1
|
Mills CM, Trinca V. The Evidence for Screening Older Adults for Nutrition Risk in Primary Care: An Umbrella Review. CAN J DIET PRACT RES 2023; 84:159-166. [PMID: 36920030 DOI: 10.3148/cjdpr-2022-043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
It is not known if nutrition risk screening of older adults should be a standard practice in primary care. The evidence in support of nutrition risk screening of older adults in primary care was examined and critically analyzed using an umbrella review. The peer reviewed and grey literature were searched for clinical practice guidelines (CPGs) and systematic reviews (SRs). Titles and abstracts were independently screened by the two authors. Resources were excluded if they did not apply to older adults, did not discuss nutrition/malnutrition risk screening, or were in settings other than primary care. Full texts were independently screened by both authors, resulting in the identification of six CPGs and three SRs that met the review criteria. Guidelines were appraised with the AGREE II tool and SRs with the AMSTAR 2 tool. The quality of the CPGs was high, while the quality of the SRs was low. The CPGs and SRs acknowledged a lack of high-quality research on the benefits of regular nutrition risk screening for older adults in primary care; however, CPGs recommended annual screening for older adults in primary care practices or other community settings. High-quality research investigating nutrition risk screening of older adults in primary care is needed.
Collapse
Affiliation(s)
- Christine Marie Mills
- Aging & Health Program, School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Vanessa Trinca
- Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada
| |
Collapse
|
2
|
Cara KC, Goldman DM, Kollman BK, Amato SS, Tull MD, Karlsen MC. Commonalities among dietary recommendations from 2010-2021 clinical practice guidelines: A meta-epidemiological study from the American College of Lifestyle Medicine. Adv Nutr 2023; 14:500-515. [PMID: 36940903 DOI: 10.1016/j.advnut.2023.03.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/17/2023] [Accepted: 03/14/2023] [Indexed: 03/22/2023] Open
Abstract
Clinical practice guidelines (CPGs) provide recommendations to clinicians based on current medical knowledge to guide and reduce variability in clinical care. With advances in nutrition science research, CPGs increasingly include dietary guidance; however, the degree of consistency in dietary recommendations across CPGs has not been investigated. Using a systematic review approach adapted for meta-epidemiological research, this study compared dietary guidance from current guidelines developed by governments, major medical professional societies, and large health stakeholder associations due to their often well-defined and standardized processes for guideline development. CPGs making recommendations for dietary patterns and food groups or components for generally healthy adults or those with pre-specified chronic diseases were eligible. Literature from January 2010-2022 was searched in five bibliographic databases and augmented by searches in point-of-care resource databases and relevant websites. Reporting followed an adapted Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement and included narrative synthesis and summary tables. The protocol was pre-published on PROSPERO (CRD42021226281). Seventy-eight CPGs for major chronic conditions (autoimmune=7, cancers=5, cardiovascular-related=35, digestive=11, diabetes=12, weight-related=4, or multiple=3) and general health promotion (n=1) were included. Nearly all (91%) made dietary pattern recommendations, and roughly half (49%) endorsed patterns centered around plant foods. Overall, CPGs were most closely aligned in promoting consumption of major plant food groups (vegetables=74% of CPGs, fruit=69%, whole grains=58%) while discouraging intake of alcohol (62%) and salt or sodium (56%). CVD and diabetes CPGs were similarly aligned with additional messaging to consume legumes/pulses (60% of CVD CPGs; 75%, diabetes), nuts and seeds (67%, CVD), and low-fat dairy (60%, CVD). Diabetes guidelines discouraged sweets/added sugars (67%) and sweetened beverages (58%). This alignment across CPGs should boost clinician confidence in relaying such dietary guidance to patients in accordance with their relevant CPGs.
Collapse
Affiliation(s)
- Kelly C Cara
- American College of Lifestyle Medicine, Chesterfield, MO 63006, USA; Tufts University, Friedman School of Nutrition Science and Policy, Division of Nutrition Epidemiology and Data Science, Boston, MA, USA
| | | | - Brooke K Kollman
- The Integrative Medicine Center of Western Colorado, Grand Junction, CO, USA
| | - Stas S Amato
- University of Vermont Medical Center, Department of General Surgery, Burlington, VT, USA
| | - Martin D Tull
- American College of Lifestyle Medicine, Chesterfield, MO 63006, USA
| | - Micaela C Karlsen
- American College of Lifestyle Medicine, Chesterfield, MO 63006, USA; University of New England, Applied Nutrition & Global Public Health, Biddeford, ME, USA.
| |
Collapse
|
3
|
Relationship of domain-specific quality of life with body mass index and waist circumference in a Korean elderly population. Aging Clin Exp Res 2021; 33:3257-3267. [PMID: 34028707 DOI: 10.1007/s40520-021-01876-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 04/30/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Obesity affects health-related quality of life (QoL); however, their relationship among elderly Asians is not well known. AIMS Relationship of domain-specific QoL with body mass index (BMI) and waist circumference and the sex differences were investigated using a nationally representative sample of elderly Korean population. METHODS In the Korea National Health and Nutrition Examination Survey phase VII (2016-2018), 3659 adults aged ≥ 65 years (1551 men and 2108 women) participated. BMI and waist circumference were classified according to Asian- and Korean-specific criteria. QoL was evaluated using the European Quality of Life Scale-Five Dimensions (EQ-5D). Multivariable logistic regressions were used to examine the relationship of QoL with BMI and waist circumference. RESULTS Men with BMI < 18.5 kg/m2 and ≥ 25.0 kg/m2 had a significant association with poor QoL in mobility and self-care, but no relationship was found with the other domains. Women with BMI ≥ 25.0 kg/m2 had poor QoL in mobility and self-care, and those with BMI ≥ 30.0 kg/m2 had poor QoL in usual activities and pain/discomfort. There was no significant association with anxiety/depression. Both elderly men and women with abdominal obesity had a significant association with poor QoL in mobility, self-care, usual activities, and pain/discomfort; however, there was no significant relationship with waist circumference and anxiety/depression. CONCLUSIONS The association between QoL and BMI was different according to sex and the domains of QoL. Domain-specific QoL should be considered in the management of body weight of the elderly.
Collapse
|
4
|
Fraile Navarro D, López García-Franco A, Niño de Guzmán E, Rabassa M, Zamanillo Campos R, Pardo-Hernández H, Ricci-Cabello I, Canelo-Aybar C, Meneses-Echavez JF, Yepes-Nuñez JJ, Kuindersma J, Gich Saladich I, Alonso-Coello P. Vitamin D recommendations in clinical guidelines: A systematic review, quality evaluation and analysis of potential predictors. Int J Clin Pract 2021; 75:e14805. [PMID: 34486779 DOI: 10.1111/ijcp.14805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 08/16/2021] [Accepted: 09/03/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Vitamin D has been widely promoted for bone health through supplementation and fortification of the general adult population. However, there is growing evidence that does not support these strategies. Our aim is to review the quality and recommendations on vitamin D nutritional and clinical practice guidelines and to explore predictive factors for their direction and strength. METHODS We searched three databases and two guideline repositories from 2010 onwards. We performed a descriptive analysis, a quality appraisal using AGREE II scores (Appraisal of Guidelines Research and Evaluation) and a bivariate analysis evaluating the association between direction and strength of recommendations, AGREE II domains' scores and pre-specified characteristics. RESULTS We included 34 guidelines, 44.1% recommended, 26.5% suggested and 29.4% did not recommend vitamin D supplementation. Guidelines that scored higher for "editorial independence" and "overall quality score" were less likely to recommend or suggest vitamin D supplementation (median 68.8 vs 35.4; P = .001 and 58.3 vs 37.5; P = .02). Guidance produced by government organisations and those that reported source of funding were associated with higher AGREE II scores. Unclear role of source of funding was associated with recommending or suggesting vitamin D supplementation (P = .034). Editorial independence was an independent predictor for recommending or suggesting vitamin D supplementation (OR 1.09; CI95% 1.02 to 1.16; P = .006). CONCLUSIONS Policymakers, clinicians and patients should be aware that lower quality guidelines and those reporting conflicts of interest are more likely to promote vitamin D supplementation. Guideline organisations should improve the quality of their recommendations' development and the management of conflicts of interest. Users and editors should be aware of these findings when using and appraising guidelines.
