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Dericioglu D, Methven L, Clegg ME. Understanding age-related changes: exploring the interplay of protein intake, physical activity and appetite in the ageing population. Proc Nutr Soc 2024:1-13. [PMID: 38557431 DOI: 10.1017/s0029665124002192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Globally, we are currently facing a rapid demographic shift leading to an increase in the proportion of older adults within the population. This raises concerns about the potential increase in age-related diseases and their impact on our ability to provide adequate health and end-of-life care. To apply appropriate interventions, understanding the changes that happen with ageing becomes essential. Ageing is often accompanied by a decrease in appetite and physical activity, which may lead to malnutrition, resulting in decreased muscle mass, physical capabilities and independence. To preserve muscle mass, older adults are advised to increase protein intake and physical activity. However, protein's high satiating effect may cause reduced energy intake. Physical activity is also advised to maintain or enhance older adult's appetite. This review paper aims to discuss appetite-related changes that occur with ageing and their consequences. In particular, it will focus on investigating the relationship between protein intake and physical activity and their impact on appetite and energy intake in the ageing population. Recent studies suggest that physical activity might contribute to maintaining or enhancing appetite in older adults. Nevertheless, establishing a definitive consensus on the satiating effect of protein in ageing remains a work in progress, despite some promising results in the existing literature.
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Affiliation(s)
- Dilara Dericioglu
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, ReadingRG6 6DZ, UK
- Institute of Food, Nutrition and Health, University of Reading, Whiteknights, Reading RG6 6EU, UK
| | - Lisa Methven
- Institute of Food, Nutrition and Health, University of Reading, Whiteknights, Reading RG6 6EU, UK
- Food Research Group, Department of Food and Nutritional Sciences, University of Reading,Whiteknights, Reading RG6 6DZ, UK
| | - Miriam E Clegg
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Whiteknights, ReadingRG6 6DZ, UK
- Institute of Food, Nutrition and Health, University of Reading, Whiteknights, Reading RG6 6EU, UK
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
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Chan YT, Lin CS. Structural brain feature is associated with changes of masticatory performance in healthy elderly people: Evidence from longitudinal neuroimaging research over two years. J Oral Rehabil 2024; 51:526-535. [PMID: 37904309 DOI: 10.1111/joor.13605] [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: 11/22/2022] [Revised: 07/19/2023] [Accepted: 09/29/2023] [Indexed: 11/01/2023]
Abstract
BACKGROUND Human neuroimaging studies have revealed the association between brain structure and masticatory function. However, the majority of the studies adopted a cross-sectional design, which hardly reveals the change in masticatory function and brain structure between different timepoints, and the dynamical association between changes in masticatory function and changes in brain structure has not been elucidated. OBJECTIVE With a longitudinal design, we assessed the association between changes in masticatory performance (MP) and regional brain volume. METHODS Twenty-two elderly participants received assessments of the number of missing teeth and MP (via colour-changeable chewing gum) when they entered the study (i.e. the initial stage, T0 ), approximately 6 months later (T0.5 ), and approximately 1-2 years later (T1 ). Difficulty of food intake was assessed using a questionnaire. The participants received magnetic resonance imaging (MRI) at T0 and T1 . The brain volume of the motor-related area was estimated using FreeSurfer for MRI data. The associations between different stages were analysed using Spearman's rho correlation coefficients. RESULTS (1) Individually, a smaller volume of right primary motor cortex at T0 was associated with increased MP from T0 to T1 , suggesting the brain's role in changing oral functions; (2) higher MP at T0 was associated with an increased volume of the left superior frontal cortex from T0 to T1 p, suggesting a potential effect on brain plasticity, and (3) increased difficulty to eat was associated with decrease MP but not brain volume of motor-related area. CONCLUSIONS The preliminary findings revealed a complicated pattern of structural brain features and masticatory function in elderly people, and either the hypothesis that the brain predisposes masticatory function or the hypothesis that mastication reshapes the brain is oversimplified.
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Affiliation(s)
- Yu-Ting Chan
- General dentistry private practice, Hui-An Dental Clinic, New Taipei City, Taiwan
| | - Chia-Shu Lin
- Department of Dentistry, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
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Mills CM, Keller HH, DePaul VG, Donnelly C. Factors Associated with the Development of High Nutrition Risk: Data from the Canadian Longitudinal Study on Aging. Can J Aging 2024; 43:153-166. [PMID: 37749058 DOI: 10.1017/s0714980823000545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023] Open
Abstract
This study aimed to determine which social network, demographic, and health-indicator variables were able to predict the development of high nutrition risk in Canadian adults at midlife and beyond, using data from the Canadian Longitudinal Study on Aging. Multivariable binomial logistic regression was used to examine the predictors of the development of high nutrition risk at follow-up, 3 years after baseline. At baseline, 35.0 per cent of participants were at high nutrition risk and 42.2 per cent were at high risk at follow-up. Lower levels of social support, lower social participation, depression, and poor self-rated healthy aging were associated with the development of high nutrition risk at follow-up. Individuals showing these factors should be screened proactively for nutrition risk.
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Affiliation(s)
- Christine Marie Mills
- Faculty of Health Sciences, School of Rehabilitation Therapy, Aging and Health Program, Queen's University, Kingston, ON, Canada
| | - Heather H Keller
- Schlegel-UW Research Institute for Aging and Department of Kinesiology & Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Vincent Gerard DePaul
- School of Rehabilitation Therapy and Health Services and Policy Research Institute, Queen's University, Kingston, ON, Canada
| | - Catherine Donnelly
- School of Rehabilitation Therapy and Health Services and Policy Research Institute, Queen's University, Kingston, ON, Canada
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Noritake K, Fujii K, Kubo Y, Yorozuya K, Hayashi T, Goto F, Watanabe H, Yoshida A, Tsubouchi Y, Nakashima D. Appetite and family and friends network among community-dwelling older adults: A cross-sectional study. Nutrition 2024; 119:112321. [PMID: 38199033 DOI: 10.1016/j.nut.2023.112321] [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: 08/21/2023] [Revised: 11/23/2023] [Accepted: 11/29/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVES The aim of this study was to investigate the stronger correlate of appetite-family or friend networks-in community-dwelling older adults, given that undernutrition can impair physical function, increase mortality, and be influenced by social networks. METHODS A cross-sectional study was conducted in Kasugai City, Aichi Prefecture, and Nara City, Nara Prefecture, Japan, between August 2019 and March 2023. The analysis included 119 participants (women: 79%, mean age: 76.5 ± 5.6 y). A multiple regression analysis was performed, using the scores from the Japanese version of the Simplified Nutritional Appetite Questionnaire (SNAQ-J) as the dependent variable and family network and friend network as the independent variables. The analysis included social participation, living alone status, sex, age, body mass index, skeletal muscle mass index, grip strength, walking speed, and the Japanese version of the 15 Geriatric Depression Scale score as covariates to examine their relationship with appetite. RESULTS The mean value of the SNAQ-J score of the participants was 15.4 ± 1.2. Seven participants (6%) had a loss of appetite. Family network was significantly associated with appetite (B = 0.121, β = 0.266, P <0.05; 95% condidence interval [CI], 0.030-0.212). In the single regression analysis, the friend network was significantly associated with the total score of the SNAQ-J (B = 0.115, P <0.001; 95% CI, 0.052-0.177); however, this association was not observed in the multiple regression analysis (B = 0.002, β = 0.006, P = 0.954; 95% CI, -0.074-0.078). CONCLUSION Appetite was associated with family networks. Among social networks, focusing on family networks may help prevent the loss of appetite in older adults in Japan.
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Affiliation(s)
- Kento Noritake
- Faculty of Health Sciences, Nihon Fukushi University, Handa, Japan
| | - Keisuke Fujii
- Faculty of Health Science, Suzuka University of Medical Science, Suzuka, Japan
| | - Yuta Kubo
- Faculty of Health Science, Suzuka University of Medical Science, Suzuka, Japan
| | - Kyosuke Yorozuya
- Faculty of Rehabilitation and Care, Seijoh University, Tokai, Japan
| | - Takahiro Hayashi
- Faculty of Rehabilitation and Care, Seijoh University, Tokai, Japan
| | - Fumihiko Goto
- Department of Rehabilitation, Tokai Memorial Hospital, Kasugai, Japan
| | - Hidehiro Watanabe
- Department of Rehabilitation, Tokai Memorial Hospital, Kasugai, Japan
| | - Akihiro Yoshida
- Department of Rehabilitation, Tokai Memorial Hospital, Kasugai, Japan
| | | | - Daiki Nakashima
- Faculty of Health Science, Naragakuen University, Nara, Japan
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Jayawardena R, Wickramawardhane P, Dalpatadu C, Hills AP, Ranasinghe P. The impact of an oral nutritional supplement on body weight gain in older adults with malnutrition: an open-label randomized controlled trial. Trials 2023; 24:625. [PMID: 37784119 PMCID: PMC10544200 DOI: 10.1186/s13063-023-07622-4] [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: 04/08/2023] [Accepted: 09/04/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND The global aging population is expanding rapidly and many individuals have a particularly higher risk of malnutrition. Malnutrition can lead to impaired body function, morbidity, and mortality. Meeting nutritional requirements is a key strategy to minimize multiple debilitating adverse outcomes associated with malnutrition in the elderly. Oral nutritional supplements (ONS) have been widely used as a dietary intervention for malnutrition in older adults. These supplements provide additional nutrients and calories to support nutritional requirements and have been shown to improve nutritional status, physical function, and quality of life in malnourished older adults. METHODS This is an open-label, randomized controlled, parallel-group study including 50 institutionalized older adults (aged > 60 years) with malnutrition or at risk of malnutrition, living in a selected elderly care institution in Colombo, Sri Lanka. The aim is to assess improvement in healthy body weight gain and body composition in older adults with malnutrition at risk of malnutrition by using an ONS. Older adults will be screened for malnutrition using the Mini Nutrition Assessment (MNA) tool and eligible participants randomized using the simple random sampling technique to intervention and control groups (1:1 allocation ratio). The intervention group will consume 200 mL of ONS before bed continuously for 12 weeks. The primary outcome is the percentage who achieved at least 5% weight gain in the intervention group compared to the control group. Nutritional status (anthropometric, biochemical, clinical, and dietary), body composition (dual-energy X-ray absorptiometry), frailty, functional capacity (hand grip strength, knee extension, and Barthel index) cognitive status (Montreal Cognitive Assessment), and physical activity will be assessed as secondary outcomes at baseline and at the end of the 12-week intervention. Some measurements (anthropometry, dietary, and functional assessments) will also be performed at the end of the 4th week. Data will be analyzed using SPSS V-23. DISCUSSION This study will determine whether the use of an ONS is effective in promoting healthy weight gain in older adults with malnutrition or at risk of malnutrition. In addition, investigating the impact of an ONS on multiple outcomes via clinical, nutritional, functional, and cognitive function will provide a more comprehensive understanding of the potential benefits of these supplements. TRIAL REGISTRATION Sri Lanka Clinical Trail Registry SLCTR/2022/021. Oct. 6, 2022.
