Adequacy and change in nutrient and food intakes with aging in a seven-year cohort study in elderly women

Lactobacillus plantarum LLY-606 Supplementation Ameliorates the Cognitive Impairment of Natural Aging in Mice: The Potential Role of Gut Microbiota Homeostasis

This work explored the effects of Lactobacillus plantarum LLY-606 (LLY-606) on cognitive function in aging mice. Our findings demonstrated that LLY-606 effectively prolonged the lifespan of mice and improved age-related cognitive impairments. Additionally, our study revealed that supplementation with LLY-606 resulted in the downregulation of inflammatory cytokine levels and the upregulation of antioxidant capacity. Furthermore, probiotic supplementation effectively mitigated the deterioration of the intestinal barrier function in aging mice. Amplicon analysis indicated the successful colonization of probiotics, facilitating the regulation of age-induced gut microbiota dysbiosis. Notably, the functional abundance prediction of microbiota indicated that tryptophan metabolism pathways, glutamatergic synapse pathways, propanoate metabolism pathways, and arginine and proline metabolism pathways were enriched after the LLY-606 intervention. In summary, LLY-606 emerged as a potential functional probiotic capable of influencing cognitive function in aging mice. This effect was achieved through the modulation of gut microbiota, the regulation of synaptic plasticity, and the enhancement of neurotrophic factor levels.

Energy and nutrient intake by people with and without sarcopenia diagnosed by the European Working Group on Sarcopenia in Older People: a systematic review and meta-analysis

CONTEXT

There is growing evidence that insufficient dietary intake is associated with sarcopenia.

OBJECTIVE

In this systematic review and meta-analysis, the energy and nutrient intakes by people with and without sarcopenia were compared using only the European Working Group on Sarcopenia in Older People 2010 (EWGSOP1) and 2019 (EWGSOP2) consensus diagnostic criteria.

DATA SOURCES

Only observational studies that compared energy and nutrient intake from food alone by individuals with and without sarcopenia were included. Studies were searched in the following databases: Embase, PubMed, Scopus, Web of Science, Lilacs, Ovid, and Scopus. The review followed the PRISMA checklist and submitted the protocol to PROSPERO.

DATA EXTRACTION

Data were extracted by 2 authors independently. The methodological quality of the studies was assessed using the Newcastle-Ottawa scale.

DATA ANALYSIS

A total of 8648 articles were identified and 12 were selected. Among individuals with sarcopenia, lower intakes of energy and some nutrients, mainly with antioxidant properties, were observed compared with those without sarcopenia. Meta-analyses showed that individuals with sarcopenia consume fewer calories/day than individuals without sarcopenia (n = 10 studies; standardized mean difference (SMD) -0.15; 95% confidence interval: -0.29, -0.01) diagnosed by EWGSOP1 and EWGSOP2. Individuals with sarcopenia consume less omega-3, folate, magnesium, phosphorus, selenium, zinc, and vitamins C, D, and E when compared with those without sarcopenia.

CONCLUSION

The results of the present study suggest that insufficient intake of energy and nutrients with antioxidant potential may be associated with sarcopenia.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD 42020195698.

Associations of polyunsaturated fatty acids with cardiovascular disease and mortality: a study of NHANES database in 2003-2018

BACKGROUND

This study was to explore the association between dietary polyunsaturated fatty acids (PUFAs) consumption and cardiovascular diseases (CVDs), all-cause mortality, and CVD-specific mortality.

METHODS

This retrospective cohort study extracted demographic and clinical data of 38,838 adult participants from the National Health and Nutrition Examination Survey (NHANES) database in 2003-2018. We explored the association between octadecadienoic acid (ODA), octadecatrienoic acid (ALA), octadecatetraenoic acid (ODTA), eicosatetraenoic acid (AA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) and different CVDs using weighted univariate and multivariate logistic regression analyses with odds ratio (OR) and 95% confidence interval (CI). The PUFAs were divided into four levels according to the quartiles (≤ Q1, Q1 to Q2, Q1 to Q2, > Q3). Weighted univariate and multivariate COX regression analyses with hazard ratio (HR) and 95% CI were used for exploring the association between PUFAs and all-cause mortality, CVD-specific mortality and other cause-specific mortality.

RESULTS

During the follow-up, a total of 4,908 (9.12%) eligible participants died. The results showed that after adjusting for covariates, ODTA intake was related to low odds of coronary heart disease (CHD) [OR = 0.75, 95%CI: (0.64-0.88)]. Q1-Q2 quartile of ALA [OR = 0.81, 95%CI: (0.66-0.99)] and Q2-Q3 quartile of DPA [OR = 0.78, 95%CI: (0.62-0.99)] intakes were linked to low odds of heart attack, and > Q3 quartile of ODA intake was associated with low odds of congestive heart failure (CHF) [OR = 0.66, 95%CI: (0.49-0.90)] and stroke [OR = 0.65, 95%CI: (0.47-0.90)]. Q2-Q3 quartile of DPA intake was linked to low odds of angina [OR = 0.76, 95%CI: (0.58-0.99)]. Higher ALA intake was associated with a lower risk of all-cause mortality [Q2-Q3: HR = 0.86, 95%CI: (0.74-0.99); > Q3: HR = 0.76, 95%CI: (0.63-0.91)]. Additionally, Q2-Q3 quartile of ALA, Q1-Q2 quartile of AA and DPA intakes were respectively related to a low risk of CVD-specific mortality, while that > Q3 quartile of ALA related to that of mortality by other causes.

CONCLUSION

Our study found that PUFAs were associated with different CVDs, and higher ALA intake was related to lower risk of all-cause mortality. Ensuring adequate intake of PUFAs was beneficial to the health and may decrease the risk of mortality.

Vitamin D deficiency and insufficiency in Hawaii: Levels and sources of serum vitamin D in older adults

OBJECTIVE

To examine the major sources of vitamin D [25-hydroxyvitamin D (25(OH)D)] and evaluate their collective role on rates of vitamin D deficiency/insufficiency among older adults.

METHODS

Cross-sectional analysis of the relationship between serum 25(OH)D levels and sources of vitamin D (self-reported and objectively validated sun exposure, supplementation, food including fortified sources). Study subjects were part of the Hawaii Longitudinal Study of Personality and Health who completed a clinic visit between 55 and 65 years (M = 59.6) and food frequency questionnaire, and provided serum to assay 25(OH)D (n = 223).

RESULTS

Although mean serum 25(OH)D levels were overall sufficient (34.3 ng/ml, [SD = 10.9]), over one-third of participants (38%) had vitamin D deficiency/insufficiency (<30 ng/ml). Asians were the most likely to be insufficient and Filipinos were the least likely (43% vs. 11%, respectively). Overall, supplement use and sun exposure were both associated with higher 25(OH)D levels and lower risk of vitamin D deficiency/insufficiency. Moreover, Vitamin D sources varied by race/ethnic groups. In multivariate models, higher body mass index, being Asian or Native Hawaiian/Pacific Islander, low supplement use, and low sun exposure were associated with higher risk for vitamin D deficiency/insufficiency (<30 ng/ml).

CONCLUSIONS

Over 1/3 of the older adult sample was vitamin D deficient/insufficient, despite most of the participants living in a tropical climate with year-round access to sun as a vitamin D source. Sun exposure and supplement use, but not food intake, explained differences in vitamin D deficiency/insufficiency in this population.

Malnutrition Prevalence and Nutrient Intakes of Indonesian Community-Dwelling Older Adults: A Systematic Review of Observational Studies

Background

Malnutrition and inadequate nutrient intake are associated with functional decline, frailty, and bad clinical outcomes among community-dwelling older adults. Despite the growing proportion of the elderly population in Indonesia, data on the prevalence of malnutrition and adequacy of macronutrient and micronutrient intakes among Indonesian older adults are scattered and vary between studies. Therefore, our study aims to obtain data on malnutrition prevalence, level and distribution of nutrient intakes, and prevalence of macronutrient and micronutrient inadequacies in Indonesian community-dwelling older adults.

Methods

We carried out a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and registered in PROSPERO. A systematic electronic database search of MEDLINE, CENTRAL, EMBASE, ProQuest, HINARI, IMSEAR, GARUDA, and Indonesian Publication Index was undertaken. Additional searches were conducted in gray literature sources, hand-searching, retrospective searching, and personal communication with authors of the relevant publication. Observational studies presenting the malnutrition prevalence of habitual dietary intakes of older adults (60 years or older) were included. The risk of bias of studies was assessed using the Joanna Briggs Institute critical appraisal form. Sex-specific mean (and standard deviation) habitual macronutrient and a selection of micronutrients (calcium, vitamin D, and vitamin B12) intakes were extracted from each article to calculate the percentage of older people who were at risk for inadequate micronutrient intakes using a proxy of estimated average requirement (EAR) cut-point method, which is calculated from the national guideline of recommended dietary allowance (RDA). Prevalence of malnutrition, based on body mass index (BMI) categories and mini-nutritional assessment (MNA) criteria. and the population at risk of malnutrition were presented descriptively.