Collapse
Affiliation(s)
- David Fraile Navarro
- Health Centre Dr Mendiguchia Carriche, Servicio Madrileño de Salud, Leganes, Madrid, Spain
- Primary Care, Servicio Madrileño de Salud, Madrid, Spain
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Alberto López García-Franco
- Health Centre Dr Mendiguchia Carriche, Servicio Madrileño de Salud, Leganes, Madrid, Spain
- Primary Care, Servicio Madrileño de Salud, Madrid, Spain
| | - Ena Niño de Guzmán
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Montserrat Rabassa
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Rocío Zamanillo Campos
- Health Research Institute of the Balearic Islands (IdISBa), Balearic Islands, Spain
- Department of Health, Valencian International University (VIU), Valencia, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Balearic Islands, Spain
| | - Héctor Pardo-Hernández
- Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Ignacio Ricci-Cabello
- Health Research Institute of the Balearic Islands (IdISBa), Balearic Islands, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Balearic Islands, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Carlos Canelo-Aybar
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Jose F Meneses-Echavez
- Norwegian Institute of Public Health, Oslo, Norway
- Facultad de Cultura Física, Deporte y Recreación, Universidad Santo Tomás, Bogotá, Colombia
| | - Juan José Yepes-Nuñez
- School of Medicine, Universidad de los Andes, Bogotá, Colombia
- Pulmonology Service, Internal Medicine Section, Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia
| | - Jesse Kuindersma
- Biomedical Sciences, University of Groningen, Groningen, Netherlands
| | - Ignasi Gich Saladich
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| |
Collapse
|
5
|
Werber T, Bata Z, Vaszine ES, Berente DB, Kamondi A, Horvath AA. The Association of Periodontitis and Alzheimer's Disease: How to Hit Two Birds with One Stone. J Alzheimers Dis 2021; 84:1-21. [PMID: 34511500 DOI: 10.3233/jad-210491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Alzheimer's disease (AD) is the leading cause of cognitive impairment in the elderly. Recent evidence suggests that preventive interventional trials could significantly reduce the risk for development of dementia. Periodontitis is the most common dental disease characterized by chronic inflammation and loss of alveolar bone and perialveolar attachment of teeth. Growing number of studies propose a potential link between periodontitis and neurodegeneration. In the first part of the paper, we overview case-control studies analyzing the prevalence of periodontitis among AD patients and healthy controls. Second, we survey observational libraries and cross-sectional studies investigating the risk of cognitive decline in patients with periodontitis. Next, we describe the current view on the mechanism of periodontitis linked neural damage, highlighting bacterial invasion of neural tissue from dental plaques, and periodontitis induced systemic inflammation resulting in a neuroinflammatory process. Later, we summarize reports connecting the four most common periodontal pathogens to AD pathology. Finally, we provide a practical guide for further prevalence and interventional studies on the management of cognitively high-risk patients with and without periodontitis. In this section, we highlight strategies for risk control, patient information, dental evaluation, reporting protocol and dental procedures in the clinical management of patients with a risk for periodontitis and with diagnosed periodontitis. In conclusion, our review summarizes the current view on the association between AD and periodontitis and provides a research and intervention strategy for harmonized interventional trials and for further case-control or cross-sectional studies.
Collapse
Affiliation(s)
- Tom Werber
- Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Zsofia Bata
- Department of Conservative Dentistry, Semmelweis University, Budapest, Hungary
| | - Eniko Szabo Vaszine
- Department of Conservative Dentistry, Semmelweis University, Budapest, Hungary
| | - Dalida Borbala Berente
- Faculty of Medicine, Semmelweis University, Budapest, Hungary.,Neurocognitive Research Center, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary
| | - Anita Kamondi
- Neurocognitive Research Center, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary.,Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Andras Attila Horvath
- Neurocognitive Research Center, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary.,Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary
| |
Collapse
|
6
|
Niemeläinen S, Huhtala H, Andersen J, Ehrlich A, Haukijärvi E, Koikkalainen S, Koskensalo S, Kössi J, Mattila A, Pinta T, Uotila-Nieminen M, Vihervaara H, Hyöty M, Jämsen E. The Clinical Frailty Scale is a useful tool for predicting postoperative complications following elective colon cancer surgery at the age of 80 years and above: A prospective, multicentre observational study. Colorectal Dis 2021; 23:1824-1836. [PMID: 33915013 DOI: 10.1111/codi.15689] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/14/2021] [Accepted: 04/19/2021] [Indexed: 12/12/2022]
Abstract
AIM Identification of the risks of postoperative complications may be challenging in older patients with heterogeneous physical and cognitive status. The aim of this multicentre, observational study was to identify variables that affect the outcomes of colon cancer surgery and, especially, to find tools to quantify the risks related to surgery. METHOD Patients aged ≥80 years with electively operated Stage I-III colon cancer were recruited. The prospectively collected data included comorbidities, results of the onco-geriatric screening tool (G8), Clinical Frailty Scale (CFS), Charlson Comorbidity Index (CCI) and Mini Nutritional Assessment-Short Form (MNA-SF), and operative and postoperative outcomes. RESULTS A total of 161 patients (mean 84.5 years, range 80-97, 60% female) were included. History of cerebral stroke (64% vs. 37%, p = 0.02), albumin level 31-34 g/l compared with ≥35 g/l (57% vs. 32%, p = 0.007), CFS 3-4 and 5-9 compared with CFS 1-2 (49% and 47% vs. 16%, respectively) and American Society of Anesthesiologists score >3 (77% vs. 28%, P = 0.006) were related to a higher risk of complications. In multivariate logistic regression analysis CFS ≥3 (OR 6.06, 95% CI 1.88-19.5, p = 0.003) and albumin level 31-34 g/l (OR 3.88, 1.61-9.38, p = 0.003) were significantly associated with postoperative complications. Severe complications were more common in patients with chronic obstructive pulmonary disease (43% vs. 13%, p = 0.047), renal failure (25% vs. 12%, p = 0.021), albumin level 31-34 g/l (26% vs. 8%, p = 0.014) and CCI >6 (23% vs. 10%, p = 0.034). CONCLUSION Surgery on physically and cognitively fit aged colon cancer patients with CFS 1-2 can lead to excellent operative outcomes similar to those of younger patients. The CFS could be a useful screening tool for predicting postoperative complications.
Collapse
Affiliation(s)
- Susanna Niemeläinen
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
| | - Heini Huhtala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Jan Andersen
- Department of Surgery, Vaasa Central Hospital, Vaasa, Finland
| | - Anu Ehrlich
- Department of Abdominal Surgery, Helsinki University Hospital, Finland
| | - Eija Haukijärvi
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
| | | | - Selja Koskensalo
- Department of Abdominal Surgery, Helsinki University Hospital, Finland.,Faculty of Medicine, Helsinki University, Helsinki, Finland
| | - Jyrki Kössi
- Department of Surgery, Päijät-Häme Central Hospital, Lahti, Finland
| | - Anne Mattila
- Department of Surgery, Central Hospital of Central Finland, Jyväskylä, Finland
| | - Tarja Pinta
- Department of Surgery, Seinäjoki Central Hospital, Seinäjoki, Finland
| | | | - Hanna Vihervaara
- Division of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland.,Faculty of Medicine, Turku University, Turku, Finland
| | - Marja Hyöty
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland
| | - Esa Jämsen
- Centre of Geriatrics, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Gerontology Research Center (GEREC), Tampere, Finland
| |
Collapse
|
7
|
Agostini F, Bernetti A, Di Giacomo G, Viva MG, Paoloni M, Mangone M, Santilli V, Masiero S. Rehabilitative Good Practices in the Treatment of Sarcopenia: A Narrative Review. Am J Phys Med Rehabil 2021; 100:280-287. [PMID: 33595941 DOI: 10.1097/phm.0000000000001572] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
ABSTRACT To date, rehabilitative good practices that analyze all aspects of the rehabilitation management of the patient with sarcopenia are absent in the literature. The purpose of this article is to carry out research and evaluation of the evidence, good practice, and recommendations in the literature relating to the rehabilitative treatment of disabilities associated with sarcopenia. Bibliographic research was conducted on Medline, PEDro, Cochrane Database, and Google Scholar. All articles published in the last 10 yrs were analyzed. The results of this research generated three guidelines, eight meta-analyses, five systematic reviews, a Cochrane review, 17 reviews, and seven consensus conferences. From the analysis of the literature, it seems that most of the works agree in affirming that exercise and diet supplementation are the cornerstones of rehabilitation treatment of patients with sarcopenia. The practice of an adequate lifestyle received numerous high-grade recommendations in the included guidelines. Based on the data obtained, the rehabilitation management of the patient with sarcopenia must be personalized and must include exercise and nutritional supplementation. These factors are important in increasing the autonomy of the elderly essential for safe walking without neglecting stretching exercises that are important for flexibility and balance and coordination exercises.