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Affiliation(s)
- Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | | | - Chamila Dalpatadu
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Priyanga Ranasinghe
- Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
- University/British Heart Foundation Centre for Cardiovascular Science, The University of Edinburgh, Edinburgh, UK
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Wang X, Wu Y, Miao J, Pu K, Ming WK, Zang S. Factors associated with eating behaviors in older adults from a socioecological model perspective. BMC Public Health 2023; 23:1726. [PMID: 37670266 PMCID: PMC10481492 DOI: 10.1186/s12889-023-16651-2] [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: 01/31/2023] [Accepted: 08/29/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND The eating behaviors of older adults are associated with multiple factors. To promote older adults' healthy diets, it is imperative to comprehensively study the factors associated with the eating behaviors of the aging population group. This study aimed to probe the associated factors of older adults' eating behaviors from a socioecological model (SEM) perspective. METHODS In 2021, a cross-sectional survey was performed to recruit participants in China. The survey data were analyzed using a multivariate generalized linear model to identify the factors associated with eating behaviors in older adults. Standardized regression coefficients (β) and 95% confidence intervals (CIs) were estimated using a multivariate generalized linear model. RESULTS The survey contained 1147 valid older adult participants. Multivariate generalized linear model results showed that older adults with older age [aged 71-80 (β = -0.61), ≥ 81 (β = -1.12)], conscientiousness personality trait (β = -0.27), and higher family health levels (β = -0.23) were inclined to have better eating behaviors. The older adults with higher education levels [junior high school and high school (β = 1.03), junior college and above (β = 1.71)], higher general self-efficacy (β = 0.09), more severe depression symptoms (β = 0.24), and employment (β = 0.82) tended to have poorer eating behaviors. CONCLUSIONS This study identified factors that are specifically associated with older adults' eating behaviors from an SEM perspective. The comprehensive multiple-angle perspective consideration may be a valuable idea for studying healthy eating behaviors in older adults.
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Affiliation(s)
- Xue Wang
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, China
| | - Yibo Wu
- School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Juanxia Miao
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, China
| | - Keping Pu
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, China
| | - Wai-Kit Ming
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, To Yuen Building, No.31 To Yuen Street, Hong Kong, 999077, China
| | - Shuang Zang
- Department of Community Nursing, School of Nursing, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, 110122, China.
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Vegas Aguilar IM, Porca Fernández C, Casañas Quintana T, Calleja Fernández A, Tejera Pérez C, Tinahones Madueño FJ, Bellido Guerrero D, García Almeida JM. [Organoleptic evaluation of a diabetes-specific oral nutritional supplement with extra virgin olive oil in patients at nutritional risk and type 2 diabetes mellitus: Double-blind, randomized, crossover and multicenter clinical trial (DIACARE)]. NUTR HOSP 2023; 40:686-691. [PMID: 37409710 DOI: 10.20960/nh.04569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023] Open
Abstract
Introduction Introduction: oral nutritional supplements specific for diabetes (DSF) usually have a composition that favors their palatability and simultaneous glycemic and metabolic control. Objetive: to compare the sensory acceptability of a DSF with respect to a standard oral nutritional supplement (STF) in patients at risk of malnutrition with type 2 diabetes mellitus. Method: randomized, double-blind, crossover, multicenter, controlled, double-blind clinical trial. Odor, taste and perceived texture of a DSF and a STD were evaluated using a scale of 1 to 4. Results: twenty-nine patients were recruited and 58 organoleptic evaluations of the supplements were registered. A better evaluation of DSF was observed with respect to STD, although no statistically significant differences were reached: odor, 0.04 (CI 95 %) -0.49 to 0.56 (p = 0.092); taste, 0.14 (CI 95 %), -0.35 to 0.63 (p = 0.561); texture, 0.14 (CI 95 %), -0.43 to 0.72 (p = 0.619). No differences were found when analyzed by order of randomization, sex, degree of malnutrition, greater or lesser degree of complexity, greater or lesser time of evolution of diabetes, or by being older or younger. Conclusions: the specific nutritional supplement for diabetic patients formulated with extra virgin olive oil, EPA and DHA, a specific mixture of carbohydrates, and fiber, presented an adequate sensory acceptance by malnourished patients with type 2 diabetes mellitus.
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Affiliation(s)
| | | | | | | | - Cristina Tejera Pérez
- Servicio de Endocrinología y Nutrición. Complejo Hospitalario Universitario de Ferrol
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Egele VS, Stark R. Specific health beliefs mediate sex differences in food choice. Front Nutr 2023; 10:1159809. [PMID: 37342550 PMCID: PMC10277620 DOI: 10.3389/fnut.2023.1159809] [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: 02/06/2023] [Accepted: 05/15/2023] [Indexed: 06/23/2023] Open
Abstract
Objective Although sex differences in dietary habits are well documented, the etiology of those differences is still a focus of research. The present study examines the role of specific health beliefs regarding healthy amounts of food for food choice and its relation to sex, more specifically, the assumption that sex differences in food choices are mediated by differentiating health beliefs. Method 212 German participants (44.3% female) aged 18-70 answered an online self-report questionnaire on their dietary habits and health beliefs, based on the recommendations of the German Nutrition Society. Results Most of the anticipated sex differences in food choice and some differences in health beliefs were found. The mediation hypothesis was partly supported, as the relationship between sex and fruit, vegetable, and fish consumption was mediated by the respective health beliefs. However, no mediation effects were found for meat, egg, cereal, and milk product consumption. Conclusion The support for the mediation hypothesis aligns with previous findings and indicates that health beliefs might be an important pathway to fostering healthier food choices, especially for men. Nonetheless, sex differences in food choice were only partially mediated by sex differences in specific health beliefs, indicating that future studies might benefit from parallel mediation analyses to reveal the impact of other relevant factors influencing sex differences in food choice.
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Borkent J, Manders M, Nijhof A, Wijker L, Feskens E, Naumann E, de van der Schueren M. Too low protein and energy intake in nursing homes residents. Nutrition 2023; 110:112005. [PMID: 36966585 DOI: 10.1016/j.nut.2023.112005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/06/2023] [Accepted: 02/10/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVES An optimal diet contributes to reducing malnutrition prevalence in the nursing home population. For this population, recommended daily intakes are ≥1.0 g protein/kg body weight and ≥27 energy kcal/kg body weight. The aim of this study was to identify the protein and energy intake of nursing home residents and to assess groups at increased risk for low intake. METHODS Cross-sectional data regarding food intake was collected by three-day observations in 189 residents (aged ≥65 y, mean age 85.0 y) of five different nursing homes. Linear mixed models were used to examine associations of protein and energy intake as dependent variables with demographic and disease-related problems as determinants. Results were adjusted for age, sex, and mobility levels and stratified by a protein/energy-enriched diet (P/E+). RESULTS The daily protein intake of the residents was 0.80 (SD 0.22) g/kg body weight, with 84.7% having an intake below the recommended daily 1 g/kg body weight. Mean daily energy intake was 20.7 (SD 6.1) kcal/kg body weight, with 85.2% having an intake below recommendation. Protein/energy intake was higher in the P/E+ group compared with standard diet: 0.92 (SD 0.23) versus 0.74 (SD 0.19) g/kg body weight, and 23.9 (SD 6.1) versus 19.1 (SD 5.4) kcal/kg body weight, respectively. The oldest age groups (>85 y), chair-bound residents, women, and residents having difficulties with chewing, dysphagia, a reported decreased food intake, or a decreased appetite were at a higher risk for a low protein/energy intake. CONCLUSION Nearly all nursing home residents were at increased risk for not meeting the minimum protein/energy requirements. Intakes should, on average, be increased with ≥15 g protein and ≥520 kcal to reach the minimum intake targets. Although using a P/E+ diet was associated with higher intakes, even these residents had intakes below the requirements.