Results

Nine studies retrieved from electronic databases and gray literature were included in the pooled systematic analysis. According to BMI criteria, the underweight prevalence ranged from 8.0 to 26.6%. According to the MNA, the prevalence of malnutrition ranged from 2.1 to 14.6%, whereby the prevalence of at risk of malnutrition amounted to 18–78%. Our systematic review identified a high prevalence of nutrient inadequacies, most markedly for protein, calcium, vitamin D, and vitamin B12.

Conclusion

We signal a high risk of malnutrition along with poor macronutrients and micronutrients intakes among Indonesian community-dwelling older adults. These findings provide important and robust evidence on the magnitude of malnutrition and nutrient inadequacy concerns that call for appropriate nutrition, as well as public health policies and prompt intervention.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018102268.

The Acute Effects of Breakfast Drinks with Varying Protein and Energy Contents on Appetite and Free-Living Energy Intake in UK Older Adults

Proposed strategies for preventing protein deficiencies in older patients include increasing protein intake at breakfast. However, protein is highly satiating and the effects of very high protein intakes at breakfast on subsequent appetite and free-living energy intake (EI) in older adults are unclear. This study compared the acute effects of two breakfast drinks varying in protein and energy contents on appetite and free-living EI in healthy older adults using a randomized 2 × 2 crossover design. Participants (n = 48 (20 men, 28 women); mean ± SD age: 69 ± 3 years; BMI: 22.2 ± 2.0 kg·m⁻²; fat-free mass: 45.5 ± 8.0 kg) consumed two drinks for breakfast (high-protein (30.4 ± 5.3 g), low-energy (211.2 ± 37.1 kcal) content (HPLE) and very high-protein (61.8 ± 9.9 g), fed to energy requirements (428.0 ± 68.9 kcal) (VHPER)) one week apart. Appetite perceptions were assessed for 3 h post-drink and free-living EI was measured for the remainder of the day. Appetite was lower in VHPER than HPLE from 30 min onwards (p < 0.01). Free-living energy and protein intake did not differ between conditions (p = 0.814). However, 24 h EI (breakfast drink intake + free-living intake) was greater in VHPER than HPLE (1937 ± 568 kcal vs. 1705 ± 490 kcal; p = 0.001), as was 24 h protein intake (123.0 ± 26.0 g vs. 88.6 ± 20.9 g; p < 0.001). Consuming a very high-protein breakfast drink acutely suppressed appetite more than a low-energy, high-protein drink in older adults, though free-living EI was unaffected. The long-term effects of adopting such a breakfast strategy in older adults at high risk of energy and protein malnutrition warrants exploration.

Intake of isoflavones reduces the risk of all-cause mortality in middle-aged Japanese

BACKGROUND/OBJECTIVES

To clarify the effects of intake of legumes and isoflavones on all-cause mortality in middle-aged and older Japanese.

SUBJECT/METHODS

The subjects were 2136 randomly chosen community-dwelling Japanese men and women aged 40-79 years who participated in a first-wave survey (1997-2000; baseline). The subjects were followed from baseline to December 31, 2017 (mean period of 16.6 ± 4.2 years). Intake of legumes, soybeans, and isoflavones at baseline was assessed using a 3-day dietary record with photographs. The relationships of intake amounts of legumes and isoflavones to mortality were assessed using Cox proportional hazards regression controlling for age, sex, education, employment, body mass index, smoking habits, medical histories, drinking, and energy intake.

RESULTS

There were 491 deaths during the follow-up period. We found inverse associations of the intake of total soy products and intake of each of the isoflavones with all-cause mortality (p for trend < 0.05) in subjects aged < 60 years: the multivariate-adjusted hazard ratios (95% confidence intervals) for all-cause mortality in the highest intake group (third tertile) of total soy products and total isoflavones were 0.32 (0.13-0.78) and 0.35 (0.17-0.73), respectively, compared with the reference group (first tertile). In contrast, there were no significant associations of intake amounts of legumes, soybeans, and isoflavones with all-cause mortality in subjects aged 60 years or older.

CONCLUSIONS

The findings suggest that a higher intake of isoflavones might decrease the risk of all-cause mortality, especially in middle-aged Japanese.

Functional Aging in Male C57BL/6J Mice Across the Life-Span: A Systematic Behavioral Analysis of Motor, Emotional, and Memory Function to Define an Aging Phenotype

Aging is characterized generally by progressive and overall physiological decline of functions and is observed in all animals. A long line of evidence has established the laboratory mouse as the prime model of human aging. However, relatively little is known about the detailed behavioral and functional changes that occur across their lifespan, and how this maps onto the phenotype of human aging. To better understand age-related changes across the life-span, we characterized functional aging in male C57BL/6J mice of five different ages (3, 6, 12, 18, and 22 months of age) using a multi-domain behavioral test battery. Spatial memory and physical activities, including locomotor activity, gait velocity, and grip strength progressively declined with increasing age, although at different rates; anxiety-like behaviors increased with aging. Estimated age-related patterns showed that these functional alterations across ages are non-linear, and the patterns are unique for each behavioral trait. Physical function progressively declines, starting as early as 6 months of age in mice, while cognitive function begins to decline later, with considerable impairment present at 22 months of age. Importantly, functional aging of male C57BL/6J mouse starts at younger relative ages compared to when it starts in humans. Our study suggests that human-equivalent ages of mouse might be better determined on the basis of its functional capabilities.

Exploring trajectories in dietary adequacy of the B vitamins folate, riboflavin, vitamins B6 and B12, with advancing older age: a systematic review

Maintaining nutritional adequacy contributes to successful ageing. B vitamins involved in one-carbon metabolism regulation (folate, riboflavin, vitamins B6 and B12) are critical nutrients contributing to homocysteine and epigenetic regulation. Although cross-sectional B vitamin intake in ageing populations is characterised, longitudinal changes are infrequently reported. This systematic review explores age-related changes in dietary adequacy of folate, riboflavin, vitamins B6 and B12 in community-dwelling older adults (≥65 years at follow-up). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, databases (MEDLINE, Embase, BIOSIS, CINAHL) were systematically screened, yielding 1579 records; eight studies were included (n 3119 participants, 2–25 years of follow-up). Quality assessment (modified Newcastle–Ottawa quality scale) rated all of moderate–high quality. The estimated average requirement cut-point method estimated the baseline and follow-up population prevalence of dietary inadequacy. Riboflavin (seven studies, n 1953) inadequacy progressively increased with age; the prevalence of inadequacy increased from baseline by up to 22·6 and 9·3 % in males and females, respectively. Dietary folate adequacy (three studies, n 2321) improved in two studies (by up to 22·4 %), but the third showed increasing (8·1 %) inadequacy. Evidence was similarly limited (two studies, respectively) and inconsistent for vitamins B6 (n 559; −9·9 to 47·9 %) and B12 (n 1410; −4·6 to 7·2 %). This review emphasises the scarcity of evidence regarding micronutrient intake changes with age, highlighting the demand for improved reporting of longitudinal changes in nutrient intake that can better direct micronutrient recommendations for older adults. This review was registered with PROSPERO (CRD42018104364).

Lipids: biomarkers of healthy aging

Life expectancy, and longevity have been increasing in recent years. However, this is, in most cases, accompanied by age-related diseases. Thus, it became essential to better understand the mechanisms inherent to aging, and to establish biomarkers that characterize this physiological process. Among all biomolecules, lipids appear to be a good target for the study of these biomarkers. In fact, some lipids have already been associated with age-related diseases. With the development of analytical techniques such as Mass Spectrometry, and Nuclear Magnetic Resonance, Lipidomics has been increasingly used to study pathological, and physiological states of an organism. Thus, the study of serum, and plasma lipidome in centenarians, and elderly individuals without age-related diseases can be a useful tool for the identification of aging biomarkers, and to understand physiological aging, and longevity. This review focus on the importance of lipids as biomarkers of aging, and summarize the changes in the lipidome that have been associated with aging, and longevity.

