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Lourenço PDF, Angst L, Srinivasan M. Quality of nutritional uptake of community-dwelling, care-dependent older adults in Zurich. J Dent 2024; 148:105155. [PMID: 38944266 DOI: 10.1016/j.jdent.2024.105155] [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: 06/03/2024] [Revised: 06/21/2024] [Accepted: 06/22/2024] [Indexed: 07/01/2024] Open
Abstract
OBJECTIVE This study evaluated the quality of nutritional uptake of the care-dependent, community-dwelling older adults. METHODS Community-dwelling care-dependent elders were recruited in this study. The food items along with their nutritional content were extracted from the participants' refrigerators and categorized according to the NOVA classification (G1: unprocessed/minimally processed; G2: processed culinary ingredients; G3: processed; G4: ultra-processed). The nutritional information of the food items was entered into a dietary analysis software that analyzed the content. Data was verified for a normal distribution and non-parametric tests were applied for statistical analysis (p < 0.05). RESULTS 100 subjects (mean age = 81.1±9.5 y; mean MMSE: 26.6±6.8) participated in this study. The participants had significantly more G1 than G2, G3 or G4 (p < 0.001) foods. Women had more G1 items in their refrigerators than men (rs = 0.372, p < 0.001). Higher socio-economic status indicated a presence of more G1 (rs = 0.313, p = 0.002), G2 (rs = 0.342, p < 0.001) and G4 (rs = 0.237, p = 0.024) foods. Higher cognitive scores revealed an increase in presence of G4 (rs = 0.238, p = 0.023) items. Participants with an increased need for assistance had less G2 (rs = -0.332, p = 0.001), and G4 (rs = -0.215, p = 0.041) foods; age had no influence. CONCLUSION The findings of this study confirm that the majority of care-dependent, community-dwelling adults procured healthy dietary aliments for their daily living; however, whether this correlated to the actual nutritional state of these older adults needs to be further investigated. This highlights the need for further investigation and tailored interventions to ensure good nutrition, emphasizing regular assessments and comprehensive support beyond just food access. CLINICAL RELEVANCE Clinicians must recognize that access to healthy food alone may not ensure good nutrition in older adults. Regular nutritional assessments, personalized dietary interventions, and additional support services like meal preparation assistance, nutritional counseling, and tailored programs are essential to address specific dietary needs and preferences.
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Affiliation(s)
- Patricia Daniela Ferreira Lourenço
- Clinic of General-, Special Care- and Geriatric Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; Clinic of Orthodontics and Pediatric Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Lea Angst
- Clinic of General-, Special Care- and Geriatric Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; Clinic of Orthodontics and Pediatric Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Murali Srinivasan
- Clinic of General-, Special Care- and Geriatric Dentistry, Center for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland.
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Scheufele P, Rappl A, Visser M, Kiesswetter E, Volkert D. Dietary characteristics of community-dwelling older adults with poor appetite: a cross-sectional analysis. Age Ageing 2024; 53:ii4-ii12. [PMID: 38745488 PMCID: PMC11094405 DOI: 10.1093/ageing/afae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Indexed: 05/16/2024] Open
Abstract
RATIONALE Poor appetite is considered a key factor in the development of malnutrition, a link that can be explained by alterations in dietary intake. Given the limited data on dietary characteristics in community-dwelling older adults with poor appetite, the present study aimed to examine whether poor appetite is associated with lower nutrient intake and more unfavourable food choices. METHODS In 569 participants of the Longitudinal Aging Study Amsterdam aged ≥70 years appetite was assessed using the Simplified Nutritional Appetite Questionnaire and dichotomised into normal (>14) and poor (≤14). Intake of energy, 19 nutrients, 15 food groups, the Dutch Healthy Diet Index 2015 (DHD15) and Mediterranean Diet Score (MDS) were calculated from a food frequency questionnaire. Dietary differences between appetite groups were examined using Mann-Whitney U test and binary logistic regression adjusted for potential confounders. RESULTS Mean age was 78 ± 6 years and 52% were female. Appetite was poor in 12.5% of participants. Energy intake was 1951 (median; quartiles 1-3: 1,653-2,384) kcal/day with no difference between appetite groups. Poor appetite was associated with lower intake of protein (OR 0.948, 95%CI 0.922-0.973), folate (0.981, 0.973-0.989), zinc (0.619, 0.454-0.846), vegetables (0.988, 0.982-0.994) and lower scores of DHD15 (0.964, 0.945-0.983) and MDS (0.904, 0.850-0.961), as well as higher intake of carbohydrates (1.015, 1.006-1.023), and vitamins B2 (4.577, 1.650-12.694) and C (1.013, 1.005-1.021). CONCLUSIONS Community-dwelling older adults with poor appetite showed poorer diet quality with a lower intake of protein, folate, zinc and vegetables, compared with those reporting normal appetite and should be advised accordingly.
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Affiliation(s)
- Pia Scheufele
- Institute for Biomedicine of Ageing, Faculty of Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Anja Rappl
- Institute of Medical Informatics, Biometry and Epidemiology, Faculty of Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Marjolein Visser
- Department of Health Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Eva Kiesswetter
- Institute for Biomedicine of Ageing, Faculty of Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
- Institute for Evidence in Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Dorothee Volkert
- Institute for Biomedicine of Ageing, Faculty of Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
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Değer MS, Sezerol MA, Atak M. Assessment of frailty, daily life activities, and nutrition of elderly immigrants: A household based cross-sectional study. Medicine (Baltimore) 2024; 103:e37729. [PMID: 38669436 PMCID: PMC11049769 DOI: 10.1097/md.0000000000037729] [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: 09/04/2023] [Accepted: 03/05/2024] [Indexed: 04/28/2024] Open
Abstract
With the global migrant population on the rise, it's imperative to focus on the health status of more vulnerable groups within these communities. The elderly immigrants face myriad physical and psychosocial challenges that significantly impact their health and quality of life. This study aims to investigate the nutrition, daily life activities, and clinical frailty status of elderly immigrants residing in Türkiye. A cross-sectional design was employed in the Sultanbeyli District, focusing on Syrian immigrants aged 65 and over. Participants were surveyed face-to-face by interpreters proficient in Arabic. The questionnaire comprised sociodemographic details, health status, and scales like Katz Daily Life Activities, Clinical Frailty, and Mini Nutritional Assessment. The data analysis was executed using SPSS 22. Continuous variables were presented as mean ± standard deviation (SD) and median, while categorical ones were expressed in numbers and percentages (%). A significance level of P < .05 was considered for the analyses. The average age of the participants was determined as 71.64 ± 6.20 years. In the study group, 49.7% were female, 75.5% were younger than 75 years old, 47.7% had less than primary school education, 56.3% were married, 42.4% had a low income level, and 56.9% lived in the same household with 5 or more people. Among the participants in the study group, 47% had walking and balance problems, 29.1% had a history of falls in the last year, 10.6% were disabled, 69.5% complained of pain, 82.8% had a chronic illness, and 43% had polypharmacy. The median value of the KATZ Daily Living Activities scale was 6, the mean score of the Clinical Frailty Score scale was 3.25 ± 1.25, and the mean score of the Mini Nutritional Assessment scale was 12.40 ± 2.15. Among immigrant elderly individuals, 88.1% were able to sustain their lives independently, 13.9% were clinically frail, and 3.3% were at risk of malnutrition. Factors such as age, level of education, socioeconomic status, marital status, number of cohabitants in the household, BMI, neurological problems, walking-balance disorders, disability, and presence of chronic diseases are associated with daily life activities, frailty, and malnutrition status. It is believed that broader field research with greater participation would be beneficial for evaluating the nutritional status of immigrant elderly individuals.
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Affiliation(s)
- Mehmet Sait Değer
- Department of Public Health, Hitit University – Faculty of Medicine, Çorum, Türkiye
| | - Mehmet Akif Sezerol
- Department of Public Health, Istanbul Medipol University – School of Medicine, Istanbul, Türkiye
| | - Muhammed Atak
- Department of Public Health, Istanbul University – Istanbul Faculty of Medicine, Istanbul, Türkiye
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Wakabayashi H, Kinoshita S, Isowa T, Sakai K, Tohara H, Momosaki R. Impact of Motivation for Eating Habits, Appetite and Food Satisfaction, and Food Consciousness on Food Intake and Weight Loss in Older Nursing Home Patients. Ann Geriatr Med Res 2024; 28:110-115. [PMID: 38246748 PMCID: PMC10982441 DOI: 10.4235/agmr.23.0185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/18/2023] [Accepted: 01/13/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND This study analyzed data from the Long-term care Information system For Evidence (LIFE) database to examine the effects of motivation to eat, appetite and food satisfaction, and food consciousness on food intake and weight loss. METHODS Of the 748 nursing home residents enrolled in the LIFE database, 336 met the eligibility criteria for this cross-sectional study. Motivation to eat, appetite and food satisfaction, and food consciousness were rated on five-point Likert scales (e.g., good, fair, normal, not so good, and not good). We applied Spearman rank correlation coefficient and multiple regression analyses to analyze the relationships between these three items, daily energy and protein intake, and body weight loss over 6 months. RESULTS The mean participant age was 87.4±8.1 years and 259 (77%) were female. The required levels of care included-level 1, 1 (0%); level 2, 4 (1%); level 3, 107 (32%); level 4, 135 (40%); and level 5, 89 (27%). The mean daily energy intake was 28.2±7.8 kcal/kg. The mean daily protein intake was 1.1±0.3 g/kg. The mean weight loss over six months was 1.2±0.7 kg. We observed strong positive correlations among motivation to eat, appetite and food satisfaction, and food consciousness (r>0.8). These three items were significantly associated with higher daily energy intake but not with daily protein intake. Only appetite and food satisfaction were significantly associated with lower weight loss over six months. CONCLUSION The observed associations of appetite and food satisfaction suggest that these factors may be more important to assess than motivation to eat or food consciousness among older adult residents of long-term care facilities.
