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Smit A, Meijer O, Winter E. The multi-faceted nature of age-associated osteoporosis. Bone Rep 2024; 20:101750. [PMID: 38566930 PMCID: PMC10985042 DOI: 10.1016/j.bonr.2024.101750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/03/2024] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Age-associated osteoporosis (AAOP) poses a significant health burden, characterized by increased fracture risk due to declining bone mass and strength. Effective prevention and early treatment strategies are crucial to mitigate the disease burden and the associated healthcare costs. Current therapeutic approaches effectively target the individual contributing factors to AAOP. Nonetheless, the management of AAOP is complicated by the multitude of variables that affect its development. Main intrinsic and extrinsic factors contributing to AAOP risk are reviewed here, including mechanical unloading, nutrient deficiency, hormonal disbalance, disrupted metabolism, cognitive decline, inflammation and circadian disruption. Furthermore, it is discussed how these can be targeted for prevention and treatment. Although valuable as individual targets for intervention, the interconnectedness of these risk factors result in a unique etiology for every patient. Acknowledgement of the multifaceted nature of AAOP will enable the development of more effective and sustainable management strategies, based on a holistic, patient-centered approach.
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Affiliation(s)
- A.E. Smit
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden, the Netherlands
| | - O.C. Meijer
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden, the Netherlands
| | - E.M. Winter
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden, the Netherlands
- Department of Medicine, Center for Bone Quality, Leiden University Medical Center, Leiden, the Netherlands
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Norton V, Lovegrove JA, Tindall M, Garcia JR, Lignou S. Fibre4life: Investigating older adults dietary fibre preferences and the role of targeted educational materials on modulating future dietary fibre intake. Appetite 2024; 192:107109. [PMID: 37914038 DOI: 10.1016/j.appet.2023.107109] [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] [Received: 09/07/2023] [Revised: 10/17/2023] [Accepted: 10/29/2023] [Indexed: 11/03/2023]
Abstract
The UK has an ever-increasing ageing population; hence, promoting balanced nutrition can have fundamental health and cost benefits. In addition, the majority of older adults' dietary fibre intake is below recommendations and this is despite its well-cited benefits; therefore, more emphasis should be placed on identifying viable age-suitable strategies to overcome the associated dietary fibre-related knowledge gap. Accordingly, one hundred and seventy older adults (65-87 years) were recruited to partake in two survey related studies: (1) initial insights (e.g., dietary fibre-related knowledge, awareness, attitudes and behaviour as well as information preferences) were captured to inform the design of educational materials; and (2) the impact of two targeted educational materials on modulating older adults' future dietary fibre intake was tested. Older adults were willing to learn more about dietary fibre and requested additional information relating to its benefits, recommendations and food-based examples in a clear and accessible format. Therefore, two educational materials (factsheet and practical tips) were developed encompassing key themes. Overall, older adults engaged with the educational materials (regardless of topic and format); thus, demonstrating the potential benefits of this approach going forwards. There was strong agreement with all variables: learning something new, change future dietary fibre intake, format liking, content engaging and share with others as well as the overall experience being cited as useful/helpful. Going forwards, importance should be placed on measuring dietary fibre consumption post engaging with educational materials. In addition, utilising a holistic approach incorporating support from different sources (e.g., health professionals, government, food companies, supermarkets and community) could be fundamental in helping older adults to consume more dietary fibre and subsequently contributing to positive health outcomes.
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Affiliation(s)
- Victoria Norton
- Department of Food and Nutritional Sciences, Harry Nursten Building, University of Reading, Whiteknights, Reading, RG6 6DZ, United Kingdom
| | - Julie A Lovegrove
- Department of Food and Nutritional Sciences, Harry Nursten Building, University of Reading, Whiteknights, Reading, RG6 6DZ, United Kingdom; Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, Harry Nursten Building, University of Reading, Whiteknights, Reading, RG6 6DZ, United Kingdom; Institute of Food, Nutrition and Health, University of Reading, PO Box 237, Earley Gate, Reading, RG6 6EU, United Kingdom; Institute of Cardiovascular and Metabolic Research, University of Reading, Whiteknights, Reading, RG6 6AA, United Kingdom
| | - Marcus Tindall
- Institute of Cardiovascular and Metabolic Research, University of Reading, Whiteknights, Reading, RG6 6AA, United Kingdom; Department of Mathematics and Statistics, University of Reading, PO Box 220, Reading, RG6 6AX, United Kingdom
| | - Julia Rodriguez Garcia
- Department of Food and Nutritional Sciences, Harry Nursten Building, University of Reading, Whiteknights, Reading, RG6 6DZ, United Kingdom
| | - Stella Lignou
- Department of Food and Nutritional Sciences, Harry Nursten Building, University of Reading, Whiteknights, Reading, RG6 6DZ, United Kingdom.