Energy, Macronutrients, Dietary Fibre and Salt Intakes in Older Adults in Ireland: Key Sources and Compliance with Recommendations

The global population is rapidly ageing. Adequate nutritional status can play a key role in preventing or delaying the progression of age-related diseases. The aim of this study was to estimate the usual intake of energy, macronutrients, dietary fibre and salt in order to determine compliance with recommendations and to identify the sources of these nutrients in older adults (≥65 years) in Ireland. This study is based on data from the cohort of older adults aged ≥65 years (n = 226) in the Irish National Adult Nutrition Survey (NANS) (2008-2010) which estimated food and nutrient intakes in a representative sample of adults 18-90 years using a 4 day weighed food record. This study found that while intakes of macronutrients are generally sufficient in this population group, older adults in Ireland have high intakes of total fat, saturated fat, sugar and salt and low intakes of dietary fibre. Future strategies to address the nutritional issues identified in older adults could include the promotion of healthy food choices together with improvements of the food supply including reformulation (fat, sugar and salt) to support successful ageing of our population.

The Impact of Changes in the Intake of Fiber and Antioxidants on the Development of Chronic Obstructive Pulmonary Disease

Diet is a health-related factor that can modify lung function. This study hypothesized that the change in age-related dietary intake affects lung function. The subjects who undertook a dietary assessment and spirometry in 2012 and 2017, were retrospectively collected in a health screening center. Dietary intakes were directly evaluated using food frequency questionnaires (FFQ) administered by trained dietitians and were compared at the baseline (2012) and 5-year follow-up (2017). A forced expiratory volume in one second (FEV₁)/forced vital capacity (FVC) value below 0.70 was defined as airflow limitation. Logistic regression models were used to estimate the odds ratio (ORs) adjusted for potential confounders. A total of 1439 subjects with normal spirometry were enrolled. New airflow limitations were detected in 48 subjects (3.3%) at the 5-year follow-up, including 41 (85.4%) men and 11 (22.9%) current smokers. After adjusting for age, sex, smoking history, and baseline FEV1/FVC, the odd ratios (OR) for new airflow limitation in fiber, vitamin C, and folic acid per 10% decrease in daily recommended requirement were 2.714 (95% confidence interval (CI), 1.538–4.807; p = 0.001), 1.083 (95% CI: 1.020–1.149; p = 0.007), and 1.495 (95% CI: 1.172–1.913; p = 0.001), respectively. A decreased intake of dietary fiber, vitamin C, and folic acid is associated with a newly developed airflow limitation.

The Association between Dietary Amino Acid Intake and Cognitive Decline 8 Years Later in Japanese Community-Dwelling Older Adults

OBJECTIVES

Previous studies have reported a relationship between low protein intake and cognitive decline and have suggested that this association may be related to specific amino acid intake. However, the effects of amino acid intake on the maintenance of cognitive function have yet to be clarified. We examined the longitudinal association between dietary amino acid intake and cognitive function in community-dwelling older adults.

DESIGN

Longitudinal epidemiological study.

SETTING

Community-based setting.

PARTICIPANTS

This study comprised 427 study participants aged 60-82 years with no cognitive decline, defined as a Mini-Mental State Examination (MMSE) score of >27 at baseline, who also participated in a follow-up. The average and standard deviation of the follow-up period was 8.2 ± 0.3 years.

MEASUREMENTS

Dietary intake was assessed using three-day dietary records at baseline. Participants were classified into quartiles (Q1-Q4) based on the intake of 19 amino acids for males and females. Next, we classified participants into Q1 and Q2-Q4 groups. Cognitive function was assessed using the MMSE both at baseline and at follow-up. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between the Q1 group and cognitive decline (MMSE ≤27), using the Q2-Q4 group as a reference group. Covariates were age, sex, body mass index, years of education, severity of depressive symptoms, history of lifestyle diseases (hypertension, dyslipidemia, diabetes mellitus, stroke, and ischemic heart disease), energy intake (kcal/d), protein intake (g/d), and MMSE score at baseline.

RESULTS

Cognitive decline was present in 133 (31.1%) participants. After adjustment for covariates, including total protein intake, the ORs (95% CIs) for cognitive decline were 2.40 (1.21-4.75) for lysine, 2.05 (1.02-4.09) for phenylalanine, 2.18 (1.09-4.34) for threonine, and 2.10 (1.06-4.15) for alanine.

CONCLUSION

The results suggest that lysine, phenylalanine, threonine, and alanine intake is important for the maintenance of cognitive function in older people, independent of total protein intake.

Association between Oral Frailty and Dietary Variety among Community-Dwelling Older Persons: A Cross-Sectional Study

OBJECTIVE

To examine the association between the severity of oral frailty (OF), which is one of the comprehensive oral functions evaluated, and dietary variety in community-dwelling older persons.

DESIGN

Cross-sectional study.

SETTING

Community-based.

PARTICIPANTS

A total of 769 community-dwelling older persons aged 65 and over.

INTERVENTIONS

We examined basic demographic information, functional status, cognitive status, depressive symptoms, medical history, and oral functions of the participants.

MEASUREMENTS

OF was defined by 1-2 and 3 or more of 6 items of oral function evaluation in the pre-oral frailty and oral frailty groups, respectively. Dietary variety was assessed using the dietary variety score (DVS). The participants were categorized into 3 groups for evaluation: those with a low score (0-2), medium score (3-5), and high score (≥6). Ordinal logistic regression analysis was performed to examine the association between OF and DVS.

RESULTS

The rate of OF in the participants was 21.6%, and its severity was significantly associated with DVS after adjusting for potential confounders (Pre-OF; adjusted odds ratio [OR] = 1.687, 95% confidence interval [CI] = 1.219-2.335, OF; adjusted OR = 2.857, 95% CI = 1.489-5.484).

CONCLUSION

The severity of OF was significantly associated with DVS in community-dwelling older persons. This suggests that DVS may be useful in understanding the effects of OF on the nutritional status. Further longitudinal studies are needed to elucidate the association between OF and DVS.

Appetite Control across the Lifecourse: The Acute Impact of Breakfast Drink Quantity and Protein Content. The Full4Health Project

Understanding the mechanisms of hunger, satiety and how nutrients affect appetite control is important for successful weight management across the lifecourse. The primary aim of this study was to describe acute appetite control across the lifecourse, comparing age groups (children, adolescents, adults, elderly), weight categories, genders and European sites (Scotland and Greece). Participants (n = 391) consumed four test drinks, varying in composition (15% (normal protein, NP) and 30% (high protein, HP) of energy from protein) and quantity (based on 100% basal metabolic rate (BMR) and 140% BMR), on four separate days in a double-blind randomized controlled study. Ad libitum energy intake (EI), subjective appetite and biomarkers of appetite and metabolism (adults and elderly only) were measured. The adults' appetite was significantly greater than that of the elderly across all drink types (p < 0.004) and in response to drink quantities (p < 0.001). There were no significant differences in EI between age groups, weight categories, genders or sites. Concentrations of glucagon-like peptide 1 (GLP-1) and peptide YY (PYY) were significantly greater in the elderly than the adults (p < 0.001). Ghrelin and fasting leptin concentrations differed significantly between weight categories, genders and sites (p < 0.05), while GLP-1 and PYY concentrations differed significantly between genders only (p < 0.05). Compared to NP drinks, HP drinks significantly increased postprandial GLP-1 and PYY (p < 0.001). Advanced age was concomitant with reduced appetite and elevated anorectic hormone release, which may contribute to the development of malnutrition. In addition, appetite hormone concentrations differed between weight categories, genders and geographical locations.

Displacing Sedentary Behaviour with Light Intensity Physical Activity Spontaneously Alters Habitual Macronutrient Intake and Enhances Dietary Quality in Older Females

Displacing Sedentary Behaviour (SB) with light intensity physical activity (LIPA) is increasingly viewed as a viable means of health enhancement. It is, however, unclear whether any behavioural compensations accompany such an intervention. Therefore, the aim of this study was to identify any dietary changes that accompany SB displacement. We hypothesised that SB displacement would improve dietary quality. Thirty-five elderly females (73 ± 5 years) were randomly allocated to one of three groups: (1) sedentary behaviour fragmentation (SBF) (n = 14), (2) continuous LIPA (n = 14), or (3) control (n = 7). Habitual diet (four-day food diary) and physical behaviour (accelerometery) were assessed at weeks 0 and 8. Out of 45 nutrients examined, only glucose exhibited a group × time interaction (p = 0.03), mediated by an exclusive reduction following SBF (-31%). SBF was also the sole experimental group to increase nutrients promoting bone health (SBF: 17%, LIPA: -34%. control: 21%), whereas both experimental groups consumed more nutrients promoting anabolism (SBF: 13%, LIPA: 4%, control: -34%) (z-scores). New ambulators (n = 8) also consumed more nutrients promoting bone health (16%)/anabolism (2%) (z-scores), including significantly increased Zinc intake (p = 0.05, 29%). Displacing SB with LIPA improves dietary quality in older females. Furthermore, SB fragmentation appears advantageous for various dietary outcomes.