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Affiliation(s)
- Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Shoji Kinoshita
- Department of Rehabilitation Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Tokiko Isowa
- Department of Nursing, Graduate School of Medicine, Mie University, Mie, Japan
| | - Kotomi Sakai
- Department of Research, Heisei Medical Welfare Group Research Institute, Tokyo, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryo Momosaki
- Department of Rehabilitation Medicine, Graduate School of Medicine, Mie University, Mie, Japan
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Wijnhoven HAH, Kok AAL, Schaap LA, Hoekstra T, van Stralen MM, Twisk JWR, Visser M. The associations between sleep quality, mood, pain and appetite in community dwelling older adults: a daily experience study. J Nutr Health Aging 2024; 28:100028. [PMID: 38388106 DOI: 10.1016/j.jnha.2023.100028] [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: 09/29/2023] [Accepted: 11/29/2023] [Indexed: 02/24/2024]
Abstract
OBJECTIVES To investigate the daily life experiences of sleep, mood, and pain in relation to appetite in community-dwelling older adults aged 75 years and older, stratified by sex. DESIGN Existing data from a daily experience study embedded in the Longitudinal Aging Study Amsterdam (LASA) among the oldest-old (≥75 years). SETTING LASA is an ongoing cohort study of a nationally representative sample of older adults aged ≥55 years from three culturally distinct regions in the Netherlands. PARTICIPANTS 434 community-dwelling older adults aged ≥75 years. MEASUREMENTS Participants filled-out a one-week diary on daily experience of pain, mood, last night sleep (10-point Likert scale), and appetite (5-point Likert scale) on five measurement occasions between 2016 and 2021. (Hybrid) linear mixed models were used to investigate overall, within-subject and between-subject association between mood, sleep, and pain (independent variables) and appetite (dependent variable), while correcting between-subject associations for season, age, educational level, partner status, body mass index, alcohol consumption, physical activity level, smoking status, chronic diseases and use of nervous system medication, stratified by sex. RESULTS Averaged over all days, males reported a poor appetite on 12% of the days and females on 19% of the days. Statistically significant between-subject associations with a poorer appetite were found for lower mood (unstandardized b = 0.084 [95% CI 0.043-0.126] (males), (b = 0.126 [95% CI 0.082-0.170] (females)), poorer sleep (b = 0.045 [95% CI 0.007-0.083] (males), (b = 0.51 [95% CI 0.017-0.085] (females)) and more severe pain in males only (b = 0.026 [95% CI 0.002-0.051]). Except for pain, within-subject associations were somewhat weaker: mood: b = 0.038 [95% CI 0.016-0.060] (males), (b = 0.082 [95% CI 0.061-0.104] (females)); sleep: b = 0.029 [95% CI 0.008-0.050] (males), (b = 0.15 [95% CI 0.005-0.025] (females)); and pain (b = 0.032 [95% CI 0.004-0.059] (males)). CONCLUSIONS This study found that poor sleep, low mood (more strongly in females) and more severe pain (males only) are associated with poor appetite in older adults on a daily level both within and between persons. Sex differences in factors related to poor appetite should be considered in future research.
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Affiliation(s)
- Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Almar A L Kok
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Methodology Programme, Amsterdam UMC, Location VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, Amsterdam Public Health Research Institute, Aging & Later Life Programme, Amsterdam UMC, Location VU University Medical Center, Amsterdam, The Netherlands
| | - Laura A Schaap
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Trynke Hoekstra
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maartje M van Stralen
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Methodology Programme, Amsterdam UMC, Location VU University Medical Center, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Jeżewska-Zychowicz M. Lifestyle Variation among the Elderly: Do Nutritional Knowledge and Diet Quality Differ When the Other Lifestyle Components Are Similar? Life (Basel) 2023; 13:2057. [PMID: 37895438 PMCID: PMC10608023 DOI: 10.3390/life13102057] [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: 09/05/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
Older people's health is strongly determined by their lifestyle, and its deterioration is a cause for concern and calls for effective efforts to slow down the process. The aim of the study was to determine the relationship between diet quality and other non-food lifestyle elements. The data were collected in 2017 through a cross-sectional survey among 271 Polish elder citizens. A K-means cluster analysis was applied to separate homogeneous groups by lifestyle components (without diet) and a logistic regression was used to analyze the relationships between identified clusters and sociodemographic characteristics, nutritional knowledge and diet quality. Three homogenous clusters were identified, i.e., individuals with moderate physical activity and recommended sleep duration (pro-healthy), with low physical activity (low PA), and with short sleep (short sleep). Gender, age, education, place of residence, BMI, and health-promoting diet index (pHDI) did not differentiate adherence to clusters. The probability of being in the pro-healthy cluster increased with nutritional knowledge and declaring the same or better health status compared to peers, while it decreased when above-average financial status was reported. The obtained results importantly extend the previous findings by showing that the individual elements of lifestyle should be also perceived in the context of others. Further research focused on lifestyle as a whole might considerably support the implementation of multifaceted lifestyle interventions.
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Affiliation(s)
- Marzena Jeżewska-Zychowicz
- Department of Food Market and Consumer Research, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Nowoursynowska 159C, 02-776 Warsaw, Poland
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Andreae C, Lennie TA, Chung ML. Diet variety sup the relationship between appetite and micronutrient intake in patients with heart failure. Eur J Cardiovasc Nurs 2023; 22:537-543. [PMID: 36172803 PMCID: PMC10050227 DOI: 10.1093/eurjcn/zvac093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 08/15/2022] [Accepted: 09/25/2022] [Indexed: 11/14/2022]
Abstract
AIMS Eating a varied diet promotes adequate micronutrient intake. Poor appetite could decrease the desire to eat a varied diet leading to dietary micronutrient insufficiencies. The interrelationships among appetite, diet variety, and dietary micronutrient intake have not been investigated in patients with heart failure (HF). The purpose of the study was to determine whether the relationship between appetite and micronutrient insufficiency was mediated through diet variety. METHODS AND RESULTS A total of 238 patients with HF, mean age 61 ± 12.1; 68% male, and 45% NYHA class III/IV were included in this secondary analysis. Data collection consisted of a 4-day food diary and self-reported appetite on a 10-point visual analogue scale. Micronutrient insufficiency was defined as the total number of 17 minerals and vitamins that were insufficient in the diet. Diet variety was calculated as the number of 23 food types consumed over the 4 days. Mediation analysis, controlling for covariates age, gender, NYHA class, and body mass index showed that diet variety mediated the relationship between appetite and micronutrient insufficiencies [indirect effect = -0.0828, 95% confidence interval (CI): -0.1585 to -0.0150]. There was no direct effect of appetite on micronutrient insufficiency (c´ = -0.1802; 95% CI = -0.3715 to.0111). CONCLUSIONS Diet variety played a previously unrecognized role in the relationship between appetite and dietary micronutrient intake in patients with HF. More research is needed to validate these associations in patients with HF.
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Affiliation(s)
- Christina Andreae
- Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden
- Centre for Clinical Research Sormland, Uppsala University, 631 88 Eskilstuna, Sweden
| | - Terry A. Lennie
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY 40536-0232, USA
| | - Misook L. Chung
- College of Nursing, University of Kentucky, 751 Rose Street, Lexington, KY 40536-0232, USA
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Carrillo E, Chaya C, Viadel A, Laguna L, Tarrega A. Early changes in elderly food habits related to reduced protein intake. Food Qual Prefer 2023. [DOI: 10.1016/j.foodqual.2023.104862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
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Characterisation of community-dwelling older adults with poor appetite. Eur J Nutr 2023:10.1007/s00394-023-03129-5. [PMID: 36869911 DOI: 10.1007/s00394-023-03129-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/21/2023] [Indexed: 03/05/2023]
Abstract
PURPOSE A poor appetite affects up to 27% of community-dwelling older adults in Europe and is an early predictor of malnutrition. Little is known about the factors associated with poor appetite. The present study, therefore, aims to characterise older adults with poor appetite. METHODS As part of the European JPI project APPETITE, data from 850 participants, aged ≥ 70 years of the Longitudinal Ageing Study Amsterdam (LASA) from 2015/16 were analysed. Appetite during the last week was assessed with a five-point scale and dichotomised into "normal" and "poor". Binary logistic regression was used to examine associations between 25 characteristics from 5 domains-physiological, emotional, cognitive, social, and lifestyle-and appetite. First, domain-specific models were calculated using stepwise backward selection. Second, all variables contributing to poor appetite were combined in a multi-domain model. RESULTS The prevalence of self-reported poor appetite was 15.6%. Fourteen parameters from all five single-domain models contributed to poor appetite and were entered into the multi-domain model. Here, female sex (total prevalence: 56.1%, odds ratio: 1.95 [95% confidence interval 1.10-3.44]), self-reported chewing problems (2.4%, 5.69 [1.88-17.20]), any unintended weight loss in the last 6 months (6.7%, 3.07 [1.36-6.94]), polypharmacy defined as ≥ 5 medications in the past 2 weeks (38.4%, 1.87 [1.04-3.39]), and depressive symptoms (Centre for Epidemiologic Studies Depression Scale without appetite item) (1.12 [1.04-1.21]) were associated with an increased likelihood of having poor appetite. CONCLUSION According to this analysis, older people with the characteristics described above are more likely to have a poor appetite.