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Mills CM, Keller HH, DePaul VG, Donnelly C. Nutrition risk varies according to social network type: data from the Canadian Longitudinal Study on Aging. Fam Med Community Health 2023; 11:fmch-2022-002112. [PMID: 36813466 PMCID: PMC9950914 DOI: 10.1136/fmch-2022-002112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE There were two primary objectives, namely: (1) to determine the social network types that Canadian adults aged 45 and older belong to and (2) to discover if social network type is associated with nutrition risk scores and the prevalence of high nutrition risk. DESIGN A retrospective cross-sectional study. SETTING Data from the Canadian Longitudinal Study on Aging (CLSA). PARTICIPANTS 17 051 Canadians aged 45 years and older with data from baseline and first follow-up of the CLSA. RESULTS CLSA participants could be classified into one of seven different social network types that varied from restricted to diverse. We found a statistically significant association between social network type and nutrition risk scores and percentage of individuals at high nutrition risk at both time points. Individuals with restricted social networks had lower nutrition risk scores and are more likely to be at nutrition risk, whereas individuals with diverse social networks had higher nutrition risk scores and are less likely to be at nutrition risk. CONCLUSIONS Social network type was associated with nutrition risk in this representative sample of Canadian middle-aged and older adults. Providing adults with opportunities to deepen and diversify their social networks may decrease the prevalence of nutrition risk. Individuals with more restricted networks should be proactively screened for nutrition risk.
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Affiliation(s)
| | - Heather H Keller
- Schlegel-UW Research Institute for Aging, University of Waterloo, Waterloo, Ontario, Canada,Department of Kinesiology & Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Vincent Gerard DePaul
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada,Health Services and Policy Research Institute, Queen's University, Kingston, Ontario, Canada
| | - Catherine Donnelly
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada,Health Services and Policy Research Institute, Queen's University, Kingston, Ontario, Canada
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Mills CM, Keller HH, DePaul VG, Donnelly C. Social Network Factors Affect Nutrition Risk in Middle-Aged and Older Adults: Results from the Canadian Longitudinal Study on Aging. J Nutr Health Aging 2023; 27:46-58. [PMID: 36651486 DOI: 10.1007/s12603-022-1877-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To determine which social network, demographic, and health-indicator variables are associated with SCREEN-8 (nutrition risk) scores at two time points, three years apart, using data from the Canadian Longitudinal Study on Aging. DESIGN A retrospective cross-sectional study. SETTING AND PARTICIPANTS 17051 Canadians aged 45 years and older with data from baseline and first follow-up of the Canadian Longitudinal Study on Aging. MEASUREMENTS Nutrition risk was measured using SCREEN-8. Social network factors included social network size, frequency of contact with social network members, social participation, social support, self-rated social standing, and household income. Demographic variables included age, sex assigned at birth, marital status, educational attainment, and living situation (alone or with others). Health-indicator variables included depression, disability, and self-rated general health, mental health, healthy aging, and oral health. Multivariable linear regression was used to analyze the relationship between the social network, demographic, and health-indicator variables and SCREEN-8 scores at two time points, three years apart. RESULTS Among the social network variables, individuals with higher social participation, self-rated social standing, and social support had higher SCREEN-8 scores at baseline and follow-up. Among the demographic variables, individuals who were single or widowed, compared to married or partnered, had lower SCREEN-8 scores at both time points. For the health-indicator variables, individuals who screened negative for depression, and those with higher self-rated general health, healthy aging, and oral health had higher SCREEN-8 scores at both time points. At baseline, as age increased, SCREEN-8 scores also increased. CONCLUSION Individuals with low social participation, low social standing, and low social support may be at increased nutrition risk and should be proactively screened by healthcare professionals. Interventions and community programs designed to increase levels of social participation and foster social support may help to reduce the prevalence of nutrition risk.
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Affiliation(s)
- C M Mills
- Christine Maire Mills, Queen's University, Faculty of Health Sciences, School of Rehabilitation Therapy, Kingston, ON, Canada, https://orcid.org/0000-0002-6662-8613
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Ueland Ø, Grini IS, Schillinger I, Varela P. Opportunities and barriers for food intake in older age - a Norwegian perspective. Food Nutr Res 2022; 66:8628. [PMID: 36590856 PMCID: PMC9793769 DOI: 10.29219/fnr.v66.8628] [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: 02/21/2022] [Revised: 09/12/2022] [Accepted: 10/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background The ageing processes occur slowly over time and are often not detectable by the individual. Thus, preparing for dietary needs in later years should start at an earlier age than most people realise. Objective This study aims at better understanding what characterises food-related practices in active, home-living older adults, in order to identify food-related factors that act as barriers and those that promote healthy ageing. Design Three experiments were conducted: First, a web-based quantitative survey to collect information about home-living older adults' food-related behaviours (67+ years, N = 1,005). Second, two focus groups with respondents 67-74 years (N = 7) and 75-84 years (N = 6) to elicit aspects not adequately covered in the survey. Third, 10 individual interviews to provide in-depth insights. Results Two distinct groups were identified in the survey; 67-79 years and 80+ years. The older age group experienced more barriers and restrictions in food intake and food-related behaviours compared to the younger group. Good taste, routines and social settings were important for appetite and food intake. Discussion Using a mixed-methods approach proved valuable for extracting information and a better understanding of what impacts on food-related aspects amongst older adults. Strategies for upholding a healthy food intake involve establishing daily routines and meeting arenas where older adults can socialise and eat food together. Conclusion This study confirmed that knowledge of older adults' physical needs, barriers and abilities must be a part in preparation for a healthy diet.
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Affiliation(s)
- Øydis Ueland
- Nofima, Osloveien 1, 1430 Ås, Norway,Øydis Ueland, Nofima AS Box 410 Ås, NO-1431 Ås, Norway.
| | | | - Ine Schillinger
- The Norwegian University of Life Science, Department of Chemistry, Biotechnology and Food Science (KBM), Ås, Norway
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Shi H, Schweren LJS, Ter Horst R, Bloemendaal M, van Rooij D, Vasquez AA, Hartman CA, Buitelaar JK. Low-grade inflammation as mediator between diet and behavioral disinhibition: A UK Biobank study. Brain Behav Immun 2022; 106:100-110. [PMID: 35944739 DOI: 10.1016/j.bbi.2022.07.165] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/19/2022] [Accepted: 07/30/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Dietary patterns have been associated with variations in behavior. However, evidence has been limited and mixed, and the underlying mechanism remains unclear. OBJECTIVE Extend a previous study reporting significant associations between food patterns and behavioral disinhibition and explore whether low-grade inflammation is linked to behaviors and mediates the association between diet and behavioral disinhibition. DESIGN Among participants of the UK Biobank (UKB) we extracted a single behavioral disinhibition principal component using the UKB touchscreen questionnaire, Mental Health Questionnaire (MHQ), and registered diagnoses. We identified four dietary patterns (prudent diet, elimination of wheat/dairy/eggs, meat-based diet, full-cream dairy consumption) by using the Food Frequency Questionnaire (FFQ). Immune biomarkers and an aggregated inflammation score (INFLA-score) were used to characterize low-grade inflammation. Associations between dietary patterns and immune biomarkers, between immune biomarkers and disinhibition were assessed, with adjustment for demographics, lifestyle factors, and somatic health conditions. Next, mediation analyses were run to examine whether the association between dietary patterns and disinhibition was partially explained by inflammatory levels. We also conducted subgroup analyses to explore whether associations and the mediation effect differed by sex, age, ethnicity/race, body-mass-index (BMI), and socioeconomic status (SES). RESULTS The prudent diet was negatively, and the meat-based diet was positively associated with several pro-inflammatory biomarkers. Most immune biomarkers were positively associated with disinhibition (numbers of lymphocytes (βstandardized = 0.082, p < 0.001), monocytes (βstandardized = 0.043, p < 0.001), neutrophils (βstandardized = 0.071, p < 0.001), platelets (βstandardized = 0.022, p < 0.001), leukocytes (βstandardized = 0.093, p < 0.001), C-reactive protein (βstandardized = 0.051, p < 0.001), and for INFLA-score (βstandardized = 0.074, p < 0.001). In the mediation model, the INFLA-score mediated the association between prudent diet and meat-based diet and disinhibition score, with a significant indirect effect of low-grade inflammation for the prudent diet-disinhibition association (βstandardized = -0.007, p < 0.001) and for meat-disinhibition association (βstandardized = 0.001, p < 0.001)). Although all effects were small, covariates and interaction term adjustments did not attenuate the effects, and neither did most subgroup-only analyses. CONCLUSIONS The prudent diet was associated with a lower disinhibition score and this effect was partially mediated by the lower inflammation. Reversely, the meat-based diet was linked to more inflammation, which was associated with more disinhibition. Our findings suggest mediating effects of immune function in the relationship between diet and behavioral disinhibition. However further alternative designs such as interventional trials are needed to establish causal effects.