Trace Mineral Intake and Deficiencies in Older Adults Living in the Community and Institutions: A Systematic Review

The global population is ageing with many older adults suffering from age-related malnutrition, including micronutrient deficiencies. Adequate nutrient intake is vital to enable older adults to continue living independently and delay their institutionalisation, as well as to prevent deterioration of health status in those living in institutions. This systematic review investigated the insufficiency of trace minerals in older adults living independently and in institutions. We examined 28 studies following a cross-sectional or cohort design, including 7203 older adults (≥60) living independently in 13 Western countries and 2036 living in institutions in seven Western countries. The estimated average requirement (EAR) cut-off point method was used to calculate percentage insufficiency for eight trace minerals using extracted mean and standard deviation values. Zinc deficiency was observed in 31% of community-based women and 49% of men. This was higher for those in institutional care (50% and 66%, respectively). Selenium intakes were similarly compromised with deficiency in 49% women and 37% men in the community and 44% women and 27% men in institutions. We additionally found significant proportions of both populations showing insufficiency for iron, iodine and copper. This paper identifies consistent nutritional insufficiency for selenium, zinc, iodine and copper in older adults.

Dietary Micronutrients Intake Status among Chinese Elderly People Living at Home: Data from CNNHS 2010-2012

The aim of this study was to examine the status of usual dietary micronutrient intakes among Chinese elderly living at home. The data was based on China National Nutrition and Health Survey (CNNHS) 2010-2012. We analyzed data from the participants aged 60-year-old and more (n = 16,612) living at home, who provided dietary data on three days 24 h dietary survey combining with the household weighing method. The means and distribution percentiles for usual intakes of dietary micronutrients were estimated using the Multiple Source Method (MSM). The prevalence of inadequacy for the selected micronutrients was expressed using the proportion of individuals with usual intakes below the Estimated Average Requirement (EAR). For vitamin E, sodium and potassium, the means and the distribution of intakes were compared to the Adequate Intake (AI) level. Usual dietary intakes of most micronutrients were inadequate in the participants, especially folate, calcium, vitamin B6 and vitamin B2, with the prevalence of inadequacy more than 90%. However, dietary sodium intake was extremely high with an average usual intake of 4702 mg/day. The usual dietary intakes of all selected micronutrients in old males were higher than females, and the prevalence of inadequacy of most micronutrients was higher in old women (p < 0.01). The subjects aged 60-74 years tended to have higher usual dietary micronutrient intakes and lower prevalence of inadequate micronutrients than those aged 75 years and over (p < 0.01). Higher usual dietary intakes and lower prevalence of inadequacy of most micronutrients were found in the elderly living in the southern region (p < 0.01). The average usual intakes of most micronutrients declined with socioeconomic status. The prevalence of inadequate vitamin A, B2, C, calcium and selenium below EAR increased with socioeconomic status (p < 0.01, p for trend < 0.01). Thus, essential micronutrients insufficient intake is a public health concern among Chinese community-dwelling old population, especially the females, older people, the elderly in undeveloped areas or living in northern regions. Nutrition education and appropriate approach should be undertaken to address these problems.

Fish and Meat Intake, Serum Eicosapentaenoic Acid and Docosahexaenoic Acid Levels, and Mortality in Community-Dwelling Japanese Older Persons

The associations between meat/fish consumption, docosahexaenoic acid (DHA)/eicosapentaenoic acid (EPA) intakes, and blood DHA/EPA levels, and mortality in Japan were examined as part of the National Institute for Longevity Sciences-Longitudinal Study of Aging: 520 men and 534 women (60–79 years at baseline) were followed from 1997–2017. Nutritional intakes were assessed using a 3-day dietary record and fasting venous blood samples were collected. Serum EPA/DHA concentrations, the EPA/arachidonic acid (ARA) ratio, EPA/DHA intakes, and fish/meat intakes were examined in tertiles as indicator variables, and hazard ratios (HR) were calculated to compare the risk of death across tertiles controlling for sex, age, body mass index, smoking status, alcohol drinking, physical activity, education, employment, and history of diseases. During follow-up (mean 11.7 years), 422 subjects (40.4%) died. The multivariate-adjusted HR for all-cause mortality in subjects in the highest tertile of serum DHA and EPA/ARA ratio was 0.73 (95% confidence intervals (CI): 0.53–0.99) and 0.71 (95% CI: 0.53–0.96) compared with subjects in the lowest tertile, respectively (trend p < 0.05). There were no significant associations between mortality and serum EPA/ARA and DHA/EPA intakes. An increased serum DHA level or EPA/ARA ratio might be recommended for longevity to Japanese community dwellers.

The Prevalence of Vitamin D Deficiency and the Determinants of 25(OH)D Concentration in Older Irish Adults: Data From The Irish Longitudinal Study on Ageing (TILDA)

Background

Few data are available examining the determinants of vitamin D status exclusively in older adults. We aimed to investigate the prevalence and determinants of vitamin D deficiency in a representative sample of the older Irish population (aged 50-98 years).

Methods

The concentration of 25-hydroxyvitamin D (25(OH)D) was measured in 5,356 community-dwelling older Irish adults from The Irish Longitudinal Study on Ageing (TILDA). Detailed demographic, geographic, lifestyle, and socioeconomic factors were assessed by questionnaire. Proportions of deficiency prevalence were generated by season sampled. Linear regression was used to investigate the association between 25(OH)D concentration and reported risk factors.

Results

The prevalence of deficiency (25(OH)D < 30 nmol/L) was 13.1% (95% CI: 12.1-14.2). Deficiency status was more prevalent in nonsupplement users, in winter, in smokers, in obese adults, the physically inactive, those living alone, and in the oldest old (>80 years). The main predictors (p < .05) of 25(OH)D concentration were supplement use (coefficient nmol/L: 27.2 [95% CI: 15.3-39.2]), smoking (-8.9 [-12.6--5.2]), summer season (5.9 [2.7-9.1]), and obesity (-4.0 [-6.3--1.7]).

Conclusion

Vitamin D deficiency is common among older Irish adults. These data indicate the need for targeted strategies within sections of the older population to improve vitamin D status.

Nutritional challenges for older adults in Europe: current status and future directions

Population ageing is rapidly progressing and it is estimated that by 2050 one in every five people globally will be aged 60 years or over. Research has shown that adequate nutritional status can positively impact the ageing process, resulting in improved quality of life and the prevention of chronic disease and mortality. However, due to physiological and social changes associated with ageing, older adults may be at increased risk of nutrient deficiencies. This review aims to investigate the nutrient intake and status of older adults in Europe and to explore the potential role of fortified foods and nutritional supplements in addressing some of the nutritional challenges identified in this population group. The available literature has highlighted unfavourable intakes of total and saturated fat, sugar, salt and dietary fibre together with low intakes and suboptimal status of key micronutrients such as vitamins D, B2, B12, folate and calcium. Evidence has shown that the consumption of fortified foods and use of nutritional supplements make significant contributions to intakes and status of these micronutrients in older adults. Continued monitoring of nutrient intake and status is important in light of changing fortification practices and food consumption patterns. Future strategies to address the nutritional issues identified in older adults could include the promotion of healthy food choices together with improvements of the food supply including reformulation (fat, sugar and salt), food fortification or supplementation to support successful ageing of our populations.

Protein Carbamylation: A Marker Reflecting Increased Age-Related Cell Oxidation

Carbamylation is a post-translational modification of proteins that may partake in the oxidative stress-associated cell damage, and its increment has been recently proposed as a “hallmark of aging”. The molecular mechanisms associated with aging are related to an increased release of free radicals. We have studied whether carbamylated proteins from the peripheral blood of healthy subjects are related to oxidative damage and aging, taking into account the gender and the immune profile of the subjects. The study was performed in healthy human volunteers. The detection of protein carbamylation and malondialdehyde (MDA) levels was evaluated using commercial kits. The immune profile was calculated using parameters of immune cell function. The results show that the individuals from the elderly group (60–79 years old) have increased carbamylated protein and MDA levels. When considered by gender, only men between 60 and 79 years old showed significantly increased carbamylated proteins and MDA levels. When those subjects were classified by their immune profile, the carbamylated protein levels were higher in those with an older immune profile. In conclusion, the carbamylation of proteins in peripheral blood is related to age-associated oxidative damage and to an aging functional immunological signature. Our results suggest that carbamylated proteins may play an important role at the cellular level in the aging process.