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Clegg ME, Methven L, Lanham-New SA, Green MA, Duggal NA, Hetherington MM. The Food4Years Ageing Network: Improving foods and diets as a strategy for supporting quality of life, independence and healthspan in older adults. NUTR BULL 2023; 48:124-133. [PMID: 36718711 PMCID: PMC10946951 DOI: 10.1111/nbu.12599] [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: 04/29/2022] [Revised: 11/20/2022] [Accepted: 11/28/2022] [Indexed: 02/01/2023]
Abstract
By 2050, it is predicted that one in four people in the United Kingdom will be aged 65 years and over. Increases in lifespan are not always translated into years spent in good health. Incidence rates for chronic diseases are increasing, with treatments allowing people to live longer with their disease. There is good evidence to support changes to lifestyle to maintain or improve body composition, cognitive health, musculoskeletal health, immune function and vascular health in older adults. Much research has been done in this area, which has produced significant support for foods and nutrients that contribute to improved healthspan. Yet two major barriers remain: firstly, older adult consumers are not meeting current UK recommendations for macro- and micronutrients that could benefit health and quality of life and secondly, the UK-specific recommendations may not be sufficient to support the ageing population, particularly for nutrients with key physiological roles. More work is needed to improve intakes of specific foods, diets and nutrients by older adults, through a variety of mechanisms including (i) development of specific food products; (ii) improved clarity of information and (iii) appropriate marketing, and policy changes to enable incentives. The Food4Years Ageing Network aims to build a wide-reaching and multidisciplinary community that is committed to the development, integration and communication of healthy, affordable foods and specific diets for all older adults across the UK food landscape. The Network will identify evidence-based strategies for improving food intake and nutrition in older adults, paving the way to "living well while living longer."
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Affiliation(s)
- Miriam E Clegg
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | - Lisa Methven
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | - Susan A Lanham-New
- Nutritional Sciences Department, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Surrey, UK
| | - Mark A Green
- Department of Geography and Planning, University of Liverpool, Liverpool, UK
| | - Niharika A Duggal
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
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Cox NJ, Roberts HC. Editorial: Anorexia of Ageing and Routinely Collected 'Big Data'- Helpful Insights and New Challenges. J Nutr Health Aging 2023; 27:182-183. [PMID: 36973923 DOI: 10.1007/s12603-023-1899-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Affiliation(s)
- N J Cox
- Natalie J Cox, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Tremona Road, Southampton, UK,
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Promoting Protein Intake in an Ageing Population: Product Design Implications for Protein Fortification. Nutrients 2022; 14:nu14235083. [PMID: 36501113 PMCID: PMC9735980 DOI: 10.3390/nu14235083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/21/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022] Open
Abstract
Protein is a macronutrient of interest for an ageing population and intake requirements increase with age. Accordingly, protein is often fortified into products for older adults to help alleviate malnutrition and impede sarcopenia. However, more emphasis needs to be placed upon designing protein-fortified products to ensure suitability for older adults. This study involved a two-stage approach: (1) an initial review of products commonly fortified with protein and (2) two questionnaires for younger and older adults (n = 73; 18-30; 65+) to investigate optimal portion sizes (drinks and cakes) as well as attitudes, consumption habits and preferences towards protein fortification. The initial literature and market review demonstrated protein-fortified products are typically in liquid or snack format; however, there is considerable variability in terms of product types, serving size and protein sources. There were no age-related differences found for ideal cakes portion size whereas there were for liquids. Older adults are typically not consuming protein-fortified products; therefore, more importance should be placed on the consumption moment (breakfast or as snacks between meals) and on cereals, pasta, porridge, cakes, and biscuits. Older adults need increased awareness of, and more education on, the benefits of protein consumption, coupled with products tailored and designed to encourage intake.
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Montez De Sousa ÍR, Bergheim I, Brombach C. Beyond the Individual -A Scoping Review and Bibliometric Mapping of Ecological Determinants of Eating Behavior in Older Adults. Public Health Rev 2022; 43:1604967. [PMID: 35992753 PMCID: PMC9381692 DOI: 10.3389/phrs.2022.1604967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/27/2022] [Indexed: 11/20/2022] Open
Abstract
Objectives: The objective of this scoping review was to summarize and provide a visual overview of the present-day knowledge on ecological determinants of eating behavior in community-dwelling elderly persons in relation with nutrition communication, considering the evolution of the field. The second objective was to integrate results in recommendations for the development of nutrition communication strategies. Methods: A literature review was performed on Medline, PubMed and Google Scholar, according with the PRISMA protocol for scoping reviews. An a-priori analysis was executed by categorizing determinants from the literature according with the different levels represented in the ecological framework and an a-posteriori analysis by using VosViewer for a chronological bibliometric mapping analysis. Results: Of 4029 articles retrieved, 77 were selected for analysis. Initial publications focused more on individual determinants of eating behavior. Over time, there was a shift towards a holistic view of eating behavior considering the “food environment”, including social networks, physical settings and public policy. Conclusion: Beyond the individual, all ecological levels are relevant when targeting eating behavior in the elderly. Nutrition communication strategies should be structured considering these influences.
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Affiliation(s)
- Íris Rafaela Montez De Sousa
- Institute of Food and Beverage Innovation, Life Sciences and Facility Management, Zurich University of Applied Sciences, Wädenswil, Switzerland
- Molecular Nutritional Science, Department of Nutritional Sciences, University of Vienna, Vienna, Austria
- *Correspondence: Íris Rafaela Montez De Sousa,
| | - Ina Bergheim
- Molecular Nutritional Science, Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - Christine Brombach
- Institute of Food and Beverage Innovation, Life Sciences and Facility Management, Zurich University of Applied Sciences, Wädenswil, Switzerland
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Prado CM, Landi F, Chew STH, Atherton PJ, Molinger J, Ruck T, Gonzalez MC. Advances in Muscle Health and Nutrition: A Toolkit for Healthcare Professionals. Clin Nutr 2022; 41:2244-2263. [DOI: 10.1016/j.clnu.2022.07.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 07/03/2022] [Accepted: 07/31/2022] [Indexed: 11/03/2022]
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Caso G, Vecchio R. Factors influencing independent older adults (un)healthy food choices: A systematic review and research agenda. Food Res Int 2022; 158:111476. [DOI: 10.1016/j.foodres.2022.111476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/17/2022] [Accepted: 06/04/2022] [Indexed: 11/25/2022]
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Mendonça NMP, Hengeveld LM, Presse N, Canhão H, Simonsick E, Kritchevsky SB, Farsijani S, Gaudreau P, Jagger C, Visser M. Protein intake, physical activity and grip strength in European and North American community-dwelling older adults: a pooled analysis of individual participant data from four longitudinal ageing cohorts. Br J Nutr 2022; 129:1-26. [PMID: 35791789 PMCID: PMC9816353 DOI: 10.1017/s0007114522002033] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 05/19/2022] [Accepted: 06/27/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Higher dietary protein, alone or in combination with physical activity (PA), may slow the loss of age-related muscle strength in older adults. We investigated the longitudinal relationship between protein intake and grip strength, and the interaction between protein intake and PA, using four longitudinal ageing cohorts. METHODS Individual participant data from 5584 older adults (52% women; median: 75, IQR: 71.6, 79.0 years) with up to 8.5 years (mean: 4.9, SD: 2.3 years) of follow-up from the Health ABC, NuAge, LASA and Newcastle 85+ cohorts were pooled. Baseline protein intake was assessed with food frequency questionnaires and 24h recalls and categorized into <0.8, 0.8-<1.0, 1.0-<1.2 and ≥1.2 g/kg adjusted body weight (aBW)/d. The prospective association between protein intake, its interaction with PA, and grip strength (sex- and cohort-specific) was determined using joint models (hierarchical linear mixed effects and a link function for Cox proportional hazards models). RESULTS Grip strength declined on average by 0.018 SD (95%CI: -0.026, -0.006) every year. No associations were found between protein intake, measured at baseline, and grip strength, measured prospectively, or rate of decline of grip strength in models adjusted for sociodemographic, anthropometric, lifestyle and health variables (e.g., protein intake ≥1.2 vs <0.8 g/kg aBW/d: β= -0.003, 95%CI: -0.014,0.005 SD per year). There also was no evidence of an interaction between protein intake and PA. CONCLUSIONS We failed to find evidence in this study to support the hypothesis that higher protein intake, alone or in combination with higher PA, slowed the rate of grip strength decline in older adults.