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Affiliation(s)
- Huiqing Shi
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboudumc, Nijmegen, Gelderland, the Netherlands.
| | - Lizanne J S Schweren
- Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, the Netherlands
| | - Rob Ter Horst
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Mirjam Bloemendaal
- Department of Psychiatry, and Department of Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, Gelderland, the Netherlands
| | - Daan van Rooij
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboudumc, Nijmegen, Gelderland, the Netherlands
| | - Alejandro Arias Vasquez
- Department of Psychiatry, and Department of Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, Gelderland, the Netherlands
| | - Catharina A Hartman
- Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Groningen, the Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboudumc, Nijmegen, Gelderland, the Netherlands; Karakter Child and Adolescent Psychiatry University Centre, Nijmegen Gelderland, the Netherlands
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14
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Jeruszka-Bielak M, Hamulka J, Czarniecka-Skubina E, Hoffmann M, Kostyra E, Stasiewicz B, Jeszka J, Wadolowska L. Dietary-Physical Activity Patterns in the Health Context of Older Polish Adults: The 'ABC of Healthy Eating' Project. Nutrients 2022; 14:nu14183757. [PMID: 36145132 PMCID: PMC9506088 DOI: 10.3390/nu14183757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/17/2022] Open
Abstract
The study aimed to analyze the dietary–physical activity patterns (D-PAPs) in the health context of Polish people aged 60+ years. A total of 418 respondents across Poland were recruited; however, the final analysis included 361 women and men aged 60–89 years old. D-PAPs were derived using a principal component analysis (PCA); input variables were the frequency of consumption of 10 food groups and physical activity. Finally, three D-PAPs were identified: ‘Pro-healthy eating and more-active’, ‘Sweets, fried foods and sweetened beverages’, and ‘Juices, fish and sweetened beverages’. We developed the Functional Limitations Score (FLS) using the Mini Nutritional Assessment (MNA®). A logistic regression was applied to verify the association between the D-PAPs and health-condition outcomes. Older adults were more likely to adhere to the upper tertile of the ‘Pro-healthy eating and more-active’ pattern, with good/better self-reported health status in comparison with their peers (OR = 1.86) or with good/very good self-assessed appetite (OR = 2.56), while this was less likely for older adults with malnutrition risk (OR = 0.37) or with a decrease in food intake (OR = 0.46). Subjects with a decrease in food intake (OR = 0.43), who declared a recent weight loss (OR = 0.49), or older adults in the upper tertile of the FLS (OR = 0.34) were less likely to adhere to the upper tertile of the ‘Sweets, fried foods and sweetened beverages’ pattern. The decrease in food intake due to a loss of appetite or chewing or swallowing difficulties was inversely associated with the ‘Pro-healthy eating and more-active’ pattern characterized by a relatively high frequency of consumption of vegetables, fruit, water, dairy, and grains and a high physical activity. In the interest of the good nutritional status and health of older adults, special attention should be paid to removing limitations in meal consumption, including improved appetite.
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Affiliation(s)
- 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
| | - Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS-SGGW), Nowoursynowska 159C, 02-776 Warsaw, Poland
- Correspondence:
| | - Ewa Czarniecka-Skubina
- Department of Food Gastronomy and Food Hygiene, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (WULS), 159C, 02-776 Warsaw, Poland
| | - Monika Hoffmann
- Department of Functional and Organic Food, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C, 02-776 Warsaw, Poland
| | - Eliza Kostyra
- Department of Functional and Organic Food, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), 159C, 02-776 Warsaw, Poland
| | - Beata Stasiewicz
- Department of Human Nutrition, Faculty of Food Sciences, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland
| | - Jan Jeszka
- Department of Human Nutrition and Dietetics, Poznań University of Life Sciences, Wojska Polskiego 31, 60-624 Poznan, Poland
| | - Lidia Wadolowska
- Department of Human Nutrition, Faculty of Food Sciences, University of Warmia and Mazury in Olsztyn, Sloneczna 45F, 10-718 Olsztyn, Poland
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15
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Panda A, Booth SL. Nutritional Aspects of Healthy Aging. Med Clin North Am 2022; 106:853-863. [PMID: 36154704 DOI: 10.1016/j.mcna.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Proper nutrition and healthy eating are key determinants of healthy aging. In older age, energy requirements decrease, yet micronutrient requirements stay the same or increase, which make older adults susceptible to nutrient deficiencies. Therefore, it is important to encourage older adults to consume nutrient-dense foods. Many older adults do not maintain proper hydration, so adequate water intake should also be encouraged. Most older adults have multiple chronic diseases that may influence their dietary intake and nutritional needs. However, currently, our understanding of how individual chronic diseases and their associated treatments influence dietary requirements is limited.
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Affiliation(s)
- Alexander Panda
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111, USA
| | - Sarah L Booth
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111, USA.
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16
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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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17
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Grasso AC, Olthof MR, Reinders I, Wijnhoven HAH, Visser M, Brouwer IA. Effect of personalized dietary advice to increase protein intake on food consumption and the environmental impact of the diet in community-dwelling older adults: results from the PROMISS trial. Eur J Nutr 2022; 61:4015-4026. [PMID: 35788775 PMCID: PMC9596580 DOI: 10.1007/s00394-022-02896-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 04/21/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Diet modelling studies suggest that increasing protein intake with no consideration for sustainability results in a higher environmental impact on the diet. To better understand the impact in real life, the aim of this study was to assess the effect of dietary advice to increase protein intake on food consumption and the environmental impact of the diet in community-dwelling older adults. METHODS Food consumption and environmental impact were analyzed among 124 Dutch older adults with lower habitual protein intake (< 1.0 g/kg adjusted body weight/day) participating in the six-month PROMISS trial. Dietary intake data from three 24-h dietary recalls, aided by food diaries, and results from life cycle assessments were used to examine the differences in changes in food consumption and environmental impact between those who received dietary advice to isocalorically increase protein intake to ≥ 1.2 g/kg aBW/d (Protein + ; n = 84) and those who did not receive dietary advice (Control; n = 40). RESULTS Compared to the Control, Protein + increased protein intake from animal-based food products (11.0 g protein/d, 95% CI 6.6-15.4, p < 0.001), plant-based food products (2.1 g protein/d, 95% CI 0.2-4.0, p = 0.031) and protein-enriched food products provided during the trial (18 g protein/d, 95% CI 14.5-21.6, p < 0.001) at the 6-month follow-up. Diet-associated greenhouse gas emissions increased by 16% (p < 0.001), land use by 19% (p < 0.001), terrestrial acidification by 20% (p = 0.01), and marine eutrophication by 16% (p = 0.035) in Protein + compared to the Control. CONCLUSION This study found that dietary advice increased protein intake, favoring animal-based protein, and increased the environmental impact of the diet in older adults. TRIAL REGISTRATION ClinicalTrials.gov. NCT03712306. October 2018.
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Affiliation(s)
- Alessandra C Grasso
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Margreet R Olthof
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ilse Reinders
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ingeborg A Brouwer
- Department of Health Sciences, Faculty of Science, and the Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
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18
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Zheng L, Miao M, Gan Y. A systematic and meta-analytic review on the neural correlates of viewing high- and low-calorie foods among normal-weight adults. Neurosci Biobehav Rev 2022; 138:104721. [PMID: 35667634 DOI: 10.1016/j.neubiorev.2022.104721] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/12/2022] [Accepted: 05/30/2022] [Indexed: 11/30/2022]
Abstract
In the context of current-day online shopping, people select foods based on pictures and using their visual systems. Although there are some reviews of previous neuroimaging studies on appetitive behaviors, the findings on neural activation in response to pictures of high- and low-calorie foods seem inconsistent. This study aims to systematically review, integrate, and meta-analyze neuroimaging evidence of viewing high- and low-calorie foods. There were 25 samples from 24 studies, totalizing 489 normal-weight participants (311 female, 160 male, and 18 of unknown sex). We conducted a systematic review and Activation Likelihood Estimation (ALE) meta-analysis on viewing high-calorie foods (versus non-foods), low-calorie foods (versus non-foods), and high- versus low-calorie foods. In systematic review, several brain regions were shown to be activated when viewing high- or low-calorie foods (versus non-foods) and viewing high- versus low-calorie foods, including the prefrontal cortex, orbitofrontal cortex, amygdala, insula, ventral striatum, hippocampus, superior parietal lobe, and fusiform gyrus. However, the ALE meta-analysis showed that the left orbitofrontal cortex, left amygdala, insula, superior parietal lobe, and fusiform gyrus were activated when viewing high-calorie foods (versus non-foods); the left fusiform gyrus was activated when viewing low-calorie foods (versus non-foods); and no cluster was activated when viewing high- versus low-calorie foods. Our research suggests an appetitive brain network that includes visual perception and attentional processing, sensory input integration, subjective reward value encoding, decision-making, and top-down cognitive control. Future studies should control for the effects of methodological and physiological variables when examining the neural correlates of viewing high- and low-calorie foods.
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Affiliation(s)
- Lei Zheng
- School of Economics and Management, Fuzhou University, China; School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, China
| | - Miao Miao
- Department of Medical Psychology, School of Health Humanities, Peking University, China
| | - Yiqun Gan
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, China.
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19
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Kershner M, Askren AN. It's not only swallowing: a clinician primer to adult food refusal beyond dysphagia. Curr Opin Otolaryngol Head Neck Surg 2022; 30:194-197. [PMID: 35143423 DOI: 10.1097/moo.0000000000000798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Medical teams are frequently faced with challenging clinical scenarios when their patients exhibit reduced intake of food and drink. Speech-language pathologists, who serve as oropharyngeal swallowing specialists in medical settings, are frequently the first to be summoned with the referral, 'Poor PO intake. Please evaluate and treat.' As our practices have illuminated, many differentials other than oropharyngeal dysphagia are often at play. RECENT FINDINGS Changes to taste, salivary supply/dry mouth, hunger drive, and psychosocial circumstances will significantly impact intake per os - each scenario to be explored further in this paper. Consequences to diminished nutrition and hydration include medical complications, lengthier hospital stays, and diminished quality of life. SUMMARY In this review, two medical speech-language pathologists detail more common alternative diagnoses that explain reduced intake by mouth amongst adults with acute and chronic diseases. Ultimately, a multidisciplinary approach should be considered when evaluating such patients to ensure a comprehensive and effective care plan.