Collapse
Affiliation(s)
- Francesco Agostini
- From the Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy (FA, AB, GDG, MGV, MP, MM, VS); and Department of Neuroscience, University of Padua, Padua, Italy (SM)
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Jyväkorpi SK, Ramel A, Strandberg TE, Piotrowicz K, Błaszczyk-Bębenek E, Urtamo A, Rempe HM, Geirsdóttir Ó, Vágnerová T, Billot M, Larreur A, Savera G, Soriano G, Picauron C, Tagliaferri S, Sanchez-Puelles C, Cadenas VS, Perl A, Tirrel L, Öhman H, Weling-Scheepers C, Ambrosi S, Costantini A, Pavelková K, Klimkova M, Freiberger E, Jonsson PV, Marzetti E, Pitkälä KH, Landi F, Calvani R. The sarcopenia and physical frailty in older people: multi-component treatment strategies (SPRINTT) project: description and feasibility of a nutrition intervention in community-dwelling older Europeans. Eur Geriatr Med 2021; 12:303-312. [PMID: 33583000 PMCID: PMC7990826 DOI: 10.1007/s41999-020-00438-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 12/09/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND The "Sarcopenia and Physical Frailty in Older People: Multicomponent Treatment Strategies" (SPRINTT) project sponsored a multi-center randomized controlled trial (RCT) with the objective to determine the effect of physical activity and nutrition intervention for prevention of mobility disability in community-dwelling frail older Europeans. We describe here the design and feasibility of the SPRINTT nutrition intervention, including techniques used by nutrition interventionists to identify those at risk of malnutrition and to carry out the nutrition intervention. METHODS SPRINTT RCT recruited older adults (≥ 70 years) from 11 European countries. Eligible participants (n = 1517) had functional limitations measured with Short Physical Performance Battery (SPPB score 3-9) and low muscle mass as determined by DXA scans, but were able to walk 400 m without assistance within 15 min. Participants were followed up for up to 3 years. The nutrition intervention was carried out mainly by individual nutrition counseling. Nutrition goals included achieving a daily protein intake of 1.0-1.2 g/kg body weight, energy intake of 25-30 kcal/kg of body weight/day, and serum vitamin D concentration ≥ 75 mmol/L. Survey on the method strategies and feasibility of the nutrition intervention was sent to all nutrition interventionists of the 16 SPRINTT study sites. RESULTS Nutrition interventionists from all study sites responded to the survey. All responders found that the SPRINTT nutrition intervention was feasible for the target population, and it was well received by the majority. The identification of participants at nutritional risk was accomplished by combining information from interviews, questionnaires, clinical and laboratory data. Although the nutrition intervention was mainly carried out using individual nutritional counselling, other assisting methods were used as appropriate. CONCLUSION The SPRINTT nutrition intervention was feasible and able to adapt flexibly to varying needs of this heterogeneous population. The procedures adopted to identify older adults at risk of malnutrition and to design the appropriate intervention may serve as a model to deliver nutrition intervention for community-dwelling older people with mobility limitations.
Collapse
Affiliation(s)
- S K Jyväkorpi
- Clinicum, Department of General Practice, Helsinki University Central Hospital, University of Helsinki, Tukholmankatu 8 B, 00014, Helsinki, Finland.
| | - A Ramel
- The Icelandic Gerontological Research Center, The National University Hospital of Iceland, Reykjavik, Iceland
| | - T E Strandberg
- Clinicum, Department of General Practice, Helsinki University Central Hospital, University of Helsinki, Tukholmankatu 8 B, 00014, Helsinki, Finland.,University of Oulu, Center for Life Course Health Research, Oulu, Finland
| | - K Piotrowicz
- Faculty of Medicine, Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland
| | - E Błaszczyk-Bębenek
- Department of Nutrition and Drug Research, Institute of Public Health, Faculty of Health Science, Jagiellonian University Medical College, Krakow, Poland
| | - A Urtamo
- Clinicum, Department of General Practice, Helsinki University Central Hospital, University of Helsinki, Tukholmankatu 8 B, 00014, Helsinki, Finland
| | - H M Rempe
- Institute for Biomedicine of Aging, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Ó Geirsdóttir
- The Icelandic Gerontological Research Center, The National University Hospital of Iceland, Reykjavik, Iceland
| | - T Vágnerová
- 1St Faculty of Medicine, Department of Gerontology & Geriatrics, Charles University in Prague, General University Hospital Prague, Nové Město, Czech Republic
| | - M Billot
- PRISMATICS Lab (Predictive Research In Spine/Neuromodulation Management And Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, Poitiers, France
| | - A Larreur
- Department of Geriatrics, University Hospital of Limoges, Limoges, France
| | - G Savera
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Soriano
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - C Picauron
- Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - S Tagliaferri
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | | | | | - A Perl
- Medical University of Graz, Graz, Austria
| | - L Tirrel
- Diabetes Frail, Medici Medical Practice, Luton, UK
| | - H Öhman
- Clinicum, Department of General Practice, Helsinki University Central Hospital, University of Helsinki, Tukholmankatu 8 B, 00014, Helsinki, Finland
| | | | | | | | | | - M Klimkova
- Silesian Hospital, Opava, Czech Republic
| | - E Freiberger
- 1St Faculty of Medicine, Department of Gerontology & Geriatrics, Charles University in Prague, General University Hospital Prague, Nové Město, Czech Republic
| | - P V Jonsson
- The Icelandic Gerontological Research Center, The National University Hospital of Iceland, Reykjavik, Iceland
| | - E Marzetti
- Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - K H Pitkälä
- Clinicum, Department of General Practice, Helsinki University Central Hospital, University of Helsinki, Tukholmankatu 8 B, 00014, Helsinki, Finland
| | - F Landi
- Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - R Calvani
- Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | | |
Collapse
|
9
|
Association of Baltic Sea and Mediterranean diets with frailty phenotype in older women, Kuopio OSTPRE-FPS study. Eur J Nutr 2020; 60:821-831. [PMID: 32462318 PMCID: PMC7900336 DOI: 10.1007/s00394-020-02290-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 05/18/2020] [Indexed: 02/07/2023]
Abstract
Purpose To evaluate the association between Baltic Sea diet (BSD) and Mediterranean diet (MED) with frailty. Methods This was a secondary analysis on the osteoporosis risk factor and prevention–fracture prevention study on 440 women aged 65–72 years. Frailty was ascertained with the presence of 3–5 and prefrailty 1–2 of the following criteria: weight loss ≥ 5%, low life satisfaction score, walking speed ≤ 0.51 m/s, handgrip strength divided by body mass index ≤ 0.67 kg/m2 and physical activity ≤ 2 h/week. Women answered to questionnaires on lifestyle factors and 3-day food record. BSD score was ascertained using intake of nine and MED score of eight foods or nutrients components from food record. Multinomial logistic regression models adjusted for age, energy intake, smoking, living status, marital status and intervention group evaluated associations between MED and BSD with frailty phenotype status. Results At 3-year follow-up, 206 women (46.8%) were prefrail and 36 (8.2%) were frail. After adjusting for confounders, a tendency was found between BSD per standard deviation (SD)-unit increase and lower likelihood of frailty (β = 0.62, 95% CI = 0.38–1.01, P = 0.057). Further, MED per SD-unit increase was associated with lower likelihood of prefrailty (β = 0.74, 95% CI = 0.6–0.9, P = 0.009). Consumption of vegetables was lower in frail (31.5 ± 36.0 g/day) and prefrail women (37.1 ± 42.0 g/day) than in non-frail women (48.6 ± 40.7 g/day) (P for trend = 0.041). Conclusions Positive behavioral characteristics such as following MED and BSD may be associated with lower likelihood of prefrailty and frailty in older women. However, further longitudinal analyses are warranted. Electronic supplementary material The online version of this article (10.1007/s00394-020-02290-5) contains supplementary material, which is available to authorized users.
Collapse
|
10
|
Critical appraisal of papers reporting recommendation on sarcopenia using the AGREE II tool: a EuroAIM initiative. Eur J Clin Nutr 2020; 74:1164-1172. [PMID: 32341490 DOI: 10.1038/s41430-020-0638-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/27/2020] [Accepted: 04/07/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND/OBJECTIVES The growing interest of medical community about sarcopenia resulted in the production of several clinical practice guidelines (CPGs), with an unavoidable variability in terms of the overall quality of those publications. Our aim is to evaluate the quality of CPGs on sarcopenia using the AGREE II instrument. SUBJECTS/METHODS We performed an online literature search for sarcopenia CPGs using different databases. Four independent reviewers evaluated the quality of CPGs using the AGREE II instrument. To classify the quality of each guideline, we defined specific thresholds of final score: high-quality if five or more domains scored >60%; average-quality if three or four domains scored >60%; low-quality if ≤2 domains scored >60%. RESULTS Our literature search yielded 315 articles, and after applying exclusion criteria our final analysis included 19 CPGs. The overall quality of CPGs was remarkable, as 13/19 (68.4%) were considered of "high-quality" CPGs, with more than four domains reached a score higher than 60%. "Scope and Purpose" and "Clarity of Presentations" had the best domain results (78.4% and 73.8%, respectively), while the two domains with the lowest scores were "Rigor of Development" and "Applicability" (61.5% and 58.7%, respectively). Interobserver variability ranged between moderate (0.624) and fair (0.275). CONCLUSIONS Our study showed that the overall quality of CPGs about sarcopenia was noteworthy, as more than two-third of paper obtained a "high-quality" score. The domain "applicability" had the lowest score, suggesting that emphasis should be put on possible strategies for helping other doctors to implement guideline recommendations in clinical practice.
