tour of New Research Results on Umami and Umami Compounds. Nat Prod Commun 2016. [DOI: 10.1177/1934578x1601101040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Knowledge about the fifth basic taste, the umami taste, has been investigated by many scientists in the last years and continues to gain importance. Therefore, a lot of scientific studies were conducted to explore several effects influencing the mechanism of umami, which is elicited and enhanced by defined concentrations of MSG (monosodium glutamate) and umami compounds. This paper covers the most relevant scientific literature regarding umami, its use as a flavor enhancer, and the latest umami compounds, which have been released in the last ten years. The main goal of this overview was to summarize the most important results which were related to umami as one of the five basic tastes, the umami taste receptor, the essential role of umami in a great number of physiological mechanisms, and the MSG symptom complex. Furthermore, the function of umami in the interaction of taste, aftertaste and olfactory pathways has been discussed.
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Affiliation(s)
- Sabine Greisinger
- Department of Pharmaceutical Chemistry, University of Vienna, A-1090 Vienna, Austria
| | - Stefan Jovanovski
- Department of Pharmaceutical Chemistry, University of Vienna, A-1090 Vienna, Austria
| | - Gerhard Buchbauer
- Department of Pharmaceutical Chemistry, University of Vienna, A-1090 Vienna, Austria
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Song X, Giacalone D, Bølling Johansen SM, Frøst MB, Bredie WL. Changes in orosensory perception related to aging and strategies for counteracting its influence on food preferences among older adults. Trends Food Sci Technol 2016. [DOI: 10.1016/j.tifs.2016.04.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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12
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Affiliation(s)
- Katherine Field
- Department of Food Science; University of Guelph; Guelph Ontario Canada N1G 2W1
| | - Lisa M. Duizer
- Department of Food Science; University of Guelph; Guelph Ontario Canada N1G 2W1
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13
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Doets EL, Kremer S. The silver sensory experience – A review of senior consumers’ food perception, liking and intake. Food Qual Prefer 2016. [DOI: 10.1016/j.foodqual.2015.08.010] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wysokiński A, Sobów T, Kłoszewska I, Kostka T. Mechanisms of the anorexia of aging-a review. AGE (DORDRECHT, NETHERLANDS) 2015; 37:9821. [PMID: 26232135 PMCID: PMC5005824 DOI: 10.1007/s11357-015-9821-x] [Citation(s) in RCA: 131] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 07/22/2015] [Indexed: 05/05/2023]
Abstract
Many, even healthy, older people fail to adequately regulate food intake and experience loss of weight. Aging-associated changes in the regulation of appetite and the lack of hunger have been termed as the anorexia of aging. The etiology of the anorexia of aging is multi-factorial and includes a combination of physiological changes associated with aging (decline in smell and taste, reduced central and peripheral drive to eat, delayed gastric emptying), pathological conditions (depression, dementia, somatic diseases, medications and iatrogenic interventions, oral-health status), and social factors (poverty, loneliness). However, exact mechanisms of the anorexia of aging remain to be elucidated. Many neurobiological mechanisms may be secondary to age-related changes in body composition and not associated with anorexia per se. Therefore, further studies on pathophysiological mechanisms of the anorexia of aging should employ accurate measurement of body fat and lean mass. The anorexia of aging is associated with protein-energy malnutrition, sarcopenia, frailty, functional deterioration, morbidity, and mortality. Since this symptom can lead to dramatic consequences, early identification and effective interventions are needed. One of the most important goals in the geriatric care is to optimize nutritional status of the elderly.
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Affiliation(s)
- Adam Wysokiński
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Czechosłowacka 8/10, 92-216, Łódź, Poland,
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Masic U, Yeomans MR. Monosodium glutamate delivered in a protein-rich soup improves subsequent energy compensation. J Nutr Sci 2014; 3:e15. [PMID: 25191607 PMCID: PMC4153311 DOI: 10.1017/jns.2014.15] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 03/06/2014] [Accepted: 04/02/2014] [Indexed: 01/15/2023] Open
Abstract
Previous research suggests that monosodium glutamate (MSG) may have a biphasic effect on appetite, increasing appetite within a meal with its flavour-enhancing effect, but enhancing subsequent satiety due to its proposed role as a predictor of protein content. The present study explored this by assessing the impact of a 450 g soup preload differing in MSG concentration (1 % MSG added (MSG+) or no MSG (MSG-)) and nutrient content (low-energy control or high-energy carbohydrate or high-energy protein) on rated appetite and ad libitum intake of a test meal in thirty-five low-restraint male volunteers using a within-participant design. Protein-rich preloads significantly reduced intake at the test meal and resulted in more accurate energy compensation than did carbohydrate-rich preloads. This energy compensation was stronger in the MSG+ protein conditions when compared with MSG+ carbohydrate conditions. No clear differences in rated appetite were seen in MSG or the macronutrient conditions alone during preload ingestion or 45 min after intake. Overall, these findings indicate that MSG may act to further improve energy compensation when provided in a protein-rich context.