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Affiliation(s)
- Marnie Kershner
- MedStar National Rehabilitation Hospital, Washington, District of Columbia
| | - Annette N Askren
- VA Puget Sound Healthcare System, Seattle, WA, USA, West Virginia University School of Medicine, Morgantown, WV, USA
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20
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Walker-Clarke A, Walasek L, Meyer C. Psychosocial factors influencing the eating behaviours of older adults: A systematic review. Ageing Res Rev 2022; 77:101597. [PMID: 35219902 DOI: 10.1016/j.arr.2022.101597] [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: 08/06/2021] [Revised: 01/25/2022] [Accepted: 02/21/2022] [Indexed: 11/16/2022]
Abstract
Our understanding of how eating behaviours change in later life have been dominated by the studies of physiological and biological influences on malnutrition. Insights from these studies were consequently used to develop interventions, which are predominantly aimed at rectifying nutritional deficiencies, as opposed to interventions that may enable older adults to eat well and enjoy their food-related life well into older age. The objective of the present review is to summarise the existing knowledge base on psychosocial influences on eating behaviours in later life. Following comprehensive searches, review, and appraisal, 53 articles were included (22 qualitative and 31 quantitative) to provide a greater understanding of the mechanisms underpinning the psychosocial factors influencing eating behaviours. Our analysis identified eight underpinning psychosocial factors that influences eating behaviours in later life; (1) health awareness & attitudes, (2) food decision making, (3) perceived dietary control, (4) mental health & mood, (5) food emotions & enjoyment, (6) eating arrangements, (7) social facilitation, and (8) social support. The importance and lasting influence of early food experiences were also identified as contributing to eating behaviours in later life. The review concludes with the call for further investigation into specific psychosocial factors that influence eating behaviour, calls for improvements in methodologies, and a summary of psychosocial barriers and enablers to eating well in later life.
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Affiliation(s)
- Aimee Walker-Clarke
- Applied Psychology Group, Warwick Manufacturing Group (WMG), University of Warwick, Coventry CV4 7AL, United Kingdom.
| | - Lukasz Walasek
- Behavioural Science, Department of Psychology, University of Warwick, Coventry CV4 7AL, United Kingdom.
| | - Caroline Meyer
- Vice-Provost and Chair of the Faculty of Science, Engineering and Medicine, University of Warwick, Coventry CV4 7AL, United Kingdom.
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21
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Prodhan UK, Milan AM, Shrestha A, Vickers MH, Cameron-Smith D, Barnett MPG. Circulatory amino acid responses to milk consumption in dairy and lactose intolerant individuals. Eur J Clin Nutr 2022; 76:1415-1422. [PMID: 35459911 PMCID: PMC9550627 DOI: 10.1038/s41430-022-01119-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 02/27/2022] [Accepted: 03/10/2022] [Indexed: 11/09/2022]
Abstract
Background/objectives Self-reported digestive intolerance to dairy foods is common. As dairy can be an important source of dietary protein, this study aimed to identify whether milk protein digestion is compromised in individuals with digestive intolerance. Subjects/methods Adult women (n = 40) were enroled in this double-blinded, randomised cross-over trial, with digestive symptoms characterised using a lactose challenge and self-reported digestive symptom questionnaire. Participants were classified as either lactose intolerant (LI, n = 10), non-lactose dairy intolerant (NLDI, n = 20) or dairy tolerant (DT, n = 10). In a randomised sequence, participants consumed three different kinds of milk (750 ml); conventional milk (CON), a2 Milk™ (A2M), and lactose-free conventional milk (LF-CON). Circulatory plasma amino acid (AA) concentrations were measured at baseline and every 30 min until 3 h post-ingestion. Results In all participants across all milk types, plasma AA concentrations (AUC0-180) increased after milk ingestion with no significant differences in responses observed between milk types or participants (P > 0.05), with the exception of the suppressed lysine response in the DT group following A2M ingestion, relative to the other two groups and milk types (P < 0.05). Conclusion Milk protein digestion, as determined by circulatory AAs, is largely unaffected by dairy- and lactose- intolerances. ![]()
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Affiliation(s)
- Utpal Kumar Prodhan
- Liggins Institute, The University of Auckland, 85 Park Road, Grafton, Private Bag 92019, Auckland, 1023, New Zealand.,The Riddet Institute, Palmerston North, 4442, New Zealand.,Department of Food Technology and Nutritional Science, Mawlana Bhashani Science and Technology University, Tangail, 1902, Bangladesh
| | - Amber Marie Milan
- Liggins Institute, The University of Auckland, 85 Park Road, Grafton, Private Bag 92019, Auckland, 1023, New Zealand.,Smart Foods Innovation Centre of Excellence, AgResearch Limited, Private Bag 11008, Palmerston North, 4442, New Zealand.,The High-Value Nutrition National Science Challenge, Auckland, 1023, New Zealand
| | - Aahana Shrestha
- Liggins Institute, The University of Auckland, 85 Park Road, Grafton, Private Bag 92019, Auckland, 1023, New Zealand.,The Riddet Institute, Palmerston North, 4442, New Zealand
| | - Mark Hedley Vickers
- Liggins Institute, The University of Auckland, 85 Park Road, Grafton, Private Bag 92019, Auckland, 1023, New Zealand
| | - David Cameron-Smith
- Liggins Institute, The University of Auckland, 85 Park Road, Grafton, Private Bag 92019, Auckland, 1023, New Zealand.,The Riddet Institute, Palmerston North, 4442, New Zealand.,Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, Singapore, 117609, Singapore
| | - Matthew Philip Greig Barnett
- The Riddet Institute, Palmerston North, 4442, New Zealand. .,Smart Foods Innovation Centre of Excellence, AgResearch Limited, Private Bag 11008, Palmerston North, 4442, New Zealand. .,The High-Value Nutrition National Science Challenge, Auckland, 1023, New Zealand.
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22
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Chareh N, Kiesswetter E, Kob R, Hannink A, Brandl B, Skurk T, Hauner H, Sieber CC, Volkert D. Association Between Inflammation and Appetite in Healthy Community-Dwelling Older Adults—An enable Study. FRONTIERS IN AGING 2022; 3:826816. [PMID: 35821805 PMCID: PMC9261305 DOI: 10.3389/fragi.2022.826816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/17/2022] [Indexed: 11/13/2022]
Abstract
Aging is associated with reduced appetite as well as a slight increase in pro-inflammatory status, which both might contribute to the development of malnutrition. We aimed to evaluate the association between inflammation based on serum C-reactive protein (CRP), and appetite in healthy community-dwelling older adults. In this cross-sectional study of 158 healthy and non-smoking persons (aged 75–85 years), appetite was assessed in personal interviews by a single question with five answer categories. As nobody reported (very) poor appetite, the remaining three categories were dichotomised into “(very) good” and “moderate” appetite. Fasting serum CRP was analysed according to standard procedures, values ≥ 5.0 mg/L were considered as inflammation. The association between inflammation and appetite was examined by binary logistic regression, unadjusted and adjusted for age, sex, waist circumference, leptin, depressive mood, number of medications, interleukin-6 and tumor necrosis factor-α. Appetite was very good in 27.8%, good in 58.9%, and moderate in 13.3% of participants. Inflammation was present in 10.8% overall, in 8.8% of those with (very) good and in 23.8% of those with moderate appetite (p = 0.038). In the unadjusted model, participants with inflammation were 3.2 times more likely to have moderate appetite (95%CI: 1.01–10.44, p = 0.047). In the adjusted model, the odds of having moderate appetite was 3.7 times higher in participants with inflammation, but no longer significant (95%CI: 0.77–18.55, p = 0.102). In healthy older people, we found hints for a potential association between increased levels of CRP and a slightly reduced appetite. More studies in larger samples are needed.
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Affiliation(s)
- Neshat Chareh
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
- *Correspondence: Neshat Chareh,
| | - Eva Kiesswetter
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Robert Kob
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Anne Hannink
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
| | - Beate Brandl
- ZIEL–Institute for Food and Health, Technical University of Munich, Freising, Germany
| | - Thomas Skurk
- ZIEL–Institute for Food and Health, Technical University of Munich, Freising, Germany
| | - Hans Hauner
- ZIEL–Institute for Food and Health, Technical University of Munich, Freising, Germany
- Institute of Nutritional Medicine, Else Kroener-Fresenius-Centre for Nutritional Medicine, School of Medicine, Technical University of Munich, Munich, Germany
| | - Cornel C. Sieber
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
- Department of Medicine, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Dorothee Volkert
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany
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23
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Siracusa ER, Higham JP, Snyder-Mackler N, Brent LJN. Social ageing: exploring the drivers of late-life changes in social behaviour in mammals. Biol Lett 2022; 18:20210643. [PMID: 35232274 PMCID: PMC8889194 DOI: 10.1098/rsbl.2021.0643] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Social interactions help group-living organisms cope with socio-environmental challenges and are central to survival and reproductive success. Recent research has shown that social behaviour and relationships can change across the lifespan, a phenomenon referred to as 'social ageing'. Given the importance of social integration for health and well-being, age-dependent changes in social behaviour can modulate how fitness changes with age and may be an important source of unexplained variation in individual patterns of senescence. However, integrating social behaviour into ageing research requires a deeper understanding of the causes and consequences of age-based changes in social behaviour. Here, we provide an overview of the drivers of late-life changes in sociality. We suggest that explanations for social ageing can be categorized into three groups: changes in sociality that (a) occur as a result of senescence; (b) result from adaptations to ameliorate the negative effects of senescence; and/or (c) result from positive effects of age and demographic changes. Quantifying the relative contribution of these processes to late-life changes in sociality will allow us to move towards a more holistic understanding of how and why these patterns emerge and will provide important insights into the potential for social ageing to delay or accelerate other patterns of senescence.