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Carvalho MCRD, Lopes MS, Freitas PPD, Lopes ACS. Evolution of fruit and vegetable intake among health promotion service participants in a Brazilian metropolis: 48-month follow-up of a randomized controlled community trial. Prev Med 2023; 177:107748. [PMID: 37913915 DOI: 10.1016/j.ypmed.2023.107748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/26/2023] [Accepted: 10/28/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE To assess longitudinal effects of a nutrition intervention on fruit and vegetable (F&V) intake among Primary Health Care (PHC) service participants in Belo Horizonte, Brazil. METHODS Demographics and health data on 3414 PHC service participants were collected at baseline in 2013-2014. F&V intake was assessed at baseline, 12, 36, and 48 months until 2017-2018. Services were randomized to control (CG, usual care) or intervention (IG, usual care and a Transtheoretical Model-based intervention to increase F&V intake). We performed difference-in-differences (DiD) analysis to identify intervention effects on F&V intake, and sensitivity analyses of participants observed at all timepoints. RESULTS Participants were mostly middle-aged, low-income women. Mean baseline intakes were 168.7 g of fruit, 202.0 g of vegetables, and 370.7 g of F&V, with lower fruit in the IG (164.1 g) than the CG (172.3 g). At 12 months, the intervention increased fruit intake in the IG and fruit and F&V intake among individuals with low baseline F&V intake. Fruit intake remained higher at 36 months in the IG. No effect on vegetable intake was identified. According to sensitivity analyses, effects on fruit intake among the complete sample did not remain significant at 36 months, and an effect on fruit intake at 36 months was identified among those with adequate baseline F&V intake. Reductions in F&V intake did not remain significant. CONCLUSIONS At 12 months, a TTM-based intervention increased fruit intake in the overall sample, and fruit and F&V intake among individuals with low baseline intakes. Repeated interventions may be needed over time. TRIAL REGISTRATION NUMBER RBR-9h7ckx.
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Affiliation(s)
- Maria Cecília Ramos de Carvalho
- Universidade Federal de Minas Gerais, Grupo de Pesquisa de Intervenções em Nutrição, 190 Alfredo Balena Avenue, Nursing School, Room 102, Santa Efigênia, 30130-100 Belo Horizonte, MG, Brazil.
| | - Mariana Souza Lopes
- Universidade Federal da Paraíba, Centro de Ciências da Saúde, Departamento de Nutrição, Campus I, Cidade Universitária, 58051-900 João Pessoa, PB, Brazil. Universidade Federal de Minas Gerais, Grupo de Pesquisa de Intervenções em Nutrição.
| | - Patrícia Pinheiro de Freitas
- Universidade Federal de Minas Gerais, Grupo de Pesquisa de Intervenções em Nutrição, 190 Alfredo Balena Avenue, Nursing School, Room 102, Santa Efigênia, 30130-100 Belo Horizonte, MG, Brazil.
| | - Aline Cristine Souza Lopes
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Nutrição, Grupo de Pesquisa de Intervenções em Nutrição, 190 Alfredo Balena Avenue, Nursing School, Room 316, Santa Efigênia, 30130-100 Belo Horizonte, MG, Brazil.
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Scariot EL, Lockmann ADS, Buss C. Nutrition Knowledge of Elderly Women: Effect of Two Food and Nutrition Education Programs. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2023; 42:798-806. [PMID: 36912661 DOI: 10.1080/27697061.2023.2182384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 02/15/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVE To compare the effect of two programs of Food and Nutrition Education (FNE) on the Nutrition knowledge of elderly women, Brazil. METHODS Randomized field trial. Community-based elderly women over 60 years (n = 36) participated in a twelve-week intervention in either of two FNE programs: Psychopedagogical Program (PP) or Culinary Workshop Program (CWP). There were three moments of data collection in the study; pre-intervention knowledge data); post intervention and follow up (after 6 months upon intervention completion). A questionnaire about knowledge of food and Nutrition was administered at every data collection moment. RESULTS In the analysis performed by the Generalized Estimation Equation Models (GEE) there was a significant interaction effect (P = 0.033) in the diabetes block in which the percentage of correct answers in the follow-up moment was higher compared to the pre-intervention moment in the CWP group (65.65% and 45.66%, respectively). In the knowledge blocks: total percentage of correct answers, hypertension, food processing, the evaluation effect was observed, regardless of the intervention performed. Three blocks of knowledge, including the block of the total percentage of correct answers in knowledge in Nutrition, presented a significant evaluation effect, which suggests that the interventions were important for the gain of knowledge, regardless of the type of intervention performed. Elderly-focused FNE programs should include a methodology that encompasses recreational education activities, and practical activities, such as culinary workshops.