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Affiliation(s)
- Nuno M. P. Mendonça
- EpiDoC Unit, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre (CHRC), Lisbon, Portugal
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Linda M. Hengeveld
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Health Council of the Netherlands, The Hague, the Netherlands
| | - Nancy Presse
- Research Centre on Aging, CIUSSS de l’Estrie-CHUS, Sherbrooke, QC, Canada
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Montréal, QC, Canada
| | - Helena Canhão
- EpiDoC Unit, NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Centre (CHRC), Lisbon, Portugal
| | - Eleanor Simonsick
- National Institute on Aging Intramural Research Program, Baltimore, MD, USA
| | | | - Samaneh Farsijani
- Center for Aging and Population Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Pierrette Gaudreau
- Department of Medicine, University of Montréal and Research Centre of the University of Montréal Hospital Centre, Montréal, QC, Canada
| | - Carol Jagger
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Kaipainen T, Hartikainen S, Tiihonen M, Nykänen I. Effect of individually tailored nutritional counselling on protein and energy intake among older people receiving home care at risk of or having malnutrition: a non-randomised intervention study. BMC Geriatr 2022; 22:391. [PMID: 35505290 PMCID: PMC9066874 DOI: 10.1186/s12877-022-03088-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 04/25/2022] [Indexed: 11/20/2022] Open
Abstract
Background With ageing, food intake may decrease and lead to an insufficient nutrient intake causing protein-energy malnutrition (PEM) which is associated with adverse health effects and increased mortality. The aim of this study was to investigate the effects of individually tailored dietary counseling focused on protein intake among home care clients with PEM or at risk of developing PEM. The secondary aim was to study the intake of energy and other nutrients. Methods This intervention study is part of the non-randomised population-based multidisciplinary Nutrition, Oral Health and Medication study (NutOrMed study). The intervention group comprised 112 and the control group 87 home care clients (≥75 years) with PEM or risk of PEM. PEM was defined by Mini Nutritional Assessment score < 24 and/or plasma albumin < 35 g/L. The nutrients intake was assessed from 24-hour dietary recall at the baseline and after the six-month intervention. The intervention consisted of an individually tailored dietary counseling; the persons were instructed to increase their food intake with protein and energy dense food items, the number of meals and consumption of protein-, energy- and nutrient-rich snacks for six months. Results After the six-month nutritional intervention, the mean change in protein intake increased 0.04 g/kgBW (95% CI 0.05 to 0.2), fibre 0.8 g (95% CI 0.2 to 4.3), vitamin D 8.5 μg (95% CI 0.7 to 4.4), E 0.6 mg (95% CI 0.4 to 2.2), B12 0.7 μg (95% CI 0.02 to 2.6), folate 8.7 μg (95% CI 1.5 to 46.5), iron 0.4 mg 95% CI 0.6 to 2.4), and zinc 0.5 mg (95% CI 0.6 to 2.2) in the intervention group compared with the control group. The proportion of those receiving less than 1.0 g/kg/BW protein decreased from 67 to 51% in the intervention group and from 84 to 76% in the control group. Among home care clients with a cognitive decline (MMSE< 18), protein intake increased in the intervention group by 0.2 g/kg/BW (p = 0.048) but there was no change in the control group. Conclusion An individual tailored nutritional intervention improves the intake of protein and other nutrients among vulnerable home care clients with PEM or its risk and in persons with cognitive decline. Trial registration ClinicalTrials.gov: NCT02214758. Date of trial registration: 12/08/2014.
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Affiliation(s)
- Tarja Kaipainen
- Kuopio Research Centre of Geriatric Care, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, P.O.B 1627, FI-70211, Kuopio, Finland.,Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, P.O.B 1627, FI-70211, Kuopio, Finland
| | - Sirpa Hartikainen
- Kuopio Research Centre of Geriatric Care, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, P.O.B 1627, FI-70211, Kuopio, Finland
| | - Miia Tiihonen
- Kuopio Research Centre of Geriatric Care, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, P.O.B 1627, FI-70211, Kuopio, Finland
| | - Irma Nykänen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, P.O.B 1627, FI-70211, Kuopio, Finland.
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Low awareness of community-dwelling older adults on the importance of dietary protein: new insights from four qualitative studies. J Nutr Sci 2022; 10:e102. [PMID: 35059183 PMCID: PMC8727701 DOI: 10.1017/jns.2021.92] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 09/27/2021] [Accepted: 10/09/2021] [Indexed: 01/11/2023] Open
Abstract
Meeting the recommended daily protein intake can be a challenge for community-dwelling older adults (CDOA). In order to understand why, we studied attitudes towards protein-rich products and healthy eating in general; identified needs and preferences, barriers and promotors and knowledge regarding dietary behaviour and implementation of high protein products. Attitudes towards protein-rich products and healthy eating were evaluated in focus groups (study 1, n 17). To gain insights in the needs and preferences of older adults with regard to meals and meal products (study 2, n 30), visual information on eating behaviour was assessed using photovoicing and verified in post-photovoice interviews. In studies 3 and 4, semi-structured interviews were conducted to identify protein consumption-related barriers, opportunities (n 20) and knowledge and communication channels (n 40), respectively. Risk of low protein intake was assessed using ProteinScreener55+ (Pro55+) in studies 2–4 (n 90). Focus groups showed that participants were unaware of potential inadequate dietary protein. Photovoicing showed that sixteen of thirty participants mainly consumed traditional Dutch products. In post-photovoice interviews, participants indicated that they were satisfied with their current eating behaviour. Barriers for adequate use of protein-rich products were ‘lack of knowledge’, ‘resistance to change habits’ and ‘no urge to receive dietary advice’. Promotors were ‘trust in professionals’ and ‘product offers’. Sixty-two percent had a low risk of low protein intake. CDOA feel low urgency to increase protein intake, possibly linked to low knowledge levels. A challenge for professionals would be to motivate older adults to change their eating pattern, to optimise protein intake.
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Verwijs MH, Haveman-Nies A, Borkent JW, Linschooten JO, Roodenburg AJC, de Groot LCPGM, de van der Schueren MAE. Protein Intake among Community-Dwelling Older Adults: The Influence of (Pre-) Motivational Determinants. Nutrients 2022; 14:nu14020293. [PMID: 35057473 PMCID: PMC8778399 DOI: 10.3390/nu14020293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/04/2022] [Accepted: 01/08/2022] [Indexed: 11/18/2022] Open
Abstract
An adequate protein intake is important for healthy ageing, yet nearly 50% of Dutch community-dwelling older adults do not meet protein recommendations. This study explores protein intake in relation to eight behavioral determinants (I-Change model) among Dutch community-dwelling older adults. Data were collected through an online questionnaire from October 2019–October 2020. Protein intake was assessed by the Protein Screener 55+, indicating a high/low chance of a low protein intake (<1.0 g/kg body weight/day). The behavioral determinants of cognizance, knowledge, risk perception, perceived cues, attitude, social support, self-efficacy and intention were assessed by evaluating statements on a 7-point Likert scale. A total of 824 Dutch community-dwelling older adults were included, recruited via online newsletters, newspapers and by personal approach. Poisson regression was performed to calculate quartile-based prevalence ratios (PRs). Almost 40% of 824 respondents had a high chance of a low protein intake. Univariate analyses indicated that lower scores for all different behavioral determinants were associated with a higher chance of a low protein intake. Independent associations were observed for knowledge (Q4 OR = 0.71) and social support (Q4 OR = 0.71). Results of this study can be used in future interventions aiming to increase protein intake in which focus should lie on increasing knowledge and social support.
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Affiliation(s)
- Marije H. Verwijs
- Department of Nutrition, Dietetics and Lifestyle, School of Allied Health, HAN University of Applied Sciences, Kapittelweg 33, 6525 EN Nijmegen, The Netherlands; (M.H.V.); (J.W.B.)
- Division of Human Nutrition and Health, Wageningen University & Research, Stippeneng 4, 6708 WE Wageningen, The Netherlands;
| | - Annemien Haveman-Nies
- Department of Social Sciences, Consumption and Healthy Lifestyles, Wageningen University & Research, Hollandseweg 1, 6706 KN Wageningen, The Netherlands;
| | - Jos W. Borkent
- Department of Nutrition, Dietetics and Lifestyle, School of Allied Health, HAN University of Applied Sciences, Kapittelweg 33, 6525 EN Nijmegen, The Netherlands; (M.H.V.); (J.W.B.)
- Division of Human Nutrition and Health, Wageningen University & Research, Stippeneng 4, 6708 WE Wageningen, The Netherlands;
| | - Joost O. Linschooten
- Department of Food Science & Technology, HAS University of Applied Sciences, P.O. Box 90108, 5200 MA Den Bosch, The Netherlands; (J.O.L.); (A.J.C.R.)
| | - Annet J. C. Roodenburg
- Department of Food Science & Technology, HAS University of Applied Sciences, P.O. Box 90108, 5200 MA Den Bosch, The Netherlands; (J.O.L.); (A.J.C.R.)
| | - Lisette C. P. G. M. de Groot
- Division of Human Nutrition and Health, Wageningen University & Research, Stippeneng 4, 6708 WE Wageningen, The Netherlands;
| | - Marian A. E. de van der Schueren
- Department of Nutrition, Dietetics and Lifestyle, School of Allied Health, HAN University of Applied Sciences, Kapittelweg 33, 6525 EN Nijmegen, The Netherlands; (M.H.V.); (J.W.B.)
- Division of Human Nutrition and Health, Wageningen University & Research, Stippeneng 4, 6708 WE Wageningen, The Netherlands;
- Correspondence: ; Tel.: +31-6-44296477
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Hamulka J, Frackiewicz J, Stasiewicz B, Jeruszka-Bielak M, Piotrowska A, Leszczynska T, Niedzwiedzka E, Brzozowska A, Wadolowska L. Socioeconomic, Eating- and Health-Related Limitations of Food Consumption among Polish Women 60+ Years: The 'ABC of Healthy Eating' Project. Nutrients 2021; 14:nu14010051. [PMID: 35010925 PMCID: PMC8746491 DOI: 10.3390/nu14010051] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 12/13/2022] Open
Abstract
The study aimed at identifying the socioeconomic, eating- and health-related limitations and their associations with food consumption among Polish women 60+ years old. Data on the frequency of consumption of fruit, vegetables, dairy, meat, poultry, fish, legumes, eggs, water and beverages industrially unsweetened were collected with the Mini Nutritional Assessment (MNA®) and were expressed in the number of servings consumed per day or week. Three indexes: the Socioeconomic Status Index (SESI), the Eating-related Limitations Score (E-LS) and the Health-related Limitations Score (H-LS) were developed and applied. SESI was created on the base of two variables: place of residence and the self-reported economic situation of household. E-LS included: difficulties with self-feeding, decrease in food intake due to digestive problems, chewing or swallowing difficulties, loss of appetite, decrease in the feeling the taste of food, and feeling satiety, whereas H-LS included: physical function, comorbidity, cognitive function, psychological stress and selected anthropometric measurements. A logistic regression analysis was performed to assess the socioeconomic, eating-, and health-related limitations of food consumption. Lower socioeconomic status (vs. higher) was associated with a lower chance of consuming fruit/vegetables ≥ 2 servings/day (OR = 0.25) or consuming dairy ≥ 1 serving/day (OR = 0.32). The existence of multiple E-LS limitations (vs. few) was associated with a lower chance of consuming fruit/vegetables ≥ 2 servings/day (OR = 0.72), consuming dairy ≥ 1 serving/day (OR = 0.55) or consuming water and beverages industrially unsweetened ≥6 cups/day (OR = 0.56). The existence of multiple H-LS limitations was associated with a lower chance of consuming fruit/vegetables ≥ 2 servings/day (OR = 0.79 per 1 H-LS point increase) or consuming dairy ≥ 1 serving/day (OR = 0.80 per 1 H-LS point increase). Limitations found in the studied women were related to insufficient consumption of selected groups of food, which can lead to malnutrition and dehydration. There is a need for food policy actions, including practical educational activities, to eliminate barriers in food consumption, and in turn to improve the nutritional and health status of older women.