Taste loss in the elderly: Possible implications for dietary habits

Aging may coincide with a declining gustatory function that can affect dietary intake and ultimately have negative health consequences. Taste loss is caused by physiological changes and worsened by events often associated with aging, such as polypharmacy and chronic disease. The most pronounced increase in elderly people's detection threshold has been observed for sour and bitter tastes, but their perception of salty, sweet, and umami tastes also seems to decline with age. It has often been suggested that elderly people who lose their sense of taste may eat less food or choose stronger flavors, but the literature has revealed a more complicated picture: taste loss does not appear to make elderly people prefer stronger flavors, but nutrition surveys have pointed to a greater consumption of sweet and salty foods. Real-life eating habits thus seem to be more influenced by other, social and psychological factors. Elderly gustatory function is worth investigating to identify dietary strategies that can prevent the consequences of unhealthy eating habits in the elderly. This paper discusses age-related changes in taste perception, focusing on their consequences on food preferences, and pointing to some strategies for preserving appropriate dietary habits in elderly people.

Age-Related 12-Year Changes in Dietary Diversity and Food Intakes among Community-Dwelling Japanese Aged 40 to 79 Years

OBJECTIVES

This study describes trends in dietary diversity and food intake over 12 years according to age at first participation in the study.

DESIGN

Prospective cohort study.

SETTING

The National Institute for Longevity Sciences - Longitudinal Study of Aging, a community-based study.

PARTICIPANTS

Participants included 922 men and 879 women who participated in the first study-wave (age, 40-79 years) and also participated in at least one study-wave from the second to seventh study-wave. Study-waves were conducted biennially.

MEASUREMENTS

Dietary intake was calculated from 3-day dietary records with photographs. Dietary diversity was determined using the Quantitative Index for Dietary Diversity based on food intake. A mixed-effects model was used to estimate linear changes in dietary diversity and food intake over 12 years according to age at first study-wave.

RESULTS

Mean (standard deviation (SD)) follow-up time and number of study-wave visits were 9.5 (3.7) years and 5.4 (1.8), respectively. Mean (SD, range) dietary diversity score was 0.86 (0.06, 0.52-0.96) in men and 0.88 (0.04, 0.66-0.96) in women, respectively. Fixed effects for interactions of age and time with dietary diversity score were statistically significant (p<0.05). The slope of dietary diversity among men aged 40 to 55 years increased (40-year-old slope = 0.00093/year, p<0.01; 55-year-old slope = 0.00035/year, p=0.04), with a decreasing trend started at 65 years old, although this trend was not significant (65-year-old slope = -0.00003/year, p=0.88; 79-year-old slope = -0.00057/year, p=0.21). The slope of dietary diversity among women aged 40 to 44 years increased (40-year-old slope = 0.00053/year, p=0.02; 44-year-old slope = 0.00038/year, p=0.04), whereas the slope of dietary diversity among women aged 63 to 79 years decreased (63-year-old slope = -0.00033/year, p=0.03; 79-year-old slope = -0.00092/year, p<0.001). Fruit, milk and dairy intake decreased in men around their 60s; milk and dairy intake decreased in women around their 50s; and beans and fruit intake decreased in women from their 70s.

CONCLUSION

Twelve-year longitudinal data showed dietary diversity declined in women in their 60s. In terms of food intake, fruit, milk and dairy intake decreased in both sexes in their 50s and 60s; such declines would lower dietary diversity.

Diet, the intestinal microbiota, and immune health in aging

Many countries are facing aging populations, with those over 65 years of age likely to represent the largest population over the next 10-20 years. Living longer often comes with poor health and, in particular, a decline in the immune function characterized by poor vaccine responses and increased risk of infection and certain cancers. Aging and diet represent major intrinsic and extrinsic factors that influence the makeup and activity of resident intestinal microbes, the microbiota, the efficient functioning of which is essential for sustaining overall health and the effectiveness of the immune system. The provision of elderly specific dietary recommendations appears to be lacking but is necessary since this population has an altered microbiota and immune response and may not respond in the same way as their healthy and younger counterparts. We have reviewed the evidence supporting the role of diet and, in particular, dietary carbohydrate, protein, and fat in influencing the microbiota and its generation of key metabolites that influence the efficient functioning of immune cells during aging, and how dietary intervention might be of benefit in improving the intestinal health and immune status in the elderly.

Dairy Intakes in Older Irish Adults and Effects on Vitamin Micronutrient Status: Data from the TUDA Study

BACKGROUND

Consumption of dairy products has been associated with positive health outcomes including a lower risk of hypertension, improved bone health and a reduction in the risk of type 2 diabetes. The suggested dairy intake for health in older adults is three servings per day but recent analysis of the NHANES data for older adults reported 98% were not meeting these recommendations. No studies have investigated the consequences of such declines in the dairy intakes of Irish older adults and the subsequent effects on vitamin micronutrient status.

OBJECTIVES

To study the daily dairy intakes of older Irish adults and to examine how the frequency of dairy food consumption affects vitamin micronutrient status.

METHODS

Participants (n 4,317) were from the Trinity Ulster Department of Agriculture (TUDA) Study, a large study of older Irish adults (aged >60 yrs) designed to investigate gene-nutrient interactions in the development of chronic diseases of aging. The daily intake portion for milk, cheese and yoghurt was calculated from food frequency questionnaire (FFQ) responses. Blood samples were analysed for vitamin biomarkers as follows: vitamin B12 (total serum cobalamin and holotranscobalamin (holoTC)), folate (red cell folate (RCF) and serum folate), vitamin B2 (erythrocyte glutathione reductase activation coefficient (EGRac)), vitamin B6 (serum pyridoxal phosphate) and vitamin D (serum 25(OH)D).

RESULTS

The mean total reported dairy intake was 1.16 (SD 0.79) portions per day with males consuming significantly fewer total dairy portions compared to females (1.07 vs 1.21 respectively) (P<0.05). There was no significant difference in total daily dairy serving intakes by age decade (60-69, 70-79, >80 yrs). Overall, only 3.5% of the total population (n 151) achieved the recommended daily dairy intake of three or more servings per day. A significantly higher proportion of females (4%) compared to males (2.4%) met these dairy requirements (P=0.011). Blood concentrations of vitamin B12 biomarkers, RCF, vitamin B2 and vitamin B6 were significantly worse in those with the lowest tertile of dairy intake (0-0.71 servings) compared to those in the highest tertile (1.50-4.50 servings) (P<0.05).

CONCLUSION

This study found that more than 96% of the older adults sampled did not meet current daily dairy intake recommendations. The study is the largest to-date examining dairy intakes in older Irish adults, and provides evidence that daily dairy intakes (in particular yogurt) contribute significantly to the B-vitamin and vitamin D biomarker status of older adults. These results suggest that older adults who are already vulnerable to micronutrient inadequacies, are forgoing the nutritional advantages of vitamin-rich dairy products.

The effect of modifiable healthy practices on higher-level functional capacity decline among Japanese community dwellers

This study aimed to clarify the effects of the accumulation of 8 modifiable practices related to health, including smoking, alcohol drinking, physical activity, sleeping hours, body mass index, dietary diversity, ikigai (life worth living), and health checkup status, on higher-level functional capacity decline among Japanese community dwellers. Data were derived from the National Institute for Longevity Sciences - Longitudinal Study of Aging. Subjects comprised 1269 men and women aged 40 to 79 years at baseline (1997-2000) who participated in a follow-up postal survey (2013). Higher-level functional capacity was measured using the Tokyo Metropolitan Institute of Gerontology Index of Competence (total score and 3 subscales: instrumental self-maintenance, intellectual activity, and social role). The odds ratio (OR) and 95% confidence interval (CI) for a decline in higher-level functional capacity in the follow-up study according to the total number of healthy practices were analyzed using the lowest category as a reference. Multivariate adjusted ORs (95% CIs) for the total score of higher-level functional capacity, which declined according to the total number of healthy practices (0-4, 5-6, 7-8 groups) were 1.00 (reference), 0.63 (0.44-0.92), and 0.54 (0.31-0.94). For the score of social role decline, multivariate adjusted ORs (95% CIs) were 1.00 (reference), 0.62 (0.40-0.97), and 0.46 (0.23-0.90), respectively (P for trend = 0.04). Having more modifiable healthy practices, especially in social roles, may protect against a decline in higher-level functional capacity among middle-aged and elderly community dwellers in Japan.