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Affiliation(s)
- Erin R Siracusa
- School of Psychology, Centre for Research in Animal Behaviour, University of Exeter, Exeter, UK
| | - James P Higham
- Department of Anthropology, New York University, New York, NY, USA
| | - Noah Snyder-Mackler
- Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA.,School of Life Sciences, Arizona State University, Tempe, AZ, USA.,School for Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA
| | - Lauren J N Brent
- School of Psychology, Centre for Research in Animal Behaviour, University of Exeter, Exeter, UK
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Zukeran MS, Valentini Neto J, Romanini CV, Mingardi SVB, Cipolli GC, Aprahamian I, Lima Ribeiro SM. The association between appetite loss, frailty, and psychosocial factors in community-dwelling older adults adults. Clin Nutr ESPEN 2022; 47:194-198. [DOI: 10.1016/j.clnesp.2021.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 10/15/2021] [Accepted: 12/18/2021] [Indexed: 02/08/2023]
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Van Wymelbeke-Delannoy V, Maître I, Salle A, Lesourd B, Bailly N, Sulmont-Rossé C. Prevalence of malnutrition risk among older French adults with culinary dependence. Age Ageing 2022; 51:6406696. [PMID: 34673917 DOI: 10.1093/ageing/afab208] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/06/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The term 'culinary dependence' denotes a situation in which someone delegates all or part of their daily meal-related activities to a third party. The present study aimed to explore nutritional risk among older people (≥65 years) with culinary dependence. METHOD The first survey included 559 people either living at home without help, with help unrelated to food activities, with help related to food activities or living in nursing home. The second survey included 319 people with food help provided by a caregiver, by meals-on-wheels or by a nursing home. Nutritional status was assessed with the Mini-Nutritional Assessment. Sociological background and wellness variables (health, cognitive and mental status) were collected. RESULTS The first survey found a strong association between culinary dependence and nutritional risk. About half of the people who delegated their food-related activities were malnourished or at risk of malnutrition compared with only 4% for people with no help and 12% for people with help unrelated to food activity. According to the second survey, this prevalence varied slightly depending on who the tasks were delegated to (46% for those who had the support of a caregiver; 60% for those who used a meals-on-wheels service; 69% for those living in nursing home). According to multivariate analyses, dependence categories, depressive symptoms and cognitive status were identified as independent determinants of malnutrition. CONCLUSION Without inferring a causal relationship between dependence and malnutrition, there is a strong need for care structures to take into account the issue of malnutrition when developing services targeting older people.
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Affiliation(s)
- Virginie Van Wymelbeke-Delannoy
- CHU Dijon Bourgogne F Mitterrand, Unité du Pôle Personnes Âgées, F-21000 Dijon, France
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, F-21000 Dijon, France
| | - Isabelle Maître
- Ecole Supérieure d’Agricultures (ESA), USC 1422 GRAPPE, INRAE, SFR 4207, QUASAV, Angers, France
| | - Agnès Salle
- CHU, Service d’endocrinologie, diabétologie et nutrition, Angers, France
| | - Bruno Lesourd
- Département de Gériatrie CHU, Clermont-Ferrand, France
| | - Nathalie Bailly
- University of Tours, E.A. 2114. « Psychologie des Ages de la Vie et Adaptation », Department of Psychology, Tours, France
| | - Claire Sulmont-Rossé
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, F-21000 Dijon, France
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Merchant RA, Woo J, Morley JE. Editorial: Anorexia of Ageing: Pathway to Frailty and Sarcopenia. J Nutr Health Aging 2022; 26:3-5. [PMID: 35067696 DOI: 10.1007/s12603-021-1703-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Reshma A Merchant
- Dr Reshma A Merchant, Division of Geriatric Medicine. Department of Medicine, 1E Kent Ridge Road, NUHS Tower Block, Singapore 119228,
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Cristina NM, Lucia D. Nutrition and Healthy Aging: Prevention and Treatment of Gastrointestinal Diseases. Nutrients 2021; 13:4337. [PMID: 34959889 PMCID: PMC8706789 DOI: 10.3390/nu13124337] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 12/16/2022] Open
Abstract
Nutritional well-being is a fundamental aspect for the health, autonomy and, therefore, the quality of life of all people, but especially of the elderly. It is estimated that at least half of non-institutionalized elderly people need nutritional intervention to improve their health and that 85% have one or more chronic diseases that could improve with correct nutrition. Although prevalence estimates are highly variable, depending on the population considered and the tool used for its assessment, malnutrition in the elderly has been reported up to 50%. Older patients are particularly at risk of malnutrition, due to multiple etiopathogenetic factors which can lead to a reduction or utilization in the intake of nutrients, a progressive loss of functional autonomy with dependence on food, and psychological problems related to economic or social isolation, e.g., linked to poverty or loneliness. Changes in the aging gut involve the mechanical disintegration of food, gastrointestinal motor function, food transit, intestinal wall function, and chemical digestion of food. These alterations progressively lead to the reduced ability to supply the body with adequate levels of nutrients, with the consequent development of malnutrition. Furthermore, studies have shown that the quality of life is impaired both in gastrointestinal diseases, but especially in malnutrition. A better understanding of the pathophysiology of malnutrition in elderly people is necessary to promote the knowledge of age-related changes in appetite, food intake, homeostasis, and body composition in order to better develop effective prevention and intervention strategies to achieve healthy aging.
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Affiliation(s)
- Neri Maria Cristina
- Division of Gastroenterology, Geriatric Institute Pio Albergo Trivulzio, 20146 Milan, Italy
| | - d’Alba Lucia
- Department of Gastroenterology and Endoscopy, San Camillo Forlanini Hospital, 00149 Rome, Italy;
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Factors associated with unintentional weight loss among older adults in a geriatric outpatient clinic of university hospital. PLoS One 2021; 16:e0260233. [PMID: 34793549 PMCID: PMC8601429 DOI: 10.1371/journal.pone.0260233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/04/2021] [Indexed: 12/28/2022] Open
Abstract
Background Unintentional weight loss (UWL) is defined as unintentional reduction of more than 5% of baseline body weight over 6 to 12 months. UWL is a common problem in the older adults, resulting in increased rate of morbidity and mortality. With specific reference to Thailand, no information on factors associated with UWL in older adults could be traced. The aims of this research were to identify the factors associated with UWL and to assess the common causes of UWL among older adults in the geriatric outpatient clinic of university hospital. Methods A case-control study was conducted from June 1st, 2020 to December 31st, 2020. Eighty older adults aged 60 years or older were enrolled in the UWL group while the non-UWL group consisted of 160 participants. Data collection was performed by structural questionnaire including baseline characteristics, psychosocial factors, health information, lifestyle behaviors, and medications. The factors associated with UWL were analyzed by using univariate and multivariate logistic regression analysis. Causes of UWL were recorded from electronic medical records. Results The mean age of the 240 participants was 79.6 years (SD 7.4). Most patients were female (79.2%) and had fewer than 12 years of education (62.6%). The three common causes of UWL were reduced appetite (20.1%), dementia and behavioral and psychological symptoms of dementia (13.7%) and medications (11.0%). Multivariate logistic regression analysis showed that a Charlson Comorbidity Index (CCI) score of >1 (OR 2.55, 95% CI 1.37–4.73; P = 0.003), vitamin D deficiency (OR 4.01, 95% CI 1.62–9.97; P = 0.003), and hemoglobin level of <12 g/dL (OR 2.47, 95% CI 1.32–4.63; P = 0.005) were factors significantly associated with UWL. Conclusions Factors associated with UWL were CCI score >1, vitamin D deficiency, and hemoglobin level of <12 g/dl. The early detection of these associated factors, reduced appetite, dementia and polypharmacy may be important in UWL prevention in older adults.
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Involvement of Ghrelin Dynamics in Stress-Induced Eating Disorder: Effects of Sex and Aging. Int J Mol Sci 2021; 22:ijms222111695. [PMID: 34769125 PMCID: PMC8583769 DOI: 10.3390/ijms222111695] [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: 08/30/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 12/15/2022] Open
Abstract
Stress, a factor that affects appetite in our daily lives, enhances or suppresses appetite and changes palatability. However, so far, the mechanisms underlying the link between stress and eating have not been fully elucidated. Among the peripherally produced appetite-related peptides, ghrelin is the only orexigenic peptide, and abnormalities in the dynamics and reactivity of this peptide are involved in appetite abnormalities in various diseases and psychological states. This review presents an overview of the research results of studies evaluating the effects of various stresses on appetite. The first half of this review describes the relationship between appetite and stress, and the second half describes the relationship between the appetite-promoting peptide ghrelin and stress. The effects of sex differences and aging under stress on appetite are also described.