Collapse
|
11
|
Alcohol Consumption Reduces the Beneficial Influence of Protein Intake on Muscle Mass in Middle-Aged Korean Adults: A 12-Year Community-Based Prospective Cohort Study. Nutrients 2019; 11:nu11092143. [PMID: 31500277 PMCID: PMC6770710 DOI: 10.3390/nu11092143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 08/31/2019] [Accepted: 09/04/2019] [Indexed: 01/10/2023] Open
Abstract
The influence of alcohol consumption on the association of protein intake with muscle mass was assessed using data from the Korean Genome and Epidemiology Study. Dietary protein intakes of 4412 middle-aged participants with normal baseline muscle mass were assessed using a semi-quantitative Food Frequency Questionnaire, and baseline alcohol consumption data (e.g., frequency and amount) were collected using a structured questionnaire. The skeletal muscle mass index (SMI), defined as the weight-adjusted skeletal muscle mass, was measured using multi-frequency bioelectrical impedance analyses every 2 years until the study endpoint. Low muscle mass was defined as a SMI <2 standard deviations below the sex-specific normal mean for a young reference group. During a 12-year follow-up, 395 subjects developed a low SMI. After multivariate adjustments, high protein intake (≥1.2 g/kg body weight (BW)) was shown to reduce the risk of low SMI development in both men (hazard ratio (HR): 0.24; 95% confidence interval (CI): 0.12, 0.51; p for trend < 0.001) and women (HR: 0.29; 95% CI: 0.16, 0.53; p for trend < 0.001), compared with low protein intake (<0.8 g/kg BW). Alcohol consumption attenuated the protective influence of protein intake against low SMI development in women (HR: 0.64; 95% CI: 0.18, 2.25; p for trend = 0.478). Among the total subjects, heavy drinkers with high protein intake were not significantly associated with the development of a low SMI (HR: 0.20; 95% CI: 0.03, 1.50; p = 0.117). Additional research should clarify the dose-response effects of alcohol consumption on muscle mass relative to daily protein intake.
Collapse
|
12
|
Healthy ageing, appetite, frailty and sarcopenia: A brief overview. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
13
|
Salminen KS, Suominen MH, Soini H, Kautiainen H, Savikko N, Saarela RKT, Muurinen S, Pitkala KH. Associations between Nutritional Status and Health-Related Quality of Life among Long-Term Care Residents in Helsinki. J Nutr Health Aging 2019; 23:474-478. [PMID: 31021365 DOI: 10.1007/s12603-019-1182-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We evaluated the associations between nutritional status and health-related quality-of-life (HRQoL) among older long-term care residents in Helsinki. DESIGN AND PARTICIPANTS All 3767 older (≥65 years) long-term care residents in Helsinki in 2017 were invited to participate in this cross-sectional study. After refusals and exclusions of residents without sufficient information, 2160 residents remained. MEASUREMENTS Data on characteristics, nutritional status (Mini Nutritional Assessment, MNA) and HRQoL (15D) were collected by trained nurses. RESULTS Of the participants, 64% were at-risk of malnutrition and 18% suffered from malnutrition. Residents in the "malnourished" group were more dependent in activities of daily living (ADL) functioning, suffered more often from dementia, had lower cognitive level, used less medications, and were eating more often inadequately. HRQoL was statistically significantly associated with MNA total score in both female and male residents. There was a curvilinear correlation between MNA and 15D score in females: 0.50 (95% CI 0.46 to 0.53) and males: 0.56 (95% CI 0.50 to 0.61). In partial correlation analysis, all dimensions of 15D, except for sleeping and breathing, were positively associated with MNA score. In these analyses no significant differences emerged between males and females when the results were adjusted for age and dementia. CONCLUSIONS Nutrition plays an important role in HRQoL among older long-term care residents.
Collapse
Affiliation(s)
- K S Salminen
- Karoliina Sofia Salminen, Helsingin Yliopisto, Helsinki, Finland,
| | | | | | | | | | | | | | | |
Collapse
|
14
|
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?
Collapse
|
15
|
Inadequate fluid intake in long term care residents: prevalence and determinants. Geriatr Nurs 2018; 39:330-335. [DOI: 10.1016/j.gerinurse.2017.11.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 11/05/2017] [Accepted: 11/13/2017] [Indexed: 01/23/2023]
|
16
|
Gomes MJ, Martinez PF, Pagan LU, Damatto RL, Cezar MDM, Lima ARR, Okoshi K, Okoshi MP. Skeletal muscle aging: influence of oxidative stress and physical exercise. Oncotarget 2017; 8:20428-20440. [PMID: 28099900 PMCID: PMC5386774 DOI: 10.18632/oncotarget.14670] [Citation(s) in RCA: 169] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 01/09/2017] [Indexed: 12/13/2022] Open
Abstract
Skeletal muscle abnormalities are responsible for significant disability in the elderly. Sarcopenia is the main alteration occurring during senescence and a key public health issue as it predicts frailty, poor quality of life, and mortality. Several factors such as reduced physical activity, hormonal changes, insulin resistance, genetic susceptibility, appetite loss, and nutritional deficiencies are involved in the physiopathology of muscle changes. Sarcopenia is characterized by structural, biochemical, molecular and functional muscle changes. An imbalance between anabolic and catabolic intracellular signaling pathways and an increase in oxidative stress both play important roles in muscle abnormalities. Currently, despite the discovery of new targets and development of new drugs, nonpharmacological therapies such as physical exercise and nutritional support are considered the basis for prevention and treatment of age-associated muscle abnormalities. There has been an increase in information on signaling pathways beneficially modulated by exercise; nonetheless, studies are needed to establish the best type, intensity, and frequency of exercise to prevent or treat age-induced skeletal muscle alterations.