Micronutrient intake in advanced age: Te Puāwaitanga o Ngā Tapuwae Kia ora Tonu, Life and Living in Advanced Age: A Cohort Study in New Zealand (LiLACS NZ)

A high prevalence of undernutrition has previously been reported in indigenous Māori (49 %) and non-Māori (38 %) octogenarians and may be associated with risk of micronutrient deficiencies. We examined vitamin and mineral intakes and the contributing food sources among 216 Māori and 362 non-Māori participating in Life and Living to Advanced age a Cohort Study in New Zealand, using a repeat 24-h multiple-pass recall. More than half of the Māori and non-Māori participants had intakes below the estimated average requirement from food alone for Ca, Mg and Se. Vitamin B6 (Māori women only), folate (women only), vitamin E (Māori women; all men) and Zn (men only) were low in these ethnic and sex subgroups. Women had intakes of higher nutrient density in folate, vitamin C, Ca, Mg, K, vitamin A (non-Māori) and β-carotene (Māori) compared with men (P<0·05). When controlling for age and physical function, β-carotene, folate, vitamin C, Ca and Mg were no longer significantly different, but vitamins B2, B12, E and D, Fe, Na, Se and Zn became significantly different for Māori between men and women. When controlling for age and physical function, vitamins A and C and Ca were no longer significantly different, but vitamin B2, Fe, Na and Zn became significantly different for non-Māori between men and women. For those who took nutritional supplements, Māori were less likely to be deficient in food alone intake of vitamin A, folate and Mg, whereas non-Maori were less likely to be deficient in intakes of Mg, K and Zn, but more likely to be deficient in vitamin B12 intake. A lack of harmonisation in nutrient recommendations hinders the interpretation of nutrient adequacy; nonetheless, Ca, Mg and Se are key micronutrients of concern. Milk and cheese were important contributions to Ca intake, whereas bread was a key source of Mg and Se. Examination of dietary intake related to biochemical status and health outcomes will establish the utility of these observations.

Development and Validation of a Food-Associated Olfactory Test (FAOT)

Olfactory tests are an important tool in human nutritional research for studying food preferences, yet comprehensive tests dedicated solely to food odors are currently lacking. Therefore, within this study, an innovative food-associated olfactory test (FAOT) system was developed. The FAOT comprises 16 odorant pens that contain representative food odors relating to different macronutrient classes. The test underwent a sensory validation based on identification rate, intensity, hedonic value, and food association scores. The accuracy of the test was further compared to the accuracy of the established Sniffin' Sticks identification test. The identification rates and intensities of this new FAOT were found to be comparable to the Sniffin' Sticks olfactory identification test. The odorant pens were also assessed chemo-analytically and were found to be chemically stable for at least 24 weeks. Overall, this new identification test for use in assessing olfaction in a food-associated context is valid both in terms of its use in sensory perception studies and its chemical stability. The FOAT is particularly suited to examinations of the sense of smell regarding food odors.

Nutritional Adequacy and Diet Quality in Colorectal Cancer Patients Postsurgery: A Pilot Study

Recent evidence has shown that an unhealthy diet is associated with a higher risk of tumor recurrence, metastasis, and death among patients with colorectal cancer (CRC). The aims of this study were to assess nutritional adequacy and diet quality in a group of CRC patients postsurgery and to identify possible associations between dietary and nutritional aspects and environmental factors and weight status. This was an observational study conducted on a random sample of 74 patients, aged 50-69 years. Dietary intake was evaluated utilizing a validated frequency questionnaire, and diet quality was evaluated utilizing the Healthy Eating Index for Spanish Diet and the MedDietScore. Data regarding socioeconomic, demographic, lifestyles, dietary supplements use, and body mass index were collected. Subjects followed a diet characterized by a low carbohydrate intake (94% of the cases), excessive protein (48%), high fat intake (67%), and some micronutrient deficiencies. The inadequacy of some nutrients was associated with male gender, overweight/obesity, smoking, and low educational level; and low adherence to the MedDiet was identified in those with a low educational level (adjusted odds ratio = 4.16, P < 0.05). Therefore, such patients should be an important target group when applying educational programs and giving individualized nutritional advice to improve their quality of life.

Age-related Changes in Energy Intake and Weight in Community-dwelling Middle-aged and Elderly Japanese

OBJECTIVE

This study attempts to describe trends in energy intake and weight change over 12 years according to age at first participation in the study.

DESIGN

Prospective cohort study.

SETTING

The National Institute for Longevity Sciences - Longitudinal Study of Aging (NILS-LSA), a community-based study.

PARTICIPANTS

Participants included 922 men and 879 women who participated in the first study-wave (age 40-79 years) and also participated in at least one study-wave from the second to seventh study-wave. Each study-wave was conducted biennially. For individuals, the entire follow-up period was 12 years.

MEASUREMENTS

Energy intake was calculated from 3-day dietary records with photographs. Weight and height were measured under a fasting state. To estimate linear changes in energy intake and weight over 12 years according to age at first study-wave, we used the mixed-effects model.

RESULTS

Mean (SD) follow-up time and number of study-wave visits were 9.5 (3.7) years and 5.4 (1.8) times, respectively. The fixed effect of the interaction of age and time in energy intake and weight was statistically or marginally statistically significant both in men (p<0.01) and in women (p<0.06). In men, when energy intake was estimated according to age, the rate of decrease in energy intake increased from -6.8 to -33.8 kcal/year for ages 40-79 years. In women, the rate of decrease in energy intake slightly increased in older age groups (-9.1 to -16.7 kcal/year for ages 40-79 years). Weight increased in males in their 40s (0.07 kg/year from age 40) and started to decline by age 53. In women, weight started to decline around age 47 (-0.04 kg/year).

CONCLUSION

Twelve-year longitudinal data showed energy intake declined both in men and women in their 40s, and the rate of decrease increased in older males. Weight started to decline in men in their mid-50s and women in their late 40s. Further studies that focus on energy intake and weight reduction are needed to prevent weight loss or underweight in an increasingly aging society.

Ageing Is Associated with Decreases in Appetite and Energy Intake--A Meta-Analysis in Healthy Adults

It is not well recognized that in the elderly weight loss is more common than weight gain. The aim of this analysis was to determine the effect of ageing on appetite (hunger/fullness) and energy intake, after overnight fasting and in a postprandial state, by meta-analyses of trials that included at least two age groups (>18 years). We hypothesized that appetite and energy intake would be less in healthy older compared with younger adults. Following a PubMed-database systematic search up to 30 June 2015, 59 studies were included in the random-effects-model meta-analyses. Energy intake was 16%-20% lower in older (n = 3574/~70 years/~71 kg/~25 kg/m²) than younger (n = 4111/~26 years/~69 kg/~23 kg/m²) adults (standardized mean difference: -0.77 (95% confidence interval -0.90 to -0.64)). Hunger was 25% (after overnight fasting; weighted mean difference (WMD): -17 (-22 to -13) mm) to 39% (in a postprandial state; WMD: -14 (-19 to -9) mm) lower, and fullness 37% (after overnight fasting; WMD: 6 mm (95% CI: 1 to 11 mm)) greater in older than younger adults. In conclusion, appetite and energy intake are less in healthy older than younger adults, suggesting that ageing per se affects food intake.

Dietary protein considerations to support active aging

Given our rapidly aging world-wide population, the loss of skeletal muscle mass with healthy aging (sarcopenia) represents an important societal and public health concern. Maintaining or adopting an active lifestyle alleviates age-related muscle loss to a certain extent. Over time, even small losses of muscle tissue can hinder the ability to maintain an active lifestyle and, as such, contribute to the development of frailty and metabolic disease. Considerable research focus has addressed the application of dietary protein supplementation to support exercise-induced gains in muscle mass in younger individuals. In contrast, the role of dietary protein in supporting the maintenance (or gain) of skeletal muscle mass in active older persons has received less attention. Older individuals display a blunted muscle protein synthetic response to dietary protein ingestion. However, this reduced anabolic response can largely be overcome when physical activity is performed in close temporal proximity to protein consumption. Moreover, recent evidence has helped elucidate the optimal type and amount of dietary protein that should be ingested by the older adult throughout the day in order to maximize the skeletal muscle adaptive response to physical activity. Evidence demonstrates that when these principles are adhered to, muscle maintenance or hypertrophy over prolonged periods can be further augmented in active older persons. The present review outlines the current understanding of the role that dietary protein occupies in the lifestyle of active older adults as a means to increase skeletal muscle mass, strength and function, and thus support healthier aging.

Nutritional status and eating habits of the institutionalised elderly in Turkey: a follow-up study

BACKGROUND

As the elderly population increases in Turkey, so do the associated health and nutritional problems. The main purpose of the present study was to determine the nutritional status of elderly individuals who live in institutions.

METHODS

A total of 102 elderly volunteers was recruited from seven residential homes of the Ministry of Family and Social Policies in Ankara. In the consecutive years of 2007, 2008 and 2009, dietary intake was assessed using a 24-h food recall. Nutritional status was screened using a questionnaire from the Mini-Nutritional Assessment, basic characteristics were determined and anthropometric measurements were assessed.