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Affiliation(s)
- Una Masic
- School of Psychology, University of
Sussex, Brighton BN1 9QH, UK
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Dermiki M, Mounayar R, Suwankanit C, Scott J, Kennedy OB, Mottram DS, Gosney MA, Blumenthal H, Methven L. Maximising umami taste in meat using natural ingredients: effects on chemistry, sensory perception and hedonic liking in young and old consumers. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2013; 93:3312-3321. [PMID: 23585029 DOI: 10.1002/jsfa.6177] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Revised: 04/02/2013] [Accepted: 04/12/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Umami taste in foods is elicited predominantly by the presence of glutamic acid and 5'-ribonucleotides, which act synergistically. This study aimed to use natural ingredients to maximise umami taste of a meat formulation and determine effects on liking of older consumers. Cooked meat products with added natural ingredients (yeast extract, mycoscent, shiitake extract, tomato puree, soy sauce and soybean paste) or monosodium glutamate (MSG) were prepared and compared with a control sample analytically (umami compounds), sensorially (sensory profile) and hedonically (liking by younger and older volunteers). Taste detection thresholds of sodium chloride and MSG of volunteers were collected. RESULTS Four of the seven cooked meat products developed had a significantly higher content of umami-contributing compounds compared with the control. All products, except those containing MSG or tomato puree, were scored (by trained sensory panel) perceptually significantly higher in umami and/or salty taste compared with the control. Consumer tests showed a correlation of liking by the older cohort with perceived saltiness (ρ = 0.76). CONCLUSION The addition of natural umami-containing ingredients during the cooking of meat can provide enhanced umami and salty taste characteristics. This can lead to increased liking by some consumers, particularly those with raised taste detection thresholds.
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Affiliation(s)
- Maria Dermiki
- Department of Food and Nutritional Sciences, University of Reading, Whiteknights, Reading, RG6 6AP, UK
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Abbott RA, Whear R, Thompson-Coon J, Ukoumunne OC, Rogers M, Bethel A, Hemsley A, Stein K. Effectiveness of mealtime interventions on nutritional outcomes for the elderly living in residential care: a systematic review and meta-analysis. Ageing Res Rev 2013; 12:967-81. [PMID: 23811415 DOI: 10.1016/j.arr.2013.06.002] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 06/14/2013] [Accepted: 06/17/2013] [Indexed: 11/26/2022]
Abstract
The need to improve the nutrition of the elderly living in long term care has long been recognised, but how this can best be achieved, and whether (and which) intervention is successful in reducing morbidity is less well understood. The aim of this systematic review was to determine the effectiveness of mealtime interventions for the elderly living in residential care. Mealtime interventions were considered as those that aimed to change/improve the mealtime routine, practice, experience or environment. Following comprehensive searches, review and appraisal, 37 articles were included. Inadequate reporting in over half of the articles limited data quality appraisal. Mealtime interventions were categorised into five types: changes to food service, food improvement, dining environment alteration, staff training and feeding assistance. Meta-analysis found inconsistent evidence of effects on body weight of changes to food service (0.5 kg; 95% CI: -1.1 to 2.2; p=0.51), food improvement interventions (0.4 kg; 95% CI: -0.8 to 1.7; p=0.50) or alterations to dining environment (1.5 kg; 95% CI: -0.7 to 2.8; p=0.23). Findings from observational studies within these intervention types were mixed, but generally positive. Observational studies also found positive effects on food/caloric intake across all intervention types, though meta-analyses of randomised studies showed little evidence of any effects on food/caloric intake in food improvement studies (-5 kcal; 95% CI: -36 to 26; p=0.74). There was some evidence of an effect on daily energy intakes within dining environment studies (181 kcal/day, 95% CI: -5 to 367, p=0.06). The need to improve the nutrition of the elderly living in residential long term care is well recognised. This review found some evidence that simple intervention around various aspects of mealtime practices and the mealtime environment can result in favourable nutritional outcomes. Further large scale pragmatic trials, however, are still required to establish full efficacy of such interventions.