Collapse
Affiliation(s)
- Mariana Janini Gomes
- Botucatu Medical School, Internal Medicine Departament, Sao Paulo State University, UNESP, Botucatu, SP, Brazil
| | - Paula Felippe Martinez
- School of Physical Therapy, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
| | - Luana Urbano Pagan
- Botucatu Medical School, Internal Medicine Departament, Sao Paulo State University, UNESP, Botucatu, SP, Brazil
| | - Ricardo Luiz Damatto
- Botucatu Medical School, Internal Medicine Departament, Sao Paulo State University, UNESP, Botucatu, SP, Brazil
| | | | - Aline Regina Ruiz Lima
- Botucatu Medical School, Internal Medicine Departament, Sao Paulo State University, UNESP, Botucatu, SP, Brazil
| | - Katashi Okoshi
- Botucatu Medical School, Internal Medicine Departament, Sao Paulo State University, UNESP, Botucatu, SP, Brazil
| | - Marina Politi Okoshi
- Botucatu Medical School, Internal Medicine Departament, Sao Paulo State University, UNESP, Botucatu, SP, Brazil
| |
Collapse
|
17
|
Jyväkorpi SK, Pitkälä KH, Puranen TM, Björkman MP, Suominen MH, Strandberg TE, Soini H. Higher Polyunsaturated Fatty Acid to Saturated Fatty Acid Ratio Is Associated With Cognition, Mobility, Nutrient Intakes, and Higher Diet Quality in Heterogeneous Older Populations. J Am Med Dir Assoc 2017. [PMID: 28625389 DOI: 10.1016/j.jamda.2017.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Satu K Jyväkorpi
- University of Helsinki, Department of General Practice and Primary Health Care, Helsinki, Finland
| | - Kaisu H Pitkälä
- University of Helsinki, Department of General Practice and Primary Health Care, Helsinki, Finland
| | - Taija M Puranen
- University of Helsinki, Department of General Practice and Primary Health Care, Helsinki, Finland
| | - Mikko P Björkman
- University of Helsinki, Department of General Practice and Primary Health Care, Helsinki, Finland
| | - Merja H Suominen
- University of Helsinki, Department of General Practice and Primary Health Care, Helsinki, Finland
| | - Timo E Strandberg
- University of Helsinki, Department of Medicine, Geriatric Clinic, Helsinki University Central Hospital, and University of Oulu, Institute of Health Sciences/Geriatrics, and Oulu University Hospital, Oulu, Finland
| | - Helena Soini
- University of Helsinki, Department of General Practice and Primary Health Care, Helsinki City, Department of Social Services and Health Care, Developmental and Operational Support, Helsinki, Finland
| |
Collapse
|
18
|
Saarela RKT, Muurinen S, Suominen MH, Savikko NN, Soini H, Pitkälä KH. Changes in malnutrition and quality of nutritional care among aged residents in all nursing homes and assisted living facilities in Helsinki 2003-2011. Arch Gerontol Geriatr 2017; 72:169-173. [PMID: 28672199 DOI: 10.1016/j.archger.2017.06.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 06/11/2017] [Accepted: 06/14/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND While nutritional problems have been recognized as common in institutional settings for several decades, less is known about how nutritional care and nutrition has changed in these settings over time. OBJECTIVES To describe and compare the nutritional problems and nutritional care of residents in all nursing homes (NH) in 2003 and 2011 and residents in all assisted living facilities (ALF) in 2007 and 2011, in Helsinki, Finland. METHODS We combined four cross-sectional datasets of (1) residents from all NHs in 2003 (N=1987), (2) residents from all ALFs in 2007 (N=1377), (3) residents from all NHs in 2011 (N=1576) and (4) residents from all ALFs in 2011 (N=1585). All participants at each time point were assessed using identical methods, including the Mini Nutritional Assessment (MNA). RESULTS The mean age of both samples from 2011 was higher and a larger proportion suffered from dementia, compared to earlier collected samples. A larger proportion of the residents in 2011 were assessed either malnourished or at-risk for malnutrition, according to the MNA, than in 2003 (NH: 93.5% vs. 88.9%, p<0.001) and in 2007 (ALF: 82.1% vs. 78.1%, p=0.007). The use of nutritional, vitamin D and calcium supplements, and snacks between meals was significantly more common in the 2011 residents, compared to the respective earlier samples. CONCLUSIONS In 2011, institutionalized residents were more disabled and more prone to malnourishment than in 2003 or 2007. Institutions do seem to be more aware of good nutritional care for vulnerable older people, although there is still room for improvement.
Collapse
Affiliation(s)
- Riitta K T Saarela
- City of Helsinki, Department of Social Services and Health Care, Oral Health Care, Finland; General Practice and Primary Health Care, University of Helsinki, Finland.
| | - Seija Muurinen
- General Practice and Primary Health Care, University of Helsinki, Finland
| | - Merja H Suominen
- General Practice and Primary Health Care, University of Helsinki, Finland
| | - Niina N Savikko
- General Practice and Primary Health Care, University of Helsinki, Finland
| | - Helena Soini
- General Practice and Primary Health Care, University of Helsinki, Finland; City of Helsinki, Department of Social Services and Health Care, Developmental and Operational Support, Finland
| | - Kaisu H Pitkälä
- General Practice and Primary Health Care, University of Helsinki, Finland; Helsinki University Hospital, Finland
| |
Collapse
|
19
|
Schnettler B, Miranda-Zapata E, Lobos G, Lapo M, Grunert KG, Adasme-Berríos C, Hueche C. Cross-cultural measurement invariance in the satisfaction with food-related life scale in older adults from two developing countries. Health Qual Life Outcomes 2017; 15:113. [PMID: 28558803 PMCID: PMC5450115 DOI: 10.1186/s12955-017-0687-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 05/15/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Nutrition is one of the major determinants of successful aging. The Satisfaction with Food-related Life (SWFL) scale measures a person's overall assessment regarding their food and eating habits. The SWFL scale has been used in older adult samples across different countries in Europe, Asia and America, however, there are no studies that have evaluated the cross-cultural measurement invariance of the scale in older adult samples. Therefore, we evaluated the measurement invariance of the SWFL scale across older adults from Chile and Ecuador. METHODS Stratified random sampling was used to recruit a sample of older adults of both genders from Chile (mean age = 71.38, SD = 6.48, range = 60-92) and from Ecuador (mean age = 73.70, SD = 7.45, range = 60-101). Participants reported their levels of satisfaction with food-related life by completing the SWFL scale, which consists of five items grouped into a single dimension. Confirmatory factor analysis (CFA) was used to examine cross-cultural measurement invariance of the SWFL scale. RESULTS Results showed that the SWFL scale exhibited partial measurement invariance, with invariance of all factor loadings, invariance in all but one item's threshold (item 1) and invariance in all items' uniqueness (residuals), which leads us to conclude that there is a reasonable level of partial measurement invariance for the CFA model of the SWFL scale, when comparing the Chilean and Ecuadorian older adult samples. The lack of invariance in item 1 confirms previous studies with adults and emerging adults in Chile that suggest this item is culture-sensitive. We recommend revising the wording of the first item of the SWFL in order to relate the statement with the person's life. CONCLUSIONS The SWFL scale shows partial measurement invariance across older adults from Chile and Ecuador. A 4-item version of the scale (excluding item 1) provides the basis for international comparisons of satisfaction with food-related life in older adults from developing countries in South America.
Collapse
Affiliation(s)
- Berta Schnettler
- Facultad de Ciencias Agropecuarias y Forestales, Universidad de La Frontera, Temuco, Chile
- Centro de Excelencia en Psicología Económica y del Consumo, Núcleo Científico y Tecnológico en Ciencias Sociales, Universidad de La Frontera, Temuco, Chile
| | - Edgardo Miranda-Zapata
- LICSA, Núcleo Científico y Tecnológico en Ciencias Sociales, Universidad de La Frontera, Temuco, Chile
| | - Germán Lobos
- Facultad de Economía y Negocios, Universidad de Talca, Talca, Chile
| | - María Lapo
- Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | | | | | - Clementina Hueche
- Centro de Excelencia en Psicología Económica y del Consumo, Núcleo Científico y Tecnológico en Ciencias Sociales, Universidad de La Frontera, Temuco, Chile
| |
Collapse
|
20
|
Jyväkorpi SK, Pitkälä KH, Puranen TM, Björkman MP, Kautiainen H, Strandberg TE, Soini H, Suominen MH. High Intake of Nonmilk Extrinsic Sugars Is Associated With Protein and Micronutrient Dilution in Home-Dwelling and Institutionalized Older People. J Am Med Dir Assoc 2017; 18:301-305. [PMID: 27887891 DOI: 10.1016/j.jamda.2016.09.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 09/29/2016] [Accepted: 09/29/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND High dietary sugar intake may compromise protein and micronutrient intakes in people with low energy intakes. The results of micronutrient dilution studies in older people have been few and conflicting. We examined the nutritional status and nutrient intakes associated with nonmilk extrinsic sugars (NMES) intakes in older people representing a broad spectrum of both healthy and vulnerable older populations. DESIGN AND PARTICIPANTS This cross-sectional study combined five Finnish data sets covering home-dwelling (n = 526) and institutionalized (n = 374) older people. Their nutritional status was assessed using Mini Nutritional Assessment (MNA) and nutrient intakes retrieved from 1- to 3-day food records. The participants were divided into quartiles corresponding to the proportions of energy received from NMES. Energy, nutrient, and fiber intakes were classified according to the NMES quartiles, and the participants were divided according to their places of residence (home, institution). RESULTS High NMES intakes were associated with older age, female sex, poor cognition, low MNA scores, immobility, and institutionalization. In all, 90% of the participants in the highest NMES quartile (Q4) were institutionalized. In the institutionalized individuals, low protein and micronutrient intakes were observed in both those with low energy intake (Q1) and in those with very high NMES intakes (Q4). In home-dwelling individuals, the nutrient intakes tended to decline linearly with increasing NMES intakes in protein and most micronutrients. CONCLUSIONS Institutionalized older people consumed diets high in NMES, compared with those living at home, and their low energy and high NMES intakes were associated with low protein and micronutrient intakes.