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Affiliation(s)
- Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 159C, 02-776 Warsaw, Poland; (M.J.-B.); (A.B.)
- Correspondence: (J.H.); (J.F.)
| | - Joanna Frackiewicz
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 159C, 02-776 Warsaw, Poland; (M.J.-B.); (A.B.)
- Correspondence: (J.H.); (J.F.)
| | - Beata Stasiewicz
- Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland; (B.S.); (E.N.); (L.W.)
| | - Marta Jeruszka-Bielak
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 159C, 02-776 Warsaw, Poland; (M.J.-B.); (A.B.)
| | - Anna Piotrowska
- Department of Functional and Organic Food, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Nowoursynowska 159C, 02-776 Warsaw, Poland;
| | - Teresa Leszczynska
- Department of Human Nutrition and Dietetics, Faculty of Food Technology, University of Agriculture in Krakow, Balicka 122, 30-149 Krakow, Poland;
| | - Ewa Niedzwiedzka
- Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland; (B.S.); (E.N.); (L.W.)
| | - Anna Brzozowska
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 159C, 02-776 Warsaw, Poland; (M.J.-B.); (A.B.)
| | - Lidia Wadolowska
- Department of Human Nutrition, Faculty of Food Science, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland; (B.S.); (E.N.); (L.W.)
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Volkert D, Corish CA, Dardevet D, De Vito G, Guillet C, Bader‐Mittermaier S, Robinson S, Roche HM, Sayer AA, Visser M. Innovative plAnt Protein fibre and Physical activity solutions to address poor appEtite and prevenT undernutrITion in oldEr adults – APPETITE. NUTR BULL 2021. [DOI: 10.1111/nbu.12529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Dorothee Volkert
- Institute for Biomedicine of Aging Friedrich‐Alexander‐Universität (FAU) Erlangen‐Nürnberg Nuremberg Germany
| | - Clare A. Corish
- School of Public Health, Physiotherapy and Sports Science University College Dublin (UCD) Institute of Food and Health UCD Dublin Ireland
| | - Dominique Dardevet
- Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE) Saint Genès Champanelle France
| | - Giuseppe De Vito
- Neuromuscular Physiology Laboratory Department of Biomedical Science University of Padua (UNIPD) Padova Italy
| | - Christelle Guillet
- Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE) Saint Genès Champanelle France
| | | | - Sian Robinson
- AGE Research Group Translational and Clinical Research Institute Newcastle University (NU) Newcastle upon Tyne UK
- NIHR Newcastle Biomedical Research Centre Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University Newcastle upon Tyne UK
| | - Helen M. Roche
- School of Public Health, Physiotherapy and Sports Science University College Dublin (UCD) Institute of Food and Health UCD Dublin Ireland
- Nutrigenomics Research Group UCD Conway Institute UCD Dublin Ireland
| | - Avan A. Sayer
- AGE Research Group Translational and Clinical Research Institute Newcastle University (NU) Newcastle upon Tyne UK
- NIHR Newcastle Biomedical Research Centre Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University Newcastle upon Tyne UK
| | - Marjolein Visser
- Department of Health Sciences Faculty of Science Vrije Universiteit (VU) Amsterdam Amsterdam The Netherlands
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Uršulin-Trstenjak N, Dodlek Šarkanj I, Sajko M, Vitez D, Živoder I. Determination of the Personal Nutritional Status of Elderly Populations Based on Basic Foodomics Elements. Foods 2021; 10:2391. [PMID: 34681440 PMCID: PMC8535163 DOI: 10.3390/foods10102391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/01/2021] [Accepted: 10/06/2021] [Indexed: 01/10/2023] Open
Abstract
Nutritional status is a series of related parameters collected using different available methods. In order to determine the nutritional status of elderly populations and ensure nutritional support based on an individual approach, the implementation of the increasingly used foodomics approach is available; this approach plays a key role in personalized diets and in the optimization of diets for a population group, such as an elderly population. The Mini Nutritional Assessment (MNA) method and the Nottingham Screening Tool (NST) form were used on 50 users in a home for the elderly in northwest Croatia. A loss of body mass (BM) was statistically significantly higher for those who had the following: decreased food intake in the last week and users who had complete and partial feeding autonomy. Additionally, the obtained data on drug intake, fluid, individual nutrients, and physical activity are based on an individual approach. The available documentation provides insight into nutritional values and food preparation in an attempt to satisfy a holistic approach in the evaluation of exposure while trying to achieve as many elements of foodomics as possible.
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Affiliation(s)
- Natalija Uršulin-Trstenjak
- Department of Food Technology, University Center Koprivnica, University North, Trg dr. Žarka Dolinara 1, 48000 Koprivnica, Croatia;
- Department of Nursing, University Center Varaždin, University North, Jurja Križanića 31b, 42000 Varaždin, Croatia; (M.S.); (I.Ž.)
| | - Ivana Dodlek Šarkanj
- Department of Food Technology, University Center Koprivnica, University North, Trg dr. Žarka Dolinara 1, 48000 Koprivnica, Croatia;
| | - Melita Sajko
- Department of Nursing, University Center Varaždin, University North, Jurja Križanića 31b, 42000 Varaždin, Croatia; (M.S.); (I.Ž.)
| | - David Vitez
- County Hospital Čakovec, I.G.Kovačića 1e, 40000 Čakovec, Croatia;
| | - Ivana Živoder
- Department of Nursing, University Center Varaždin, University North, Jurja Križanića 31b, 42000 Varaždin, Croatia; (M.S.); (I.Ž.)
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The protein gap-increasing protein intake in the diet of community-dwelling older adults: a simulation study. Public Health Nutr 2021; 25:248-256. [PMID: 34602101 PMCID: PMC8883780 DOI: 10.1017/s1368980021004134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: Approximately 50 % of Dutch community-dwelling older adults does not meet protein recommendations. This study assesses the effect of replacing low protein foods with protein-rich alternatives on the protein intake of Dutch community-dwelling older adults. Design: The Dutch National Food Consumption Survey—Older Adults 2010–2012 (DNFCS-OA) was used for scenario modelling. Dietary intake was estimated based on two 24-h recalls. Commonly consumed products were replaced by comparable products rich in protein (scenario 1), foods enriched in protein (scenario 2) and a combination of both (scenario 3). Replacement scenarios were confined to participants whose dietary protein intake was < 1·0 g/kg BW/d (n 391). Habitual protein intake of all older adults was estimated, adjusting for effects of within-person variation in the 2-d intake data. Setting: A simulation study based on the DNFCS-OA. Participants: 727 Dutch community-dwelling older adults aged 70+. Results: Mean protein intake of the total population increased from 1·0 to 1·2 g/kg BW/d (scenarios 1 and 2) and to 1·3 g/kg BW/d (scenario 3). The percentage of participants with intakes of ≥ 1·0 g/kg BW/d increased from 47·1 % to 91·4 %, 90·2 % and 94·6 %, respectively, in scenarios 1, 2 and 3. The largest increases in protein intake were due to replacements in food groups: yoghurt, cream desserts and pudding, potatoes, vegetables and legumes and non-alcoholic beverages and milk in scenario 1 and bread; yoghurt, cream desserts and pudding and soups in scenario 2. Conclusions: This simulation model shows that replacing low protein foods with comparable alternatives rich in protein can increase the protein intake of Dutch community-dwelling older adults considerably. Results can be used as a basis for nutritional counselling.
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Grasso AC, Hung Y, Olthof MR, Brouwer IA, Verbeke W. Understanding meat consumption in later life: A segmentation of older consumers in the EU. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2021.104242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Mathewson SL, Azevedo PS, Gordon AL, Phillips BE, Greig CA. Overcoming protein-energy malnutrition in older adults in the residential care setting: A narrative review of causes and interventions. Ageing Res Rev 2021; 70:101401. [PMID: 34237434 DOI: 10.1016/j.arr.2021.101401] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/10/2021] [Accepted: 07/02/2021] [Indexed: 01/06/2023]
Abstract
Malnutrition, in particular protein-energy malnutrition, is a highly prevalent condition in older adults, and is associated with low muscle mass and function, and increased prevalence of physical frailty. Malnutrition is often exacerbated in the residential care setting due to factors including lack of dentition and appetite, and increased prevalence of dementia and dysphagia. This review aims to provide an overview of the available literature in older adults in the residential care setting regarding the following: links between sarcopenia, frailty, and malnutrition (in particular, protein-energy malnutrition (PEM)), recognition and diagnosis of malnutrition, factors contributing to PEM, and the effectiveness of different forms of protein supplementation (in particular, oral nutritional supplementation (ONS) and protein-fortified foods (PFF)) to target PEM. This review found a lack of consensus on effective malnutrition diagnostic tools and lack of universal requirement for malnutrition screening in the residential care setting, making identifying and treating malnutrition in this population a challenge. When assessing the use of protein supplementation in the residential care setting, the two primary forms of supplementation were ONS and PFF. There is evidence that ONS and PFF increase protein and energy intakes in residential care setting, yet compliance with supplementation and their impact on functional status is unclear and conflicting. Further research comparing the use of ONS and PFF is needed to fully determine feasibility and efficacy of protein supplementation in the residential care setting.