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Sharafi M, Hayes JE, Duffy VB. Masking Vegetable Bitterness to Improve Palatability Depends on Vegetable Type and Taste Phenotype. CHEMOSENS PERCEPT 2013; 6:8-19. [PMID: 23682306 PMCID: PMC3652488 DOI: 10.1007/s12078-012-9137-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Consumption of dark green vegetables falls short of recommendations, in part, because of unpleasant bitterness. A laboratory-based study of 37 adults was used to determine bitter and hedonic responses to vegetables (asparagus, Brussels sprouts, kale) with bitter masking agents (1.33 M sodium acetate, 10 and 32 mM sodium chloride, and 3.2 mM aspartame) and then characterized by taste phenotype and vegetable liking. In repeated-measures ANOVA, aspartame was most effective at suppressing bitterness and improving hedonic responses for all sampled vegetables. Among the sodium salts, 32 mM sodium chloride decreased bitterness for kale and sodium acetate reduced bitterness across all vegetables with a tendency to increase liking for Brussels sprouts, as release from mixture suppression increased perceived sweetness. Participants were nearly equally divided into three 6-n-propylthiouracil (PROP) phenotype groups. Those tasting the least PROP bitterness (non-tasters) reported least vegetable bitterness, and the additives produced little change in vegetable liking. Aspartame persisted as the most effective bitter blocker for the PROP tasters (medium, supertasters), improving vegetable liking for the medium tasters but too much sweetness for supertasters. The sodium salts showed some bitter blocking for PROP tasters, particularly sodium acetate, without significant gains in vegetable liking. Via a survey, adults characterized as low vegetable likers reported greater increase in vegetable liking with the maskers than did vegetable likers. These results suggest that bitter masking agents (mainly sweeteners) can suppress bitterness to increase acceptance if they are matched to perceived vegetable bitterness or to self-reported vegetable disliking.
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Affiliation(s)
- Mastaneh Sharafi
- Department of Allied Health Sciences, College of Agriculture and Natural Resources, University of Connecticut, 358 Mansfield Road, Unit 2101, Storrs 06269 CT, USA
| | - John E Hayes
- Department of Food Science, College of Agricultural Sciences, The Pennsylvania State University, 220 Food Science Building, University Park 16802 PA, USA
| | - Valerie B Duffy
- Department of Allied Health Sciences, College of Agriculture and Natural Resources, University of Connecticut, 358 Mansfield Road, Unit 2101, Storrs 06269 CT, USA
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Abstract
PURPOSE OF REVIEW Anorexia represents a major problem for older persons leading to weight loss, sarcopenia, functional decline, and mortality. There is increasing information on the pathophysiological mechanisms that lead to anorexia. RECENT FINDINGS Increasing evidence has shown the importance of gastrointestinal hormones (ghrelin, cholecystokinin, and glucagon-like peptide) and adipokines in producing the anorexia of aging. Numerous neurotransmitters have been shown to be involved in this aging anorexia, but evidence in humans is lacking. SUMMARY The early recognition of anorexia of aging is important to allow intervention and prevent functional deterioration in older persons. Screening tests for anorexia have been developed. New approaches to managing anorexia are being tested.
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Affiliation(s)
- John E Morley
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St Louis, Missouri 63104, USA.
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Affiliation(s)
- J E Morley
- Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, MO 63104, USA.
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Abstract
PURPOSE OF REVIEW To summarize recent evidences and advances on the implementation and the use of the Mini Nutritional Assessment (MNA). RECENT FINDINGS Despite being introduced and validated for clinical use about 20 years ago, the MNA has recently received new attention in order to more widely disseminate among healthcare professionals the practice of a systematic nutritional screening and assessment of the old patient. Particularly, the structure has been implemented to face the difficulties in having the patients contributing to the assessment and to reduce further the time required to complete the evaluation. Recent data also confirm that in older populations prevalence of malnutrition by this tool is associated with the level of dependence. The rationale of nutritional assessment is to identify patients candidate to nutritional support. However, the sensitivity of the MNA is still debated because it has been associated with a high-risk 'overdiagnosis' and the advantages of a positive screening need to be assessed both in terms of outcome and money saving. SUMMARY The MNA is a simple and highly sensitive tool for nutritional screening and assessment. The large mass of data collected and the diffusion among healthcare professionals clearly support its use. However, the cost-effectiveness of interventions based on its scoring deserves investigation.