Collapse
Affiliation(s)
- Satu K Jyväkorpi
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.
| | - Kaisu H Pitkälä
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Taija M Puranen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Mikko P Björkman
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Timo E Strandberg
- University of Helsinki, Clinicum, and Helsinki University Hospital, Helsinki, Finland; University of Oulu, Center for Life Course Health Research, Oulu, Finland
| | - Helena Soini
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland; Helsinki City, Department of Social Services and Health Care, Developmental and Operational Support, Finland
| | - Merja H Suominen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
| |
Collapse
|
21
|
Jyväkorpi S, Pitkälä K, Björkman M, Strandberg T, Soini H, Suominen M. Psychological well-being is associated with better nutrient intakes in heterogeneous older populations. Eur Geriatr Med 2017. [DOI: 10.1016/j.eurger.2016.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
22
|
Landi F, Calvani R, Tosato M, Martone AM, Picca A, Ortolani E, Savera G, Salini S, Ramaschi M, Bernabei R, Marzetti E. Animal-Derived Protein Consumption Is Associated with Muscle Mass and Strength in Community-Dwellers: Results from the Milan EXPO Survey. J Nutr Health Aging 2017; 21:1050-1056. [PMID: 29083447 DOI: 10.1007/s12603-017-0974-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Behavioral factors, including protein intake, influence the quantity and quality of skeletal muscle. The aim of this study was to explore the relationship between animal-derived protein intake and muscle mass and function in a large sample of unselected community-dwellers. MATERIAL AND METHODS The VIP (Very Important Protein) study, conducted during Expo 2015 in Milan, was a population survey aimed at assessing major health metrics in a population outside of the research setting, with a special focus on the relation between animal-derived protein intake and muscle mass and function. A brief questionnaire exploring lifestyle habits, dietary preferences and the consumption of selected foods was administered. Muscle mass was estimated by calf circumference (CC) and mid-arm muscle circumference (MAMC) of the dominant side. Muscle strength of upper and lower extremities was assessed through handgrip strength testing and repeated chair stand test, respectively. RESULTS The mean age of the 1,853 participants was 50.3 years (standard deviation: 15.7; range: 18-98 years), of whom 959 (51.7%) were women. Participants in the highest tertile of protein consumption showed better performance at both the handgrip strength (p <0.001) and chair stand tests than those in the lowest tertile (p <0.01). The same results were found for CC (p <0.001) and MAMC (p <0.001). Participants with high protein intake and engaged in regular physical activity showed the higher scores in all the assessed domains. CONCLUSIONS The results of the VIP survey suggest an association between animal-derived protein intake and muscle mass and strength across ages. Our findings also indicate a synergistic effect of animal-derived protein intake and physical activity on muscle-related parameters.
Collapse
Affiliation(s)
- F Landi
- Francesco Landi, MD, PhD - Center for Geriatric Medicine [CEMI), Institute of Internal Medicine and Geriatrics, Catholic University of the Sacred Heart, L.go F. Vito 8, Rome 00168, Italy. Phone: +39 (06) 3388546, Fax: +39 (06) 3051-911, e-mail:
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Pitkälä KH, Suominen MH, Bell JS, Strandberg TE. Herbal medications and other dietary supplements. A clinical review for physicians caring for older people. Ann Med 2016; 48:586-602. [PMID: 27427263 DOI: 10.1080/07853890.2016.1197414] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Evidence for the safety and effectiveness of dietary supplements is mixed. The extent to which older people use dietary supplements concomitantly with conventional medications is often under-appreciated by physicians. We conducted a literature review on clinical considerations associated with dietary supplement use, focusing on benefits and harms, motivations for use and contribution to polypharmacy among older people. Vitamin D ≥ 800 IU has demonstrated benefits in fracture prevention. Vitamins A, E, and β-carotene have been associated with an increase in total mortality in several meta-analyses. A range of non-vitamin dietary supplements have been studied in randomized controlled trials but their efficacy remains largely unclear. Supplement use has been associated with a range of adverse events and drug interactions yet physicians rarely initiate discussions about their use with older patients. Older people may take dietary supplements to exercise control over their health. Given the contribution of supplements to polypharmacy, supplements may be targeted for "deprescribing" if the risk of harm is judged to outweigh benefits. This is best done as part of a comprehensive, patient-centered approach. A respectful and non-judgmental discussion may result in a shared decision to reduce polypharmacy through cessation of dietary supplements. KEY MESSAGES Herbal medications and other dietary supplements are highly prevalent among older people. Physicians are often unaware that their patients use herbal medications and other dietary supplements concomitantly with conventional medications. Herbal medications and other dietary supplements contribute to high rates of polypharmacy, particularly among older people with multimorbidity. Herbal medications and other dietary supplements can interact with conventional medications and be associated with a range of adverse events. Physicians need to be patient-centered and non-judgmental when initiating discussions about herbal medications and other dietary supplements. This is important to maintain and develop patient empowerment and self-management skills.
Collapse
Affiliation(s)
- Kaisu H Pitkälä
- a Department of General Practice and Primary Health Care , Helsinki , Finland.,b Unit of Primary Health Care, University of Helsinki, and Helsinki University Hospital , Helsinki , Finland
| | - Merja H Suominen
- a Department of General Practice and Primary Health Care , Helsinki , Finland.,b Unit of Primary Health Care, University of Helsinki, and Helsinki University Hospital , Helsinki , Finland
| | - J Simon Bell
- c Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences , Monash University , Melbourne , Australia.,d Sansom Institute, University of South Australia , Adelaide , Australia.,e Faculty of Health Sciences , University of Eastern Finland , Kuopio , Finland
| | - Timo E Strandberg
- f University of Helsinki, Clinicum , Helsinki , Finland.,g Helsinki University Hospital , Helsinki , Finland.,h University of Oulu, Centre for Life Course Health Research , Oulu , Finland
| |
Collapse
|
24
|
Berggren E, Strang P, Orrevall Y, Ödlund Olin A, Sandelowsky H, Törnkvist L. Evaluation of ConPrim: A three-part model for continuing education in primary health care. NURSE EDUCATION TODAY 2016; 46:115-120. [PMID: 27621201 DOI: 10.1016/j.nedt.2016.08.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Revised: 07/21/2016] [Accepted: 08/10/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND To overcome the gap between existing knowledge and the application of this knowledge in practice, a three-part continuing educational model for primary health care professionals (ConPrim) was developed. It includes a web-based program, a practical exercise and a case seminar. AIM To evaluate professionals' perceptions of the design, pedagogy and adaptation to primary health care of the ConPrim continuing educational model as applied in a subject-specific intervention. METHODS A total of 67 professionals (nurses and physicians) completed a computer-based questionnaire evaluating the model's design, pedagogy and adaptation to primary health care one week after the intervention. Descriptive statistics were used. RESULTS Over 90% found the design of the web-based program and case seminar attractive; 86% found the design of the practical exercise attractive. The professionals agreed that the time spent on two of the three parts was acceptable. The exception was the practical exercise: 32% did not fully agree. Approximately 90% agreed that the contents of all parts were relevant to their work and promoted interactive and interprofessional learning. In response to the statements about the intervention as whole, approximately 90% agreed that the intervention was suitable to primary health care, that it had increased their competence in the subject area, and that they would be able to use what they had learned in their work. CONCLUSIONS ConPrim is a promising model for continuing educational interventions in primary health care. However, the time spent on the practical exercise should be adjusted and the instructions for the exercise clarified. ConPrim should be tested in other subject-specific interventions and its influence on clinical practice should be evaluated.
Collapse
Affiliation(s)
- Erika Berggren
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Academic primary health care centre, Alfred Nobels allé 10, S-141 83, Huddinge, Sweden.
| | - Peter Strang
- Department of Oncology-Pathology, Karolinska Institutet and Stockholms Sjukhem Foundation, Sweden.
| | - Ylva Orrevall
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Department of Nutrition and Dietetics, Karolinska University Hospital, Stockholm, Sweden.
| | - Ann Ödlund Olin
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
| | - Hanna Sandelowsky
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Academic Primary Health Care Centre, Stockholm, Sweden.
| | - Lena Törnkvist
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Academic Primary Health Care Centre, Stockholm, Sweden.
| |
Collapse
|
25
|
Guligowska A, Pigłowska M, Fife E, Kostka J, Sołtysik BK, Kroc Ł, Kostka T. Inappropriate nutrients intake is associated with lower functional status and inferior quality of life in older adults with depression. Clin Interv Aging 2016; 11:1505-1517. [PMID: 27822023 PMCID: PMC5087705 DOI: 10.2147/cia.s114669] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES The study is a case-control analysis of whether depression impairs physical and cognitive functioning and quality of life, and whether there is a relationship between nutrient deficiencies and these adverse changes. PATIENTS AND METHODS A total of 130 older subjects participated in the study: 65 with diagnosed depression (16 men and 49 women) and 65 age- and sex-matched controls without depression. All patients underwent comprehensive geriatric assessment. Nutritional state was assessed with the Mini Nutritional Assessment, cognitive performance was evaluated by the Mini-Mental State Examination and physical functioning by the Timed "Up & Go" test and handgrip strength. The pattern of consumption of various nutrients was analyzed in detail. RESULTS The differences in cognitive functioning observed between the groups were related to specific nutrient intake, as was handgrip strength to some extent. The differences in nutritional status, several functional tests and muscle strength were related to both the presence of depression and inappropriate consumption of certain nutrients. CONCLUSION The incidence of falls and poor quality of life may be partially associated with the presence of depression. The inappropriate intake of selected nutrients may impair the functioning and quality of life of older adults with depression, such as the excess consumption of sucrose and insufficient consumption of protein, fiber, eicosapentaenoic acid, niacin and vitamin B6. Particular nutrients should be translated into dietary patterns which allow the individual patient to address these nutrient deficiencies.