RESULTS

The percentage of elderly participants who were malnourished or at risk for malnutrition increased by the completion of the follow-up (P < 0.05). It was found that energy, total protein, animal proteins, carbohydrates, niacin, vitamin C, vitamin E and zinc intake of men decreased significantly over the years studied (P < 0.05). A significant decrease occurred among women in animal protein, vitamin B1 , niacin and the percentage of energy from proteins (P < 0.05); however, an increase in energy from fat (P < 0.05) was determined. Within the years studied, the percentage of nutrients meeting the Turkish recommended daily allowances decreased from 2007 to 2009 both in men and women. During the years 2007 to 2009, the percentage of waist circumferences >102 cm for men was 46.4%, 45.6% and 48.1%, respectively, and the percentage of waist circumferences for women >88 cm was 75.6%, 75.6% and 81.8%, respectively.

CONCLUSIONS

During the follow-up, significant nutritional changes were determined. To prevent malnutrition, periodical screening of nutritional status should be a priority and a standard policy for elderly people, especially for those institutionalised.

Dietary saturated fat intake and atherosclerotic vascular disease mortality in elderly women: a prospective cohort study

BACKGROUND

The reduction of saturated fatty acid (SFA) intake has been the basis of long-standing dietary recommendations. However, recent epidemiologic studies have reported conflicting evidence in the relation between SFA consumption and risk of atherosclerotic vascular disease (ASVD) mortality.

OBJECTIVE

We investigated the association of SFA intake with serum lipid profiles and ASVD mortality in a population-based 10-y cohort study.

DESIGN

At baseline (1998) 1469 women living in Perth, Western Australia, with a mean ± SD age of 75.2 ± 2.7 y had SFA intake measured by using a validated food-frequency questionnaire. Outcome data were serum lipids at baseline and ASVD deaths over 10 y (13,649 person-years of follow-up), retrieved from the Western Australian Data Linkage System. Other risk factors for ASVD were assessed and adjusted for in multivariable analyses.

RESULTS

ASVD deaths occurred in 9.1% (134) of participants. The highest quartile of SFA intake (>31.28 g/d) had an ~16% cumulative mortality risk compared with ~5% in the lowest quartile (<17.39 g/d) (HR: 3.07; 95% CI: 1.54, 6.11; P = 0.001). Baseline SFA intake was associated with baseline serum total and LDL cholesterol in multivariable-adjusted models (β: 0.199, SE: 0.056, P < 0.001 and β: 0.190, SE: 0.051, P < 0.001, respectively). However, baseline serum total and LDL cholesterol were not associated with ASVD mortality.

CONCLUSIONS

High SFA intake was associated with the risk of ASVD mortality in this population of elderly women. Although there was a strong positive association between SFA intake and LDL cholesterol, LDL cholesterol was not associated with ASVD mortality in this cohort. Nevertheless, these data support dietary advice to reduce SFA intake.

Micronutrient intakes and potential inadequacies of community-dwelling older adults: a systematic review

Micronutrient deficiencies and low dietary intakes among community-dwelling older adults are associated with functional decline, frailty and difficulties with independent living. As such, studies that seek to understand the types and magnitude of potential dietary inadequacies might be beneficial for guiding future interventions. We carried out a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Observational cohort and longitudinal studies presenting the habitual dietary intakes of older adults (≥65 years) were included. Sex-specific mean (and standard deviation) habitual micronutrient intakes were extracted from each article to calculate the percentage of older people who were at risk for inadequate micronutrient intakes using the estimated average requirement (EAR) cut-point method. The percentage at risk for inadequate micronutrient intakes from habitual dietary intakes was calculated for twenty micronutrients. A total of thirty-seven articles were included in the pooled systematic analysis. Of the twenty nutrients analysed, six were considered a possible public health concern: vitamin D, thiamin, riboflavin, Ca, Mg and Se. The extent to which these apparent inadequacies are relevant depends on dynamic factors, including absorption and utilisation, vitamin and mineral supplement use, dietary assessment methods and the selection of the reference value. In light of these considerations, the present review provides insight into the type and magnitude of vitamin and mineral inadequacies.

Dietary intake of energy, nutrients and water in elderly people living at home or in nursing home

OBJECTIVES

There is a lack of detailed information on dietary intake in elderly people at an individual level, which is crucial for improvement of nutritional support. The aim of this study was to investigate the dietary intake in elderly people in two types of living situations.

DESIGN

Observational study, analysing prospective data.

SETTING

The dietary intake was studied in elderly people living at home or in nursing home, in different cities of Sweden.

PARTICIPANTS

A total of 264 elderly people (mean age 84) participated in the observational study.

MEASUREMENTS

Dietary intake was measured using weighed food records and food diaries, comparing females and males. The observed dietary intake was related to Recommended intake and Lower intake level.

RESULTS

All dietary intake and patient characteristic variables showed large individual differences (ranges). We found no significant differences (p>0.05) between those living at home and nursing home residents regarding the average intake of energy, protein and water when expressed as total intake per kg of body weight. A very low daily intake of energy (<20 kcal/kg body weight/day) was observed in 16% of the participants. For vitamin D and iron, 19% and 15%, respectively, had intakes below the Lower intake level. There was no correlation between intake of energy, protein or water and resident characteristics such as age, autonomy, morbidity, nutritional state or cognition.

CONCLUSIONS

The large individual differences (ranges) in energy, nutrients and water show that the use of mean values when analysing dietary intake data from elderly people is misleading. From a clinical perspective it is more important to consider the individual intake of energy, nutrients and water. Ageism is intrinsic in the realm of 'averageology'.

Lifestyle and osteoporosis

Osteoporosis is associated with a number of lifestyle factors, including nutritional factors such as intake of calcium, protein, dairy food, fruits and vegetables and vitamin D status, and behavioural factors such as physical activity, smoking and alcohol consumption. Ensuring adequate calcium intake and vitamin D status and having regular weight-bearing physical activity throughout life are important for bone health and the prevention of osteoporosis and related fractures. Studies have shown that smoking and excessive alcohol intake have adverse effects on bone health and increase the risk of fracture. There is evidence suggesting that adequate protein intake and higher intake of fruits and vegetables are beneficial to bone health.

Alkali production in the mouth and its relationship with certain patient's characteristics

Objectives

To assess the relationships among alkali production, diet, oral health behaviors, and oral hygiene.

Methods

Data from 52 subjects including demographics, diet, and oral hygiene scores were analyzed against the level of arginine and urea enzymes in plaque and saliva samples. An oral habit survey was completed that included: use of tobacco (TB), alcohol (AH), sugary drinks (SD), and diet. Alkali production through arginine deiminase (ADS) and urease activities were measured in smooth-surface supragingival dental plaque and un stimulated saliva samples from all subjects. ADS and urease activities were measured by quantification of the ammonia generated from the incubation of plaque or saliva samples. Spearman correlations were used to compute all associations.

Results

Participants in the lowest SES (Socio-economic status) group had the habit of consuming sugary drinks the most and had the highest rate of tobacco use. Males consumed significantly more alcohol than females. No significant relationship was found between age or gender and alkali production. Higher rates of sugary drink consumption and tobacco use were significantly related to lower alkali production.

Conclusion

The study showed a relationship between alkali production and oral hygiene, diet, and certain oral health behaviors. Poor oral hygiene was significantly associated with age, lower SES, tobacco use, and alcohol, and sugary drinks consumption.

Clinical relevance

Certain oral health behaviors have an impact on oral hygiene and on alkali production; it is important to address these factors with patients as a strategy for caries control.

Efficacy of Nutrition Education-Based Cooking Workshops in Community-Dwelling Adults Aged 50 Years and Older

Nutrition interventions offer an opportunity to meet the nutritional needs of community-dwelling older adults. This retrospective qualitative observational study aimed to determine if nutrition education-based cooking workshops offered in Southern Quebec helped improve dietary habits and nutrition-related knowledge, autonomy, and confidence among older adults. Participants (n = 144) in an 8-session cooking workshop program completed pre- and post-workshop session questionnaires. Baseline nutritional risk (n = 116) and body mass index (n = 112) were assessed using the Elderly Nutrition Screening Questionnaire. Paired sample t-tests and McNemar analyses were performed to determine changes over time for knowledge, autonomy, confidence and dietary habits, and specific dietary behaviors, respectively. Pearson correlation tests were performed to assess associations between variables. Significant improvements were observed over time in knowledge, confidence, and desired dietary habits but not in autonomy. At the end of the intervention a greater proportion of participants reported always consuming recommended amounts of whole grains, fruits and vegetables, water, and milk or milk alternatives. A significant association was observed between confidence and dietary habits and between knowledge and confidence. Food skills interventions that link nutrition knowledge with cooking competence offer the opportunity to improve dietary habits among community-dwelling older adults.