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30
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The Effects of Sorbet Drinking Before Meal on Food Intake and Body Mass Index Among Elderly People With Xerostomia. TOP CLIN NUTR 2021. [DOI: 10.1097/tin.0000000000000263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Minagawa Y, Saito Y. The Role of Underweight in Active Life Expectancy Among Older Adults in Japan. J Gerontol B Psychol Sci Soc Sci 2021; 76:756-765. [PMID: 32016426 DOI: 10.1093/geronb/gbaa013] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES It is underweight, rather than overweight or obesity, that has been a pressing public health concern in Japan. This study examines the impact of being underweight on the health of older Japanese men and women, measured by active life expectancy at age 65. Following the Japanese government's guideline, underweight in this study is defined using the body mass index (BMI) value of 20. METHOD Data came from five waves (1999-2009) of the Nihon University Japanese Longitudinal Study of Aging (NUJLSOA). We used the Interpolation of Markov Chain approach to estimate the number of years underweight (BMI < 20), normal weight (20 < BMI < 25), and overweight (25 < BMI) individuals were expected to live without difficulty in activities of daily living (ADLs) or instrumental ADLs. RESULTS We found differences in life and health expectancies across the three weight categories. Underweight people were expected to live the shortest lives and spend the fewest years in an active state compared with normal and overweight individuals. Results remained unchanged even when accounting for educational attainment, smoking history, and a count of existing chronic conditions. DISCUSSION Being underweight is associated with poor quality of life lived among Japanese older adults. This finding suggests the importance of maintaining proper weight and avoids nutritional risks at advanced ages.
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Affiliation(s)
- Yuka Minagawa
- Faculty of Liberal Arts, Sophia University, Tokyo, Japan
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Chang M, Geirsdottir OG, Launer LJ, Gudnasson V, Visser M, Gunnarsdottir I. A poor appetite or ability to eat and its association with physical function amongst community-dwelling older adults: age, gene/environment susceptibility-Reykjavik study. Eur J Ageing 2021; 18:405-415. [PMID: 34483804 PMCID: PMC8377134 DOI: 10.1007/s10433-020-00588-1] [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] [Accepted: 10/16/2020] [Indexed: 12/25/2022] Open
Abstract
A poor appetite or ability to eat and its association with physical function have not been explored considerably amongst community-dwelling older adults. The current study examined whether having an illness or physical condition affecting one's appetite or ability to eat is associated with body composition, muscle strength, or physical function amongst community-dwelling older adults. This is a secondary analysis of cross-sectional data from the age, gene/environment susceptibility-Reykjavik study (n = 5764). Illnesses or physical conditions affecting one's appetite or ability to eat, activities of daily living, current level of physical activity, and smoking habits were assessed with a questionnaire. Fat mass, fat-free mass, body mass index, knee extension strength, and grip strength were measured, and the 6-m walk test and timed up-and-go test were administered. Individuals who reported illnesses or physical conditions affecting their appetite or ability to eat were considered to have a poor appetite. The associations of appetite or the ability to eat with body composition and physical function were analysed with stepwise linear regression models. A total of 804 (14%) individuals reported having conditions affecting their appetite or ability to eat and had a significantly lower fat-free mass and body mass index, less grip strength, and poorer physical function than did those without any conditions affecting their appetite or ability to eat. Although the factors reported to affect one's appetite or ability to eat are seldom considered severe, their strong associations with physical function suggest that any condition affecting one's appetite or ability to eat requires attention.
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Affiliation(s)
- Milan Chang
- The Icelandic Gerontological Research Center, Landspitali University Hospital and University of Iceland, Reykjavík, Iceland.,Sport Science, School of Science and Engineering, Reykjavik University, Reykjavík, Iceland
| | - Olof G Geirsdottir
- Faculty of Food Science and Nutrition, School of Health Science, University of Iceland, Reykjavík, Iceland.,Unit for Nutrition Research, University of Iceland and Landspitali University Hospital, Reykjavík, Iceland
| | - Lenore J Launer
- Epidemiology and Pop Science Lab, National Institute on Aging, National Institute of Health, Bethesda, MD USA
| | - Vilmundur Gudnasson
- Icelandic Heart Association, Kopavogur, Reykjavík, Iceland.,Faculty of Medicine, School of Health Science, University of Iceland, Reykjavík, Iceland
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ingibjorg Gunnarsdottir
- Faculty of Food Science and Nutrition, School of Health Science, University of Iceland, Reykjavík, Iceland.,Unit for Nutrition Research, University of Iceland and Landspitali University Hospital, Reykjavík, Iceland
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Anker JJ, Nakajima M, Raatz S, Allen S, al'Absi M. Tobacco withdrawal increases junk food intake: The role of the endogenous opioid system. Drug Alcohol Depend 2021; 225:108819. [PMID: 34182373 PMCID: PMC8297656 DOI: 10.1016/j.drugalcdep.2021.108819] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 03/29/2021] [Accepted: 04/10/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND The aims of this study were to 1) determine whether acute nicotine withdrawal increases the intake of junk food (high in salt, fat, and sugar) and 2) assess whether the endogenous opioid system is involved in junk food intake during nicotine withdrawal using naltrexone as a pharmacological probe. METHODS Smokers were randomly assigned to 24-hr withdrawal from tobacco products (n = 42) or smoking ad libitum (n = 34). A non-smoking group (n = 29) was included. Participants completed two laboratory sessions where a placebo or 50 mg of naltrexone was administered. At the end of each session, participants were given a tray of snack items that differed in high to low energy density and dimensions of salty, sweet, and fat. Self-reported mood and withdrawal measures were collected immediately before the snacks were offered. Generalized linear and logistic models were used to assess the effects of acute smoking withdrawal, drug, and sex on the intake of snack items and self-reported measures. RESULTS Choice and consumption of food items were impacted by smoking condition (withdrawal > ad lib smoking and non-smokers; p < .05), the opioid blockade (naltrexone < placebo; p < .05), and sex (male > female; p < .05). The effects were evidenced in high sweet and high fat foods. No differences were found in low sweet and fat foods. CONCLUSIONS These findings extend earlier studies indicating impact of tobacco use on appetite, and identify the regulatory influence of the endogenous opioid system on appetite during nicotine withdrawal.
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Affiliation(s)
- Justin J Anker
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, 2450 Riverside Avenue, Minneapolis, MN, 55454, USA.
| | - Motohiro Nakajima
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, 1035 University Drive, Duluth, MN, 55812, USA.
| | - Susan Raatz
- Department of Food Science and Nutrition, University of Minnesota, St Paul, MN, USA.
| | - Sharon Allen
- Department of Family Medicine and Community Health, University of Minnesota Medical School, 516 Delaware St. SE, Minneapolis, MN, 55455, USA.
| | - Mustafa al'Absi
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, 1035 University Drive, Duluth, MN, 55812, USA.
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Pourhassan M, Babel N, Sieske L, Westhoff TH, Wirth R. Longitudinal Changes of Cytokines and Appetite in Older Hospitalized Patients. Nutrients 2021; 13:nu13082508. [PMID: 34444668 PMCID: PMC8400156 DOI: 10.3390/nu13082508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/16/2021] [Accepted: 07/20/2021] [Indexed: 11/16/2022] Open
Abstract
There are few data on the longitudinal association of cytokine and appetite among older hospitalized patients. We aimed to investigate the impact of the changes of inflammatory cytokines on appetite in older hospitalized patients. A total of 191 patients (mean age 81.3 ± 6.6 years, 64% women) participated in this prospective longitudinal observational study. Appetite was evaluated using the Edmonton Symptom Assessment System on admission and after seven days. Serum cytokines such as IL-1β, IL-6, IL-8, IL-10, IL-12p70, IL-17, IL-18, IL-23 and IL-33, IFN-α2, IFN-γ, TNF-α and MCP-1 were measured both times. No significant differences in the mean serum levels of all the cytokines could be detected overtime in relation to appetite changes, except for IL-18. Appetite significantly deteriorated overtime in patients with increasing IL-18 levels and improved in those without significant changes in IL-18 levels. In a stepwise regression analysis, changes of IL-18 levels were the major independent predictor for the changes of patients' appetite and explained 4% of the variance, whereas other cytokines and variables, such as age, sex, infection and disease, did not show any impact on appetite changes. We conclude that IL-18 seems to exert a significant impact on appetite in acutely ill older hospitalized patients and should, therefore, be considered as a potential target in the diagnosis, prevention and treatment of malnutrition.
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Affiliation(s)
- Maryam Pourhassan
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40D, 44625 Herne, Germany; (L.S.); (R.W.)
- Correspondence: ; Tel.: +49-2323-499-2416; Fax: +49-2323-499-2417
| | - Nina Babel
- Medical Department I, General Internal Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, 44625 Herne, Germany; (N.B.); (T.H.W.)
| | - Lars Sieske
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40D, 44625 Herne, Germany; (L.S.); (R.W.)
| | - Timm Henning Westhoff
- Medical Department I, General Internal Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, 44625 Herne, Germany; (N.B.); (T.H.W.)
| | - Rainer Wirth
- Department of Geriatric Medicine, Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40D, 44625 Herne, Germany; (L.S.); (R.W.)