Collapse
Affiliation(s)
- Agnieszka Guligowska
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Małgorzata Pigłowska
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Elizaveta Fife
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Joanna Kostka
- Department of Physical Medicine, Medical University of Lodz, Lodz, Poland
| | - Bartłomiej K Sołtysik
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Łukasz Kroc
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| | - Tomasz Kostka
- Department of Geriatrics, Healthy Ageing Research Centre, Medical University of Lodz, Lodz, Poland
| |
Collapse
|
26
|
Macronutrient intake in advanced age: Te Puāwaitanga o Ngā Tapuwae Kia ora Tonu, Life and Living in Advanced Age: A Cohort Study in New Zealand (LiLACS NZ). Br J Nutr 2016; 116:1103-15. [PMID: 27546175 DOI: 10.1017/s0007114516003020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
As part of the 12-month follow-up of the longitudinal cohort study, Life and Living in Advanced Age: A Cohort Study in New Zealand, dietary intake was assessed in 216 Māori and 362 non-Māori octogenarians using repeat 24-h multiple pass recalls. Energy and macronutrient intakes were calculated, and food items reported were allocated to food groups used in the New Zealand Adult Nutrition Survey (NZANS). Intakes were compared with the nutrient reference values (NRV) for Australia and New Zealand. The median BMI was higher for Māori (28·3 kg/m2) than for non-Māori (26·2 kg/m2) P=0·007. For Māori, median energy intake was 7·44 MJ/d for men and 6·06 MJ/d for women with 16·3 % energy derived from protein, 43·3 % from carbohydrate and 38·5 % from fat. Median energy intake was 7·91 and 6·26 MJ/d for non-Māori men and women, respectively, with 15·4 % of energy derived from protein, 45 % from carbohydrate and 36·7 % from fat. For both ethnic groups, bread was the top contributor to energy and carbohydrate intakes. Protein came from beef and veal, fish and seafood, bread, milk and poultry with the order differing by ethnic groups and sex. Fat came mainly from butter and margarine. Energy-adjusted protein was higher for Māori than non-Māori (P=0·049). For both ethnic groups, the median energy levels were similar, percent carbohydrate tended to be lower and percent fat higher compared with adults aged >70 years in NZANS. These unique cross-sectional data address an important gap in our understanding of dietary intake in this growing section of our population and highlight lack of age-appropriate NRV.
Collapse
|
27
|
O’Connor DL, Blake J, Bell R, Bowen A, Callum J, Fenton S, Gray-Donald K, Rossiter M, Adamo K, Brett K, Khatri N, Robinson N, Tumback L, Cheung A. Consensus canadien sur la nutrition féminine : adolescence, reproduction, ménopause et au-delà. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2016; 38:555-609.e19. [DOI: 10.1016/j.jogc.2016.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
28
|
O'Connor DL, Blake J, Bell R, Bowen A, Callum J, Fenton S, Gray-Donald K, Rossiter M, Adamo K, Brett K, Khatri N, Robinson N, Tumback L, Cheung A. Canadian Consensus on Female Nutrition: Adolescence, Reproduction, Menopause, and Beyond. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2016; 38:508-554.e18. [PMID: 27368135 DOI: 10.1016/j.jogc.2016.01.001] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To provide health care professionals in Canada with the basic knowledge and tools to provide nutrition guidance to women through their lifecycle. OUTCOMES Optimal nutrition through the female lifecycle was evaluated, with specific focus on adolescence, pre-conception, pregnancy, postpartum, menopause, and beyond. The guideline begins with an overview of guidance for all women, followed by chapters that examine the evidence and provide recommendations for the promotion of healthy nutrition and body weight at each life stage. Nutrients of special concern and other considerations unique to each life stage are discussed in each chapter. EVIDENCE Published literature, governmental and health agency reports, clinical practice guidelines, grey literature, and textbook sources were used in supporting the recommendations made in this document. VALUES The quality of evidence was rated using the criteria described in the report of the Canadian Task Force on Preventive Health Care. CHAPTER 2: GENERAL FEMALE NUTRITION: Summary Statements Recommendations CHAPTER 3: ADOLESCENCE NUTRITION: Summary Statements Recommendations CHAPTER 4: PRE-CONCEPTUAL NUTRITION: Summary Statement Recommendations CHAPTER 5: NUTRITION IN PREGNANCY: Summary Statements Recommendations CHAPTER 6: POSTPARTUM NUTRITION AND LACTATION: Summary Statements Recommendations CHAPTER 7: NUTRITION DURING MENOPAUSE AND BEYOND: Summary Statement Recommendations.
Collapse
|
29
|
Berggren E, Orrevall Y, Olin AÖ, Strang P, Szulkin R, Törnkvist L. Evaluation of a Continuing Educational Intervention for Primary Health Care Professionals about Nutritional Care of Patients at Home. J Nutr Health Aging 2016; 20:428-38. [PMID: 26999244 DOI: 10.1007/s12603-015-0596-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Evaluate the effectiveness of a continuing educational intervention on primary health care professionals' familiarity with information important to nutritional care in a palliative phase, their collaboration with other caregivers, and their level of knowledge about important aspects of nutritional care. DESIGN Observational cohort study. SETTING 10 primary health care centers in Stockholm County, Sweden. PARTICIPANTS 140 district nurses/registered nurses and general practitioners/physicians working with home care. INTERVENTION 87 professionals participated in the intervention group (IG) and 53 in the control group (CG). The intervention consisted of a web-based program offering factual knowledge; a practical exercise linking existing and new knowledge, abilities, and skills; and a case seminar facilitating reflection. MEASUREMENTS The intervention's effects were measured by a computer-based study-specific questionnaire before and after the intervention, which took approximately 1 month. The CG completed the questionnaire twice (1 month between response occasions). The intervention effects, odds ratios, were estimated by an ordinal logistic regression. RESULTS In the intra-group analyses, statistically significant changes occurred in the IG's responses to 28 of 32 items and the CG's responses to 4 of 32 items. In the inter-group analyses, statistically significant effects occurred in 20 of 32 statements: all 14 statements that assessed familiarity with important concepts and all 4 statements about collaboration with other caregivers but only 2 of the 14 statements concerning level of knowledge. The intervention effect varied between 2.5 and 12.0. CONCLUSION The intervention was effective in increasing familiarity with information important to nutritional care in a palliative phase and collaboration with other caregivers, both of which may create prerequisites for better nutritional care. However, the intervention needs to be revised to better increase the professionals' level of knowledge about important aspects of nutritional care.
Collapse
Affiliation(s)
- E Berggren
- Erika Berggren, Academic Primary Health Care Centre, Karolinska Institutet, Alfred Nobels allé 12, S-141 83 Huddinge, Sweden, , phone: +46 8 52488717
| | | | | | | | | | | |
Collapse
|
30
|
Chatzopoulos GS, Tsalikis L. Periodontal treatment needs and systemic diseases in an older population in Greece. J Clin Exp Dent 2016; 8:e32-7. [PMID: 26855703 PMCID: PMC4739365 DOI: 10.4317/jced.52763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 10/02/2015] [Indexed: 11/22/2022] Open
Abstract
Background To evaluate the relationship between systemic diseases, body mass index and periodontal treatment needs in an older population in Greece. Material and Methods A total of 262 older people were clinically examined about their periodontal status and medical histories were recorded using a health history questionnaire. Additionally, weight and height measurements as well as demographic data were obtained from the participants in the study. Results Older people exhibited mean age of 63.98 years, weight of 78.76 kg and height of 1.64 m. The mean CPITN score was 2.84. 31.7% of the study population were smokers and 53.8% females. No statistically significant difference was observed in seniors between periodontal treatment needs and systemic diseases. Females exhibited statistically significant more often osteoporosis, thyroid disorders (p<0.001) and hypercholesterolemia (p=0.014) than males. High CPTIN scores were not associated with higher levels of BMI. Conclusions Within the limitation of this study, older adults’ periodontal treatment needs are not associated significantly with a great number of systemic diseases and body mass index. Key words:Seniors, periodontitis, systemic diseases, body mass index (BMI), smoking, Greece.