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Mendonça N, Hengeveld LM, Visser M, Presse N, Canhão H, Simonsick EM, Kritchevsky SB, Newman AB, Gaudreau P, Jagger C. Low protein intake, physical activity, and physical function in European and North American community-dwelling older adults: a pooled analysis of four longitudinal aging cohorts. Am J Clin Nutr 2021; 114:29-41. [PMID: 33829238 PMCID: PMC8246618 DOI: 10.1093/ajcn/nqab051] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 02/09/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Dietary protein may slow the decline in muscle mass and function with aging, making it a sensible candidate to prevent or modulate disability progression. At present, studies providing reliable estimates of the association between protein intake and physical function, and its interaction with physical activity (PA), in community-dwelling older adults are lacking. OBJECTIVES We investigated the longitudinal relation between protein intake and physical function, and the interaction with PA. METHODS We undertook a pooled analysis of individual participant data from cohorts in the PROMISS (PRevention Of Malnutrition In Senior Subjects in the European Union) consortium (the Health Aging and Body Composition Study, Quebec Longitudinal Study on Nutrition and Successful Aging, Longitudinal Aging Study Amsterdam, and Newcastle 85+) in which 5725 community-dwelling older adults were followed up to 8.5 y. The relation between protein intake and walking speed was determined using joint models (linear mixed-effects and Cox proportional hazards models) and the relation with mobility limitation was investigated using multistate models. RESULTS Higher protein intake was modestly protective of decline in walking speed in a dose-dependent manner [e.g., protein intake ≥1.2 compared with 0.8 g/kg adjusted body weight (aBW)/d: β = 0.024, 95% CI: 0.009, 0.032 SD/y], with no clear indication of interaction with PA. Participants with protein intake ≥0.8 g/kg aBW/d had also a lower likelihood of incident mobility limitation, which was observed for each level of PA. This association seemed to be dose-dependent for difficulty walking but not for difficulty climbing stairs. No associations between protein intake and other mobility limitations transitions were observed. CONCLUSIONS Higher daily protein intake can reduce physical function decline not only in older adults with protein intake below the current RDA of 0.8 g/kg BW/d, but also in those with a protein intake that is already considered sufficient. This dose-dependent association was observed for each level of PA, suggesting no clear synergistic association between protein intake and PA in relation to physical function.
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Affiliation(s)
- Nuno Mendonça
- EpiDoC Unit, CEDOC, NOVA Medical School, Universidade Nova de Lisboa (UNL), Lisbon, Portugal
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, Lisbon, Portugal
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, United Kingdom
| | - Linda M Hengeveld
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Nancy Presse
- Research Centre on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, Quebec, Canada
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montréal, Quebec, Canada
| | - Helena Canhão
- EpiDoC Unit, CEDOC, NOVA Medical School, Universidade Nova de Lisboa (UNL), Lisbon, Portugal
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, Lisbon, Portugal
| | | | | | - Anne B Newman
- Center for Aging and Population Health, Department of Epidemiology, University of Pittsburgh, PA, USA
| | - Pierrette Gaudreau
- Department of Medicine, University of Montréal, H3T 1J4, Montréal, Quebec, Canada
- Research Centre of the Centre hospitalier de l'Université de Montréal (CHUM), H2X 0A9, Montréal, Quebec, Canada
| | - Carol Jagger
- Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, United Kingdom
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Morgan PT, Breen L. The role of protein hydrolysates for exercise-induced skeletal muscle recovery and adaptation: a current perspective. Nutr Metab (Lond) 2021; 18:44. [PMID: 33882976 PMCID: PMC8061049 DOI: 10.1186/s12986-021-00574-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 04/14/2021] [Indexed: 12/20/2022] Open
Abstract
The protein supplement industry is expanding rapidly and estimated to have a multi-billion market worth. Recent research has centred on understanding how the manufacturing processes of protein supplements may impact muscle recovery and remodeling. The hydrolysed forms of protein undergo a further heating extraction process during production which may contribute to amino acids (AA) appearing in circulation at a slightly quicker rate, or greater amplitude, than the intact form. Whilst the relative significance of the rate of aminoacidemia to muscle protein synthesis is debated, it has been suggested that protein hydrolysates, potentially through the more rapid delivery and higher proportion of di-, tri- and smaller oligo-peptides into circulation, are superior to intact non-hydrolysed proteins and free AAs in promoting skeletal muscle protein remodeling and recovery. However, despite these claims, there is currently insufficient evidence to support superior muscle anabolic properties compared with intact non-hydrolysed proteins and/or free AA controls. Further research is warranted with appropriate protein controls, particularly in populations consuming insufficient amounts of protein, to support and/or refute an important muscle anabolic role of protein hydrolysates. The primary purpose of this review is to provide the reader with a current perspective on the potential anabolic effects of protein hydrolysates in individuals wishing to optimise recovery from, and maximise adaptation to, exercise training.
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Affiliation(s)
- Paul T Morgan
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
| | - Leigh Breen
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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Broeckhoven I, Verbeke W, Tur-Cardona J, Speelman S, Hung Y. Consumer valuation of carbon labeled protein-enriched burgers in European older adults. Food Qual Prefer 2021. [DOI: 10.1016/j.foodqual.2020.104114] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Cox NJ, Bowyer RCE, Ni Lochlainn M, Wells PM, Roberts HC, Steves CJ. The composition of the gut microbiome differs among community dwelling older people with good and poor appetite. J Cachexia Sarcopenia Muscle 2021; 12:368-377. [PMID: 33580637 PMCID: PMC8061352 DOI: 10.1002/jcsm.12683] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/07/2020] [Accepted: 01/10/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Anorexia of ageing is common and important in the development of sarcopenia in older individuals. Links have been proposed between the gut microbiota and sarcopenia. Disordered gut function is also recognized in anorexia of ageing, but how this may relate to resident gut microbiota is unexplored. Understanding this relationship may provide a basis for novel interventions for anorexia of ageing and sarcopenia. This study explores compositional differences of the gut microbiota between community dwelling healthy older adults with good or poor appetite, and associated differences in sarcopenia. METHODS We assessed appetite by the Simplified Nutritional Appetite Questionnaire (SNAQ) in members of the TwinsUK cohort aged ≥65 years. Using a pool of 776 individuals with existing microbiome data estimated from 16S rRNA sequencing data, we identified 102 cases (SNAQ score < 14) (95% female, mean age 68 years) matched to controls (SNAQ > 14) on body mass index, gender, age, diet, calorie consumption, frailty, antibiotic use, socio-economic status, and technical variables to minimize confounding microbiota associations. Species abundance and diversity, compositional differences, and paired differences in taxa abundance were compared between cases and controls. Additionally, we compared case and controls for sarcopenia as measured by muscle mass (appendicular lean mass/height2 ) and strength (chair stand time in seconds). RESULTS Cases with poor appetite had reduced species richness and diversity of their gut microbiome (adjusted OBSERVED: beta = -0.2, P < 0.001; adjusted SHANNON: beta = -0.17, P = 0.0135), significant compositional differences (adjusted non-parametric multivariate analysis of variance, P = 0.0095), and significant differences in taxa abundance including reduction of genus Lachnospira (logFC = -1.015, q = 0.023). In all-female subgroup analysis, cases with poor appetite demonstrated reduction in muscle strength (11.03 s vs. 9.26 s, P = 0.02). CONCLUSIONS This study is the first to observe differences in the composition of gut microbiota between healthy community dwelling older individuals with good and poor appetite. We found female individuals with reduced muscle strength had poor appetite compared with those with normal strength. These associations require further examination to understand causality and mechanisms of interaction, to inform potential strategies targeting the gut microbiota as a novel intervention for anorexia of ageing and sarcopenia.
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Affiliation(s)
- Natalie J Cox
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Tremona Road, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Ruth C E Bowyer
- Department of Twins Research and Genetic Epidemiology, Kings College London, St Thomas' Hospital, London, UK
| | - Mary Ni Lochlainn
- Department of Twins Research and Genetic Epidemiology, Kings College London, St Thomas' Hospital, London, UK
| | - Philippa M Wells
- Department of Twins Research and Genetic Epidemiology, Kings College London, St Thomas' Hospital, London, UK
| | - Helen C Roberts
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Tremona Road, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.,NIHR Applied Research Collaboration (ARC) Wessex, Southampton, UK
| | - Claire J Steves
- Department of Twins Research and Genetic Epidemiology, Kings College London, St Thomas' Hospital, London, UK.,Department of Ageing and Health, Guy's and St Thomas' NHS Foundation Trust, London, UK
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Timmons JF, Hone M, Cogan KE, Duffy O, Egan B. Increased Leg Strength After Concurrent Aerobic and Resistance Exercise Training in Older Adults Is Augmented by a Whole Food-Based High Protein Diet Intervention. Front Sports Act Living 2021; 3:653962. [PMID: 33842881 PMCID: PMC8034230 DOI: 10.3389/fspor.2021.653962] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 02/15/2021] [Indexed: 12/11/2022] Open
Abstract
Most studies in older adults have utilized powdered protein supplements or oral nutrition solutions as a source of additional dietary protein, but whole foods may provide a greater anabolic stimulus than protein isolated from food matrices. Therefore, the present study investigated a concurrent aerobic and resistance exercise training program in older adults, in the absence or presence of a high protein whole food-based dietary intervention, for effects on strength, physical function, and body composition. Community-dwelling older adults (n = 56; M/F, 28/28; age, 69.3 ± 4.0 years; BMI, 26.6 ± 3.7 kg m−2) participated in a 12-week intervention after randomization to either nutrition only (NUTR; n = 16), exercise only (EX, n = 19), or nutrition plus exercise (NUTR + EX, n = 21) groups. NUTR and NUTR + EX followed a dietary intervention targeting an increase in protein-rich meals at breakfast, lunch, and dinner. Exercise training in EX and NUTR + EX consisted of 24 min sessions of concurrent aerobic and resistance exercise performed three times per week. Daily protein intake increased in NUTR and NUTR + EX, but not EX. The increase in 1RM leg press strength was greater (Interaction effect, P = 0.012) in NUTR + EX [29.6 (18.1, 41.0) kg] than increases observed in NUTR [11.1 (−1.3, 23.6) kg] and EX [12.3 (0.9, 23.8) kg]. The increase in 1RM chest press strength was greater (interaction effect, P = 0.031) in NUTR + EX [6.3 (4.0, 8.6) kg] than the increase observed in NUTR [2.9 (0.3, 5.5) kg], but not EX [6.3 (3.9, 8.7) kg]. Hand-grip strength and sit-to-stand performance were each improved in all three groups, with no differences observed between groups (interaction effect, P = 0.382 and P = 0.671, respectively). An increase in percentage body fat was observed in NUTR, but not in EX or NUTR + EX (interaction effect, P = 0.018). No between-group differences were observed for change in lean body mass (interaction effect, P = 0.402). Concurrent aerobic and resistance exercise training improves strength and physical function in older adults, but combining this training with an increase in daily protein intake through whole foods may be advantageous to increase lower limb strength.