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Affiliation(s)
- Estela Lopes Scariot
- Graduate Study Program in Health Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Rio Grande do Sul, Brasil
| | - Adriana da Silva Lockmann
- Graduate Study Program in Health Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Rio Grande do Sul, Brasil
| | - Caroline Buss
- Graduate Study Program in Health Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Rio Grande do Sul, Brasil
- Nutrition Department, UFCSPA, Porto Alegre, Rio Grande do Sul, Brasil
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Maafs-Rodríguez A, Folta SC. Effectiveness of Theory-Based Physical Activity and Nutrition Interventions in Aging Latino Adults: A Scoping Review. Nutrients 2023; 15:2792. [PMID: 37375696 DOI: 10.3390/nu15122792] [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: 05/12/2023] [Revised: 06/04/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
In the United States (US), Latino individuals older than 50 years face health disparities compared to their White counterparts. Considering the rising life expectancy and the projected increase of older Latino adults in the US, this scoping review aimed to determine the effectiveness of theory-based and culturally relevant strategies that promote healthy aging in Latinos. Web of Science and PubMed databases were searched between December 2022 and February 2023 for peer-reviewed articles assessing healthy aging interventions tailored to community-dwelling aging Latino adults. We included nine studies describing the effects of seven interventions on physical activity- or nutrition-related outcomes. Although not always statistically significant, interventions had a beneficial impact on well-being indicators. The most commonly used behavioral theories were Social Cognitive Theory and Attribution Theory. Latino cultural elements in these studies included partnering with community organizations that serve Latinos (such as Catholic churches), delivery of in-person bilingual group sessions by trusted community members (such as promotoras or Latino dance instructors), and incorporating values such as family and religion into the health curriculum, among others. Future strategies that promote healthy aging in Latino adults should proactively culturally adapt the theoretical foundations and the design, recruitment, and implementation processes to ensure their relevance and effectiveness.
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Affiliation(s)
- Ana Maafs-Rodríguez
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
| | - Sara C Folta
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA
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Ashikali EM, Ludwig C, Mastromauro L, Périvier S, Tholomier A, Ionita I, Graf C, Busnel C. Intrinsic Capacities, Functional Ability, Physiological Systems, and Caregiver Support: A Targeted Synthesis of Effective Interventions and International Recommendations for Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4382. [PMID: 36901392 PMCID: PMC10002353 DOI: 10.3390/ijerph20054382] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
The ageing population calls for interventions that can assist older people to age healthily. This study aimed to provide a targeted synthesis of high-level research and current evidence-based recommendations on effective interventions for maintaining or preventing the decline in intrinsic capacity, functional ability, and physiological systems, or for caregiver support. Nestled within the healthy ageing framework by the World Health Organization, available evidence was selected in a targeted manner, with the purpose of providing a synthesis that would allow the application of this knowledge in real life. As such, the outcome variables were examined through an Evidence and Gap Map of interventions for functional ability and through guidelines from leading institutions. Systematic reviews, meta-analyses, and guidelines on community-dwelling older adults with or without minor health limitations were considered. Thirty-eight documents were included and over fifty interventions identified. Physical activity interventions were consistently effective across several domains. Recommendations point to screening, whilst highlighting the importance of behavioural factors in the endeavour to age healthily. There is a wide range of activities which are likely to foster healthy ageing. To encourage their uptake, it is important for communities to offer suitable promotion and support, and to make these accessible to the public.
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Affiliation(s)
| | - Catherine Ludwig
- Geneva School of Health Sciences, HES-SO, University of Applied Sciences and Arts Western Switzerland, 1206 Geneva, Switzerland
| | - Laura Mastromauro
- Geneva Institution for Home Care and Assistance (imad), 1227 Carouge, Switzerland
- Geneva School of Health Sciences, HES-SO, University of Applied Sciences and Arts Western Switzerland, 1206 Geneva, Switzerland
| | - Samuel Périvier
- Geneva Institution for Home Care and Assistance (imad), 1227 Carouge, Switzerland
- Department of Rehabilitation and Geriatrics, Geneva University Hospital, 1226 Geneva, Switzerland
| | - Aude Tholomier
- Geneva Institution for Home Care and Assistance (imad), 1227 Carouge, Switzerland
| | - Irina Ionita
- PLATEFORME du Réseau Seniors Genève, 1227 Geneva, Switzerland
| | - Christophe Graf
- Department of Rehabilitation and Geriatrics, Geneva University Hospital, 1226 Geneva, Switzerland
| | - Catherine Busnel
- Geneva Institution for Home Care and Assistance (imad), 1227 Carouge, Switzerland
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