Collapse
Affiliation(s)
- Georgios S Chatzopoulos
- DDS, Resident Advanced Education Program in Periodontology, School of Dentistry, University of Minnesota, USA
| | - Lazaros Tsalikis
- DDS, Dr med dent, Associate Professor, Department of Preventive Dentistry, Periodontology and Implant biology, School of Dentistry, Aristotle University of Thessaloniki, Greece
| |
Collapse
|
31
|
Dietary protein intake is associated with better physical function and muscle strength among elderly women. Br J Nutr 2016; 115:1281-91. [PMID: 26857389 DOI: 10.1017/s000711451600012x] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Dietary protein intake might be beneficial to physical function (PF) in the elderly. We examined the cross-sectional and prospective associations of protein intake of g/kg body weight (BW), fat mass (FM) and lean mass (LM) with PF in 554 women aged 65·3-71·6 years belonging to the Osteoporosis Risk Factor and Prevention Fracture Prevention Study. Participants filled a questionnaire on lifestyle factors and 3-d food record in 2002. Body composition was measured by dual-energy X-ray absorptiometry, and PF measures were performed at baseline and at 3-year follow-up. Sarcopaenia was defined using European Working Group on Sarcopenia in Older People criteria. At the baseline, women with higher protein intake (≥ 1·2 g/kg BW) had better performance in hand-grip strength/body mass (GS/BM) (P=0·001), knee extension/BM (P=0·003), one-leg stance (P=0·047), chair rise (P=0·043), squat (P=0·019), squat to the ground (P=0·001), faster walking speed for 10 m (P=0·005) and higher short physical performance battery score (P=0·004) compared with those with moderate and lower intakes (0·81-1·19 and ≤ 0·8 g/kg BW, respectively). In follow-up results, higher protein intake was associated with less decline in GS/BM, one-leg stance and tandem walk for 6 m over 3 years. Overall, results were no longer significant after controlling for FM. Associations were detected between protein intake and PF in non-sarcopaenic women but not in sarcopaenic women, except for change of GS (P=0·037). Further, FM but not LM was negatively associated with PF measures (P<0·050). This study suggests that higher protein intake and lower FM might be positively associated with PF in elderly women.
Collapse
|
32
|
Association of protein intake with the change of lean mass among elderly women: The Osteoporosis Risk Factor and Prevention - Fracture Prevention Study (OSTPRE-FPS). J Nutr Sci 2015; 4:e41. [PMID: 26793306 PMCID: PMC4709835 DOI: 10.1017/jns.2015.31] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/10/2015] [Accepted: 10/13/2015] [Indexed: 12/25/2022] Open
Abstract
Low protein intake can lead to declined lean mass (LM) in elderly. We examined the associations of total protein (TP), animal protein (AP) and plant protein (PP) intakes with LM. The association of TP intake with LM change was further evaluated according to weight change status. This cross-sectional and prospective cohort study included 554 women aged 68 (sd 1·9) years from the Osteoporosis Risk Factor and Prevention – Fracture Prevention Study (OSTPRE-FPS). The intervention group (n 270) received daily cholecalciferol (800 IU; 20 μg) and Ca (1000 mg) for 3 years while the control group received neither supplementation nor placebo (n 282). Participants filled out a questionnaire on lifestyle factors and a 3-d food record in 2002 and underwent dual-energy X-ray absorptiometry for body composition measurements at baseline and 3 years. Multiple linear regressions evaluated the association between protein intake and LM, adjusting for relevant covariates. At the baseline TP and AP intakes were positively associated with LM and trunk LM, TP was associated also with appendicular LM (aLM). Follow-up results showed that in the total population and the intervention group, higher TP and AP were associated with increased LM and aLM (P ≤ 0·050). No such associations were observed in the control group. PP intake was also associated with aLM change in the total population. Overall, the associations were independent of fat mass. Further, among weight maintainers, TP intake was positively associated with LM, aLM and trunk LM changes (P ≤ 0·020). In conclusion, dietary TP, especially AP, intake may be a modifiable risk factor for sarcopenia by preserving LM in the elderly.
Collapse
|
33
|
Aging, Nutritional Status and Health. Healthcare (Basel) 2015; 3:648-58. [PMID: 27417787 PMCID: PMC4939559 DOI: 10.3390/healthcare3030648] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 07/07/2015] [Accepted: 07/23/2015] [Indexed: 01/06/2023] Open
Abstract
The older population is increasing worldwide and in many countries older people will outnumber younger people in the near future. This projected growth in the older population has the potential to place significant burdens on healthcare and support services. Meeting the diet and nutrition needs of older people is therefore crucial for the maintenance of health, functional independence and quality of life. While many older adults remain healthy and eat well those in poorer health may experience difficulties in meeting their nutritional needs. Malnutrition, encompassing both under and over nutrition increases health risks in the older population. More recently the increase in obesity, and in turn the incidence of chronic disease in older adults, now justifies weight management interventions in obese older adults. This growing population group is becoming increasingly diverse in their nutritional requirements. Micro-nutrient status may fluctuate and shortfalls in vitamin D, iron and a number of other nutrients are relatively common and can impact on well-being and quality of life. Aging presents a number of challenges for the maintenance of good nutritional health in older adults.
Collapse
|
34
|
Jyväkorpi SK, Pitkälä KH, Puranen TM, Björkman MP, Kautiainen H, Strandberg TE, Soini H, Suominen MH. Low protein and micronutrient intakes in heterogeneous older population samples. Arch Gerontol Geriatr 2015; 61:464-71. [PMID: 26298429 DOI: 10.1016/j.archger.2015.06.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 06/23/2015] [Accepted: 06/24/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Malnutrition is associated with comorbidities and functional decline among older people. Less is known about nutrient intakes across heterogeneous older populations. OBJECTIVE We examined nutritional status and nutrient intakes in different samples of older people representing broad spectrum of healthy and frail populations. We evaluated adequacy of their energy, protein and micronutrient intakes in comparison to recommendations. DESIGN AND PARTICIPANTS Cross-sectional study combined five datasets: home-dwelling older people participating in nutrition education and cooking classes (NC) [n=54], participants from Helsinki Businessmen Study [n=68], home-dwelling people with Alzheimer disease (AD) [n=99] and their spousal caregivers (n=97), participants from Porvoo Sarcopenia and Nutrition Trial (n=208), and residents of Helsinki assisted living facilities (ALF) [n=374]. Nutritional status was assessed using Mini Nutritional Assessment and nutrient intakes retrieved from 1 to 3 day food records. RESULTS Those suffering most from mobility limitation and cognitive decline had the poorest nutritional status (p<0.001; adjusted for age, sex, comorbidities). However, low intakes of energy, protein, and micronutrients were observed in high proportion in all groups, inadequate intakes of vitamins D, E, folate, and thiamine being most common. Protein intakes did not differ between the groups, but 77% of all participants had lower than recommended protein intake. In general, the NC group had highest micronutrient intakes and the ALF group the lowest. However, AD females had the lowest energy, protein, and vitamin C intakes. CONCLUSIONS Our study provides a detailed picture of risks related to nutrient intakes in various groups of older people. These findings could be used in planning tailored nutrition interventions.
Collapse
Affiliation(s)
- S K Jyväkorpi
- University of Helsinki, Department of General Practice and Primary Health Care, and Helsinki University Central Hospital, Unit of Primary Health Care, Finland.
| | - K H Pitkälä
- University of Helsinki, Department of General Practice and Primary Health Care, and Helsinki University Central Hospital, Unit of Primary Health Care, Finland.
| | - T M Puranen
- University of Helsinki, Department of General Practice and Primary Health Care, and Helsinki University Central Hospital, Unit of Primary Health Care, Finland.
| | - M P Björkman
- University of Helsinki, Department of General Practice and Primary Health Care, and Helsinki University Central Hospital, Unit of Primary Health Care, Finland.
| | - H Kautiainen
- University of Helsinki, Department of General Practice and Primary Health Care, and Helsinki University Central Hospital, Unit of Primary Health Care, Finland.
| | - T E Strandberg
- University of Helsinki, Department of Medicine, Geriatric Clinic, Helsinki University Central Hospital, and University of Oulu, Institute of Health Sciences/Geriatrics, and Oulu University Hospital, Oulu, Finland.
| | - H Soini
- University of Helsinki, Department of General Practice and Primary Health Care, and Helsinki University Central Hospital, Unit of Primary Health Care, Finland; City of Helsinki, Department of Social Services and Health Care, Developmental and Operational Support, Finland.
| | - M H Suominen
- University of Helsinki, Department of General Practice and Primary Health Care, and Helsinki University Central Hospital, Unit of Primary Health Care, Finland.
| |
Collapse
|