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Affiliation(s)
- Emanuele Cereda
- Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
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Landi F, Liperoti R, Lattanzio F, Russo A, Tosato M, Barillaro C, Bernabei R, Onder G. Effects of anorexia on mortality among older adults receiving home care: an observation study. J Nutr Health Aging 2012; 16:79-83. [PMID: 22238005 DOI: 10.1007/s12603-011-0064-y] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE We describe the prevalence of secondary anorexia in a population of older people living in community and receiving home care. In addition, we examined the relationship between secondary anorexia and mortality. METHODS We analyzed data from a large collaborative observational study group, the Italian Silver Network Home Care project, that collected data on patients admitted to home care programs. A total of twelve Home Health Agencies participated in such project evaluating the implementation of the Minimum Data Set for Home Care (MDS-HC) instrument. A total of 2757 patients were enrolled in the present study. The main outcome measures were the prevalence of anorexia, weight loss and survival. RESULTS More than 25% (744 subjects) of the study sample suffered from anorexia. During a mean follow-up of 10 months from initial MDS-HC assessment, 468 patients (17%) died. There was uneven distribution of the risk. After adjusting for age, gender and for all other possible risk factors for death (living alone, physical and cognitive disability, behavior problems, urinary incontinence, pressure ulcer, hearing impairment, congestive heart failure, hypertension, depression, diabetes, renal failure, cancer), subjects with anorexia were more likely to die relative to patients without anorexia (RR, 1.83; 95% CI 1.45-2.31). Even though the risk of mortality was higher among subjects suffering from anorexia and weight loss, the anorexia per se was associated with higher risk compared with subjects without anorexia (RR, 1.45; 95% CI 1.01-2.19). CONCLUSIONS Anorexia is associated with a significant higher risk of all-cause mortality. The present findings support the possibility that anorexia has an independent effect on survival even among old people receiving home care.
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Affiliation(s)
- F Landi
- Department of Gerontology-Geriatric and Medicine Rehabilitative, Catholic University of Sacred Heart, Rome, Italy.
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Glutamate. Its applications in food and contribution to health. Appetite 2010; 55:1-10. [PMID: 20470841 DOI: 10.1016/j.appet.2010.05.002] [Citation(s) in RCA: 135] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Revised: 03/28/2010] [Accepted: 05/03/2010] [Indexed: 12/13/2022]
Abstract
This article reviews application of glutamate in food and its benefits and role as one of the common food ingredients used. Monosodium glutamate is one of the most abundant naturally occurring amino acids which frequently added as a flavor enhancer. It produced a unique taste that cannot be provided by other basic taste (saltiness, sourness, sweetness and bitterness), referred to as a fifth taste (umami). Glutamate serves some functions in the body as well, serving as an energy source for certain tissues and as a substrate for glutathione synthesis. Glutamate has the potential to enhance food intake in older individuals and dietary free glutamate evoked a visceral sensation from the stomach, intestine and portal vein. Small quantities of glutamate used in combination with a reduced amount of table salt during food preparation allow for far less salt to be used during and after cooking. Because glutamate is one of the most intensely studied food ingredients in the food supply and has been found safe, the Joint Expert Committee on Food Additives of the United Nations Food and Agriculture Organization and World Health Organization placed it in the safest category for food additives. Despite a widespread belief that glutamate can elicit asthma, migraine headache and Chinese Restaurant Syndrome (CRS), there are no consistent clinical data to support this claim. In addition, findings from the literature indicate that there is no consistent evidence to suggest that individuals may be uniquely sensitive to glutamate.
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Van Staveren W, De Groot L. Editorial: The meaning of (social-)mobility and foods in frail elderly people. J Nutr Health Aging 2009; 13:759. [PMID: 19812864 DOI: 10.1007/s12603-009-0210-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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