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Affiliation(s)
- James F Timmons
- Institute for Sport and Health, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Michelle Hone
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Karl E Cogan
- Institute for Sport and Health, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Orlaith Duffy
- Medfit Proactive Healthcare, Blackrock Co., Dublin, Ireland
| | - Brendan Egan
- School of Health and Human Performance, Dublin City University, Dublin, Ireland.,National Institute for Cellular Biotechnology, Dublin City University, Dublin, Ireland.,Florida Institute for Human and Machine Cognition, Pensacola, FL, United States
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Alhammadi K, Santos-Roldán L, Cabeza-Ramírez LJ. A Theoretical Framework on the Determinants of Food Purchasing Behavior of the Elderly: A Bibliometric Review with Scientific Mapping in Web of Science. Foods 2021; 10:foods10030688. [PMID: 33807054 PMCID: PMC8004734 DOI: 10.3390/foods10030688] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 03/09/2021] [Accepted: 03/17/2021] [Indexed: 12/23/2022] Open
Abstract
The past few years have seen significant demographic changes in most regions, including an increased elderly population. Subsequently, elderly citizens comprise an important market segment of consumers, with the food industry one of the most affected areas in this context. However, food market managers previously believed that elderly consumers’ needs were stereotyped in nature. The lack of focus on this sector, therefore, left elderly consumers as an untapped market, without realizing the financial independence of this segment regarding their nutrition. This research will attempt to provide the key determinant factors on elderly consumers’ behavior related to food. For that purpose, a complete literature review of more than 123 papers regarding these concepts has been carried out. Once analyzed, we highlight the common insights to give clear guidance for supermarket managers and food manufacturers to have a better knowledge of the reasons behind elderly people’s food acquisitions.
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Protein Knowledge of Older Adults and Identification of Subgroups with Poor Knowledge. Nutrients 2021; 13:nu13031006. [PMID: 33804787 PMCID: PMC8003958 DOI: 10.3390/nu13031006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/10/2021] [Accepted: 03/17/2021] [Indexed: 12/16/2022] Open
Abstract
The aim was to investigate the protein knowledge of community-dwelling older adults. A survey was conducted among 1825 adults aged ≥65 years and living in Finland, Netherlands, Poland, Spain and United Kingdom in 2017. Protein knowledge was measured with nine objective knowledge statements provided only to participants who indicated to know what the nutrient "protein" is (64.7% of sample). Demographic, socioeconomic and health determinants of poor protein knowledge were investigated using multiple logistic regression analyses. The sample was 49.6% female and 87.0% reported no walking difficulties. Participants scored best on the true statement "You need protein in the diet for repairing bones and muscles" (89.3% correct), and worst on the false statement "One meal per day with a good protein source is sufficient" (25.4% correct). Median knowledge score was 5.0 (scale 0–9) and poor knowledge was present in 49.4% of the sample. Males (Odds Ratio 1.57), those unable to walk for 5 min (2.66), not always making their own food decision (1.36) and having lower income (1.44) were more likely to have poor knowledge. Large differences were observed across countries. In conclusion, poor protein knowledge is present in about half of community-dwelling older adults. Communication strategies should be tailored to target the identified risk groups with poor knowledge.
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Prevalence of low protein intake in 80+-year-old community-dwelling adults and association with dietary patterns and modifiable risk factors: a cross-sectional study. Br J Nutr 2021; 127:266-277. [PMID: 33678212 DOI: 10.1017/s0007114521000799] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Low protein intake may accelerate age-related loss of lean mass and physical function. We investigated the prevalence of low protein intake (<1·0 g/kg/day) and the associations between dietary patterns, modifiable risk factors and low protein intake in self-reliant community-dwelling adults ≥ 80 years. This cross-sectional study consisted of two home visits. Data collection consisted of physical measurements (e.g. physical function, physical activity) and self-report of nutritional intake (4-d food records), appetite, eating symptoms and medical conditions. Binary analyses were performed to compare participants with low and normal protein intake. Multiple logistic regression analyses were performed to investigate associations between low protein intake, dietary patterns and modifiable risk factors adjusted for age, sex, BMI categories and diseases. One hundred twenty-six were included in the study. Prevalence of low protein intake was 54 %. A greater day-to-day variation in protein intake was associated with low protein intake (adjusted OR 2·5; 95 % CI 1·14, 5·48). Participants with low protein intake had a higher prevalence of nausea, diarrhoea and mouth dryness. Reduced appetite, mouth dryness and pain increased odds of low protein intake (adjusted OR 3·06, 95 % CI 1·23, 7·63; OR 3·41, 95 % CI 1·51, 7·7; OR 1·54, 95 % CI 1·00, 2·36, respectively). There was a high prevalence of low protein intake in community-dwelling adults aged ≥ 80 years. Day-to-day variability, appetite, mouth dryness and pain may be potentially modifiable risk factors. Targeting dietary patterns and risk factors in primary prevention strategies may potentially improve intake of protein and minimise risk of physical frailty.
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Li M, Zhao S, Wu S, Yang X, Feng H. Effectiveness of Oral Nutritional Supplements on Older People with Anorexia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2021; 13:nu13030835. [PMID: 33802580 PMCID: PMC8001033 DOI: 10.3390/nu13030835] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/11/2021] [Accepted: 02/26/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Nutrition plays an important role in maintaining the overall health of older people. Inadequate intake may lead to impaired body function, higher morbidity, and mortality. Oral nutritional supplements (ONS) showed positive effect on the nutritional status of the elderly; however, systematic evidence is currently lacking on the effect of ONS on the elderly with anorexia. AIMS The current systematic review and meta-analysis included randomized controlled trial (RCT) articles to investigate the effectiveness of ONS on the main aspects of anorexia of aging (AA). METHODS By using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method, researchers independently searched PubMed/MEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Library, China National Knowledge Infrastructure (CNKI) and other gray literature resources for publications that met the inclusion criteria by October 2020. The Cochrane Risk of Bias Tools were used for quality assessment. The inverse-variance method was used for the fixed model (FM) while the DerSimonian-Laird method was used for the random model (RM). Respective 95% confidence intervals (95% CIs), mean difference (MD) or standardized mean difference (SMD) was used for indices in terms of effect size (ES). RESULTS 2497 records were found through the systematic search, while 17 RCTs (n = 1204) were included, with a mean age of 81.9 years (range: 74-87 years). Supplementation occurred in the morning, mid-day, and evening, while the times varied from one to three times a day. The results of meta-analysis showed that, generally, ONS had a positive effect on the overall appetite, MD = 0.18, 95% CI (0.03, 0.33), p = 0.02, and consumption, MD = 1.43, 95% CI (0.01, 2.86), p = 0.05; but not significant in terms of other aspects of appetite: hunger, p = 0.73; fullness, p = 0.60; desire to eat, p = 0.80; preoccupation, p = 0.15. Additionally, it showed an increase in the overall energy intake, SMD = 0.46, 95% CI (0.29, 0.63), p < 0.001, in protein intake, SMD = 0.59, 95% CI (0.16, 1.02), p = 0.007, and in fat intake, MD = 3.47, 95% CI (1.98, 4.97), p < 0.001, while no positive effect was found on carbohydrates intake, p = 0.06. Significance differences were also found in the body weight, SMD = 0.53, 95% CI (0.41, 0.65), p < 0.001, and body mass index (BMI), MD = 0.53, 95% CI (0.12, 0.95), p = 0.01. Moreover, subgroup analyses were conducted according to the nutrient density with no positive results showed except for the low-density ONS on overall energy intake. CONCLUSIONS The results of the present study indicated that ONS had beneficial effects on overall appetite, energy intake, body weight and BMI.
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Affiliation(s)
| | | | | | | | - Hui Feng
- Correspondence: ; Tel.: +86-151-7312-1969
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Abstract
PURPOSE OF REVIEW The aim of this study was to highlight recent evidence on protein requirement and physical activity recommendations in older adults and their interrelationship. RECENT FINDINGS Higher protein intake in older adults is beneficial for better physical function, reduced fracture risk, healthy ageing and lower mortality. However, the association between protein quality and health remains inconsistent. Higher physical activity is associated with a lower risk of physical dependence, frailty, cognitive impairment and mortality. Prospectively increasing or even sustaining physical activity can be protective against adverse health outcomes compared with decreasing physical activity. There is a synergistic protective effect of protein intake and physical activity on health. Data on the bidirectional link between protein intake and physical activity are scarce. Whether increasing physical activity can help to increase energy intake (and thus protein intake) and vice versa require further research. SUMMARY The key role of protein intake and physical activity in optimizing health in older adults is well established. The synergistic effects of these two modifiable lifestyle factors strengthen the need to consider dietary and physical activity recommendations together. Future research may examine the bidirectional link between diet and physical activity, which could potentially be one of the strategies to increase the uptake of recommendations for protein intake and physical activity in older adults.