Descriptive epidemiological study of food intake among Japanese adults: analyses by age, time and birth cohort model

BACKGROUND

Although food and nutrient consumption among the Japanese population, known to have one of the longest life expectancies in the world, has changed markedly after World War II, little is known about the influences age, time and birth cohort have had. The present study examined the effects age, time and birth cohort have had on intake of 14 food groups from 1989 to 2009, using published data from the National Health and Nutrition Survey in Japan.

METHODS

The survey included 575 adults (271 men and 304 women) in 1989, 8431 (3952 men and 4479 women) in 1999 and 5632 (2629 men and 3003 women) in 2009. The effects of age on energy-adjusted food intakes defined by gender and birth cohort (birth in 1930-1939, 1940-1949, 1950-1959, 1960-1969, 1970-1979) were estimated using the mean polish process.

RESULTS

Intakes of meat and confectionary increased whereas those of milk and dairy products, sugar, and fats and oils decreased from 1989 to 2009. Both men and women in the 1940's birth cohort consumed more fruit, although differences in food intake by birth cohort were less discernible. Furthermore, meat, fats and oils, and wheat intake decreased while fruits, fish, beans and vegetables consumption increased with aging in both men and women.

CONCLUSIONS

The present analysis suggests intakes of meat and confectionary have increased in Japan over the past 20 years regardless of age and generation. Also, younger individuals are less likely to consume fruits, fish, beans and vegetables regardless of the birth cohort and time period. Differences in food group consumption by birth cohorts born between 1930 and 1979 were not obvious. The first indication of these findings would be that in order to avoid ongoing increases in meat and confectionery intake, the public health strategy should target the whole Japanese population. Secondly, intervening with the diet of younger individuals, especially today, would be reasonable as it is unknown whether today's younger individuals will adopt a healthier diet when they age as the other generations did.

A preliminary investigation into diet adequacy in senior residents of Newfoundland and Labrador, Canada: a cross-sectional study

BACKGROUND

Adequate dietary intake is essential to maintain good health. This is particularly true for the elderly. This study investigated the dietary intakes of seniors residing in Newfoundland and Labrador (NL) and assessed the adequacy of nutrients which they consumed as food.

METHODS

Between November 2012 and January 2013, we recruited senior residents in NL, aged 65 years or older Participants were required to complete two questionnaires, one food-frequency questionnaire (FFQ) and one general health questionnaire (GHQ). Macro- and micro- nutrients in foods consumed were estimated using the Elizabeth Stewart Hands and Associations (ESHA) nutrient analysis software. The nutrient intakes were compared with appropriate components of the dietary reference intakes (DRIs) adopted by Health Canada to determine adequacy. Various descriptive statistical analyses were performed using SPSS.

RESULTS

One hundred-and-eleven participants (69 females and 42 males) completed the surveys and were included in the analysis. A considerable portion of subjects were overweight (41.7%) or obese (25%), and had at least one chronic illness (86.5%). Many seniors studied did not meet the daily recommendations for dietary intakes of nutrients supported by Health Canada, notably vitamin E (84.7%) and vitamin D (68.5%). Our study also suggests that about 40% of participants consumed more dietary energy as fat than is recommended.

CONCLUSION

The present study revealed an inadequate consumption of essential nutrients from foods in a noninstitutionalized senior population of NL.

Protein intake protects against weight loss in healthy community-dwelling older adults

Weight loss is prevalent in the elderly population, with deleterious health consequences, notably loss of lean body mass and subsequent functional decline. Protein intake below the current RDA [0.8 g/(kg · d)] is also common in older adults; however, the link between the 2 has received little attention. Our objective was to assess the relation between protein intake and incident 1-y weight loss ≥5% in community-dwelling older adults. We conducted a nested, prospective, case-control study in 1793 community-living elderly participants of the Quebec Longitudinal Study of Nutrition as a Determinant of Successful Aging (NuAge). We studied 211 incident cases of 1-y weight loss (≥5%) and 211 weight-stable controls (±2%) matched by sex and age category (70 ± 2, 75 ± 2, and 80 ± 2 y). Diet was measured by 3 nonconsecutive 24-h recalls. ORs (95% CIs) for the association between protein intake and weight loss were computed by using conditional logistic regression. After adjustment for body mass index, energy intake, appetite, smoking status, physical activity level, physical function, chronic diseases and medications, depressive symptoms, and serum albumin and ultrasensitive C-reactive protein, the ORs of weight loss in participants with low protein intakes [<0.8 g/(kg · d)] were 2.56 (95% CI: 1.01, 6.50) compared with participants with very high protein intakes [≥1.2 g/(kg · d)]. Corresponding numbers were 2.15 (95% CI: 1.02, 4.56) in participants with moderate protein intakes [0.8-<1.0 g/(kg · d)] and 1.33 (95% CI: 0.77, 2.28) in participants with high protein intakes [1.0-1.2 g/(kg · d)]. Our results suggest that protein intakes >1.0 g/(kg · d) are protective against weight loss in healthy older adults. These findings add epidemiologic evidence in support of higher optimal protein intakes than the current guidelines for healthy older adults.

Food and nutrient intake of Irish community-dwelling elderly subjects: who is at nutritional risk?

OBJECTIVES

To assess the dietary intakes of Irish community-dwelling elderly individuals, participating in the ELDERMET project.

DESIGN

Cross-sectional study.

SETTING

Cork city and county region of southern Ireland.

PARTICIPANTS

Two hundred and eight (94 males, 114 females) community-dwelling subjects aged 64-93 yrs.

MEASUREMENTS

Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire (FFQ). Anthropometric data were recorded. Nutritional status was assessed using the Mini Nutritional Assessment (MNA).

RESULTS

A high rate of overweight/obesity was observed in this population group. Consumption of energy-dense, low-nutrient foods was excessive among this population group. Older elderly subjects (≥75 yrs) consumed significantly (P<0.01) more desserts/sweets than younger elderly (64-74 yrs). Intakes of dietary fat and saturated fat were high while dairy food consumption was inadequate in both males and females. Elderly females typically had a more nutrient-dense diet than males. A considerable proportion of subjects, particularly males, had inadequate intakes of calcium, magnesium, vitamin D, folate, zinc and vitamin C.

CONCLUSION

The data indicate that the diet of Irish community-dwelling elderly individuals is sub-optimal with respect to nutrient intake, and excessive in terms of fat intake, with implications for the health status of this population group. Reductions in dietary fat and increased low fat dairy food intakes are recommended for the prevention of diet-related disease in older persons. In addition, strategies to improve a number of sub-optimal micronutrient intakes need to be developed and implemented, particularly among elderly males.

Prevalence, determinants, and inappropriateness of calcium supplementation among men and women in a Spanish Mediterranean area: cross-sectional data from the ESOSVAL cohort

Recently, safety concerns about calcium supplementation have arisen. In this situation, ensuring appropriateness of use is highly important. We aimed to describe the use of calcium and vitamin D supplements, the factors related to it, and to assess the appropriateness of calcium prescription among men and women aged 50 years or older. We performed a cross-sectional study in 2009-2010 including 11,035 adults who belong to the ESOSVAL cohort and attend 272 primary healthcare centers in the Valencia region of Spain. Criteria for the inappropriateness of calcium prescription, based on guidelines and recent evidence, were: excessive or insufficient daily total intake (diet plus supplements), excessive single doses of supplements, excessive or insufficient association with vitamin D, and overall inappropriateness. Calcium and/or vitamin D were prescribed to about 17% of the population. Older age, antiosteoporotic treatment, use of glucocorticoids, and a diagnosis of osteoporosis were related to prescription. The presence of other secondary causes of osteoporosis determined supplementation only in men. Calcium dietary intake was not related to the prescription of supplements. Among calcium users, 85.8% met at least one criterion of inappropriate prescription; 29% had an inappropriate daily total intake mainly resulting from excessive consumption (>2000 mg/day); 53.8% of patients were given calcium supplements in quantities higher than 500 mg per dose; and 38.9% of individuals receiving calcium supplements had inappropriate (absent or below 800 UI/day) vitamin D supplementation (all of them at high risk). In conclusion, we found high inappropriateness of calcium supplementation, mainly because of calcium overdosing, and also to undertreatment and underdosing of vitamin D in high-risk patients. Physicians should be encouraged to assess calcium dietary intakes before supplementation, recommending intake from food whenever possible, and to prescribe low calcium doses and high vitamin D doses when given in fixed-dose combinations, or vitamin D alone when calcium is not necessary.