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Affiliation(s)
- Suey S Y Yeung
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Ruth S M Chan
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong
| | - Jean Woo
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
- Centre for Nutritional Studies, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
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Lin YC, Chang YH. Poor Appetite and Eating Difficulties Can Predict the Long-Term Risk of Falling: A Longitudinal Study in Middle-Aged and Older Adults. J Appl Gerontol 2020; 40:1465-1474. [PMID: 33267709 DOI: 10.1177/0733464820976439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES This study investigates whether self-reported nutritional status affects falling among middle-aged and older adults. METHOD We used 8-year follow-up data from the Taiwan Longitudinal Study on Aging. At baseline, respondents' appetite, changes in amount of food intake, and eating difficulties were assessed in a questionnaire-based survey in addition to anthropometric measurements (body mass index, mid-arm circumferences, and involuntary body weight loss). Their associations with falls in the follow-up were examined using multivariable log-binomial regression. RESULTS The study included 2,519 respondents aged 50 years and older. Poor appetite (prevalence ratio [PR] = 1.25, 95% confidence interval [CI] = [1.07, 1.46]) and eating difficulties (PR = 1.16, 95% CI = [1.02, 1.32]) significantly predicted falling 8 years later with adjustments for sociodemographics, health behaviors, comorbidities, and anthropometric measures by taking into account probabilities of follow-up. CONCLUSION Poor appetite and eating difficulties can predict falling in the long-term independent of anthropometric measurements among middle-aged and older adults.
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Affiliation(s)
- Yu-Chun Lin
- China Medical University Hospital, Taichung City, Taiwan
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Cox NJ, Er Lim S, Howson F, Moyses H, Ibrahim K, Sayer AA, Roberts HC, Robinson SM. Poor Appetite Is Associated with Six Month Mortality in Hospitalised Older Men and Women. J Nutr Health Aging 2020; 24:1107-1110. [PMID: 33244568 DOI: 10.1007/s12603-020-1442-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Appetite loss is common in hospitalised older individuals but not routinely assessed. Poor appetite in hospital has previously been identified as predictive of greater mortality in the six months following discharge in a single study of female patients. The present study aimed to assess this association in a larger sample including both hospitalised men and women. DESIGN Longitudinal observational study with six month follow up. SETTING Acute hospital wards in a single large hospital in England. PARTICIPANTS Older inpatients aged over 70 years. MEASUREMENTS Appetite was assessed using the Simplified Nutritional Appetite Questionnaire (SNAQ) during hospital stay. Deaths during six month follow-up period were recorded. Association between SNAQ score during hospital admission and death 6 months post-discharge was assessed using binary logistic regression in unadjusted and adjusted analysis. RESULTS 296 participants (43% female, mean age 83 years (SD 6.9)) were included in this study. Prevalence of poor appetite (SNAQ score <14) was 41%. In unadjusted analysis a SNAQ score of <14 was associated with a 2.47 increase in odds of mortality at six months (OR 2.47 (95% CI 1.27,4.82)). This association remained after adjusting for number of comorbidities (Charlson index), length of stay and gender (OR 2.62 (95% CI 1.30, 5.27)). In unadjusted continuous analysis, every one point decrease in SNAQ score led to a 1.20 fold increase in odds of mortality at six months (OR 1.20 (95% CI 1.06-1.36)). This association remained in adjusted analysis (OR 1.22 (95% CI 1.07-1.39)). CONCLUSION Poor appetite is common in hospitalised older people. We have confirmed the association, previously reported in older women, between poor appetite during hospital stay and greater mortality at six months post-discharge but in a larger study including older men and women. Further research is needed to understand the mechanisms of poor appetite, which lead to increased mortality.
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Affiliation(s)
- N J Cox
- NJ Cox, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Tremona Road, Southampton, UK,
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Amasene M, Besga A, Echeverria I, Urquiza M, Ruiz JR, Rodriguez-Larrad A, Aldamiz M, Anaut P, Irazusta J, Labayen I. Effects of Leucine-Enriched Whey Protein Supplementation on Physical Function in Post-Hospitalized Older Adults Participating in 12-Weeks of Resistance Training Program: A Randomized Controlled Trial. Nutrients 2019; 11:E2337. [PMID: 31581591 PMCID: PMC6835698 DOI: 10.3390/nu11102337] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 09/25/2019] [Indexed: 12/25/2022] Open
Abstract
Age-related strength and muscle mass loss is further increased after acute periods of inactivity. To avoid this, resistance training has been proposed as an effective countermeasure, but the additional effect of a protein supplement is not so clear. The aim of this study was to examine the effect of a whey protein supplement enriched with leucine after resistance training on muscle mass and strength gains in a post-hospitalized elderly population. A total of 28 participants were included and allocated to either protein supplementation or placebo supplementation following resistance training for 12 weeks (2 days/week). Physical function (lower and upper body strength, aerobic capacity and the Short Physical Performance Battery (SPPB) test), mini nutritional assessment (MNA) and body composition (Dual X-ray Absorptiometry) were assessed at baseline and after 12 weeks of resistance training. Both groups showed improvements in physical function after the intervention (p < 0.01), but there were no further effects for the protein group (p > 0.05). Muscle mass did not improve after resistance training in either group (p > 0.05). In conclusion, 12 weeks of resistance training are enough to improve physical function in a post-hospitalized elderly population with no further benefits for the protein-supplemented group.
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Affiliation(s)
- Maria Amasene
- Department of Pharmacy and Food Science, University of the Basque Country UPV/EHU, 01006 Vitoria-Gasteiz, Spain.
| | - Ariadna Besga
- Department of Medicine, Araba University Hospital, Bioaraba Research Institute, OSI Araba. CIBERSAM, University of the Basque Country (UPV/EHU), 01004 Vitoria-Gasteiz, Spain.
| | - Iñaki Echeverria
- Department of Physiology, University of the Basque Country, UPV/EHU, 48940 Leioa, Spain.
| | - Miriam Urquiza
- Department of Physiology, University of the Basque Country, UPV/EHU, 48940 Leioa, Spain.
| | - Jonatan R Ruiz
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain.
| | - Ana Rodriguez-Larrad
- Department of Physiology, University of the Basque Country, UPV/EHU, 48940 Leioa, Spain.
| | - Mikel Aldamiz
- Department of Medicine, Araba University Hospital, Bioaraba Research Institute, OSI Araba. CIBERSAM, University of the Basque Country (UPV/EHU), 01004 Vitoria-Gasteiz, Spain.
| | - Pilar Anaut
- Department of Medicine, Araba University Hospital, Bioaraba Research Institute, OSI Araba. CIBERSAM, University of the Basque Country (UPV/EHU), 01004 Vitoria-Gasteiz, Spain.
| | - Jon Irazusta
- Department of Physiology, University of the Basque Country, UPV/EHU, 48940 Leioa, Spain.
| | - Idoia Labayen
- ELIKOS group, Institute for Innovation and Sustainable Development in Food Chain (IS-FOOD), Public University of Navarra, 31006 Pamplona, Spain.
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Grasso AC, Hung Y, Olthof MR, Verbeke W, Brouwer IA. Older Consumers' Readiness to Accept Alternative, More Sustainable Protein Sources in the European Union. Nutrients 2019; 11:E1904. [PMID: 31443177 PMCID: PMC6723411 DOI: 10.3390/nu11081904] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 08/08/2019] [Accepted: 08/08/2019] [Indexed: 01/01/2023] Open
Abstract
Protein-energy malnutrition (PEM) is a growing concern on account of an aging population and its negative health consequences. While dietary protein plays a key role in the prevention of PEM, it also plays a pivotal role in the environmental impact of the human diet. In search for sustainable dietary strategies to increase protein intake in older adults, this study investigated the readiness of older adults to accept the consumption of the following alternative, more sustainable protein sources: plant-based protein, insects, single-cell protein, and in vitro meat. Using ordinal logistic regression modeling, the associations of different food-related attitudes and behavior and sociodemographics with older adults' acceptance to consume such protein sources were assessed. Results were obtained through a consumer survey among 1825 community-dwelling older adults aged 65 years or above in five EU countries (United Kingdom, the Netherlands, Poland, Spain, and Finland). Dairy-based protein was generally the most accepted protein source in food products (75% of the respondents found its consumption acceptable or very acceptable). Plant-based protein was the most accepted alternative, more sustainable protein source (58%) followed by single-cell protein (20%), insect-based protein (9%), and in vitro meat-based protein (6%). We found that food fussiness is a barrier to acceptance, whereas green eating behavior and higher educational attainment are facilitators to older adults' acceptance to eat protein from alternative, more sustainable sources. Health, sensory appeal, and price as food choice motives, as well as gender and country of residence were found to influence acceptance, although not consistently across all the protein sources. Findings suggest that there is a window of opportunity to increase older adults' acceptance of alternative, more sustainable protein sources and in turn increase protein intake in an environmentally sustainable way in EU older adults.
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Affiliation(s)
- Alessandra C Grasso
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Yung Hung
- Department of Agricultural Economics, Ghent University, Coupure links 653, B-9000 Ghent, Belgium.
| | - Margreet R Olthof
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
| | - Wim Verbeke
- Department of Agricultural Economics, Ghent University, Coupure links 653, B-9000 Ghent, Belgium
| | - Ingeborg A Brouwer
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands
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