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Constansia RDN, Hentzen JEKR, Hogenbirk RNM, van der Plas WY, Campmans-Kuijpers MJE, Buis CI, Kruijff S, Klaase JM. Actual postoperative protein and calorie intake in patients undergoing major open abdominal cancer surgery: A prospective, observational cohort study. Nutr Clin Pract 2021; 37:183-191. [PMID: 33979002 PMCID: PMC9292321 DOI: 10.1002/ncp.10678] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Background Adequate nutritional protein and energy intake are required for optimal postoperative recovery. There are limited studies reporting the actual postoperative protein and energy intake within the first week after major abdominal cancer surgery. The main objective of this study was to quantify the protein and energy intake after major abdominal cancer surgery. Methods We conducted a prospective cohort study. Nutrition intake was assessed with a nutrition diary. The amount of protein and energy consumed through oral, enteral, and parenteral nutrition was recorded and calculated separately. Based on the recommendations of the European Society for Clinical Nutrition and Metabolism (ESPEN), protein and energy intake were considered insufficient when patients received <1.5 g/kg protein and 25 kcal/kg for 2 or more days during the first postoperative week. Results Fifty patients were enrolled in this study. Mean daily protein and energy intake was 0.61 ± 0.44 g/kg/day and 9.58 ± 3.33 kcal/kg/day within the first postoperative week, respectively. Protein and energy intake were insufficient in 45 [90%] and 41 [82%] of the 50 patients, respectively. Patients with Clavien‐Dindo grade ≥III complications consumed less daily protein compared with the group of patients without complications and patients with grade I or II complications. Conclusion During the first week after major abdominal cancer surgery, the majority of patients do not consume an adequate amount of protein and energy. Incorporating a registered dietitian into postoperative care and adequate nutrition support after major abdominal cancer surgery should be a standard therapeutic goal to improve nutrition intake.
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Affiliation(s)
| | - Judith E K R Hentzen
- Department of Surgery, University Medical Center Groningen, Groningen, the Netherlands
| | - Rianne N M Hogenbirk
- Department of Surgery, University Medical Center Groningen, Groningen, the Netherlands
| | | | - Marjo J E Campmans-Kuijpers
- Department of Gastroenterology and Hepatology, University Medical Center Groningen, Groningen, the Netherlands
| | - Carlijn I Buis
- Department of Surgery, University Medical Center Groningen, Groningen, the Netherlands
| | - Schelto Kruijff
- Department of Surgery, University Medical Center Groningen, Groningen, the Netherlands
| | - Joost M Klaase
- Department of Surgery, University Medical Center Groningen, Groningen, the Netherlands
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Keser I, Cvijetić S, Ilić A, Colić Barić I, Boschiero D, Ilich JZ. Assessment of Body Composition and Dietary Intake in Nursing-Home Residents: Could Lessons Learned from the COVID-19 Pandemic Be Used to Prevent Future Casualties in Older Individuals? Nutrients 2021; 13:1510. [PMID: 33947099 PMCID: PMC8146998 DOI: 10.3390/nu13051510] [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: 04/02/2021] [Revised: 04/27/2021] [Accepted: 04/27/2021] [Indexed: 12/13/2022] Open
Abstract
The population of older adults, especially those living in the nursing homes, is growing. The sedentary lifestyle and possible poor nutrition in nursing homes place residents (NHRs) at risk for body composition impairments, malnutrition, and, subsequently, numerous chronic diseases. The aim of this study was to assess body composition (including body fluids) and dietary intake in NHRs. The association between osteosarcopenic adiposity syndrome (OSA) and its components, osteopenic adiposity (OA), sarcopenic adiposity (SA), and adiposity-only (AD), and specific macro- and micro-nutrients was evaluated as well. The study included 84 participants (82.1% women), aged 65.3-95.2 years. Body composition was assessed with an advanced bioelectrical impedance device BIA-ACC® and dietary intake was assessed via 24-h recall and analyzed using "Nutrition" software. The majority (95%) of participants were overweight with a high body fat and low muscle and bone mass, leading to a high prevalence of OSA (>50%), OA (13%), and AD (26%). There were only a few participants with SA, and they were not analyzed. The highest extracellular water/total body water ratio was observed in the OSA participants, indicating a heightened inflammatory state. Participants in all three body composition categories had a similar nutrient intake, with protein, fiber, omega-3 fatty acids, and almost all micronutrients being far below recommendations. In conclusion, a high prevalence of OSA among NHRs accompanied by a poor dietary intake, could place these residents at a very high risk for COVID-19 infections. Therefore, optimization of body composition and nutritional status should be included along with standard medical care in order to provide better health maintenance, particularly in the COVID-19 era.
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Affiliation(s)
- Irena Keser
- Laboratory for Nutrition Science, Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000 Zagreb, Croatia; (I.K.); (A.I.); (I.C.B.)
| | - Selma Cvijetić
- Department of Occupational and Environmental Medicine, Institute for Medical Research and Occupational Health, Ksaverska Cesta 2, 10000 Zagreb, Croatia;
| | - Ana Ilić
- Laboratory for Nutrition Science, Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000 Zagreb, Croatia; (I.K.); (A.I.); (I.C.B.)
| | - Irena Colić Barić
- Laboratory for Nutrition Science, Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000 Zagreb, Croatia; (I.K.); (A.I.); (I.C.B.)
| | | | - Jasminka Z. Ilich
- Institute for Successful Longevity, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA
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Maître I, Sulmont-Rossé C, Van Wymelbeke V, Cariou V, Bailly N, Ferrandi JM, Salle A, Cardon P, Amand M, Manckoundia P, Symoneaux R, Issanchou S, Vigneau E. Food perception, lifestyle, nutritional and health status in the older people: Typologies and factors associated with aging well. Appetite 2021; 164:105223. [PMID: 33811944 DOI: 10.1016/j.appet.2021.105223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 03/16/2021] [Accepted: 03/17/2021] [Indexed: 12/31/2022]
Abstract
The aging process is associated with physiological, sensory, psychological, and sociological changes likely to have an impact on food intake and the nutritional status. The present study aimed to explore the heterogeneity of the French older population (>65 years old) using a multidisciplinary approach. More specifically, the study aimed to highlight different typologies (i.e. clusters of individuals with similar characteristics) within the older population. We conducted face-to-face interviews and tests with 559 French older people, recruited from different categories of dependency (at home without help, at home with help, in nursing homes). Clustering analysis highlighted seven clusters. Clusters 1-3 contained 'young' older people (<80) with a good nutritional status; these clusters differed according to food preferences, the desire to have a healthy diet, or interest in food. Clusters 4-7 mainly contained 'old' older people (80+), with an increase in the nutritional risk from cluster 4 to cluster 7. Two of these clusters grouped healthy and active people with a good level of appetite, while the two other clusters were associated with a clear decline in nutritional status, with people suffering from eating difficulties or depression. The results raise the need to develop targeted interventions to tackle malnutrition and implement health promotion strategies among the seniors.
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Affiliation(s)
- Isabelle Maître
- Ecole Supérieure d'Agricultures (ESA), USC 1422 GRAPPE, INRAE, SFR 4207 QUASAV, Angers, France.
| | - Claire Sulmont-Rossé
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Univ. Bourgogne Franche-Comté, Dijon, France
| | - Virginie Van Wymelbeke
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Univ. Bourgogne Franche-Comté, Dijon, France; CHU, Unité de recherche Pôle Personnes Âgées, Dijon, France
| | | | - Nathalie Bailly
- University of Tours, E.A. 2114, Psychologie des Ages de la Vie et Adaptation, Department of Psychology, Tours, France
| | - Jean-Marc Ferrandi
- Laboratoire d'Economie et Management Nantes Atlantique (LEMNA), ONIRIS, Nantes, France
| | - Agnès Salle
- CHU, Service d'endocrinologie, diabétologie et nutrition, Angers, France
| | - Philippe Cardon
- Université de Lille, U.L.R. CeRIES (Centre de Recherche "Individus, Epreuves, Sociétés"), Département de sociologie, Lille, France
| | - Marion Amand
- Ecole Supérieure d'Agricultures (ESA), USC 1422 GRAPPE, INRAE, SFR 4207 QUASAV, Angers, France; ONIRIS, INRAE, StatSC, Nantes, France
| | | | - Ronan Symoneaux
- Ecole Supérieure d'Agricultures (ESA), USC 1422 GRAPPE, INRAE, SFR 4207 QUASAV, Angers, France
| | - Sylvie Issanchou
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Univ. Bourgogne Franche-Comté, Dijon, France
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Bennett C, Burrows T, Pursey K, Poudel G, Ng KW, Nguo K, Walker K, Porter J. Neural responses to food cues in middle to older aged adults: a scoping review of fMRI studies. Nutr Diet 2020; 78:343-364. [PMID: 33191542 DOI: 10.1111/1747-0080.12644] [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] [Received: 05/22/2020] [Revised: 09/15/2020] [Accepted: 09/23/2020] [Indexed: 01/18/2023]
Abstract
AIM Understanding neural responses through functional magnetic resonance imaging (fMRI) to food and food cues in middle-older adults may lead to better treatment options to address the growing issue of malnutrition. This scoping review aimed to determine the extent, range and nature of research using fMRI, related to reward-based regions, in response to food cues in middle to older aged adults (50 years and over). METHODS The following databases were systematically searched in July 2019: CINAHL, CENTRAL, Embase, Dissertations and Theses, Ovid Medline, PsycINFO, PsycEXTRA, Scopus and Web of Science. Studies were eligible for inclusion if participants had a mean or median age ≥50 years, utilised and reported outcomes of either a food cue task-related fMRI methodology or resting-state fMRI. Data from included studies were charted, and synthesised narratively. RESULTS Twenty-two studies were included. Eighteen studies utilised a task-related design to measure neural activation, two studies measured resting state neural connectivity only and an additional two studies measured both. The fMRI scanning paradigms, food cue tools and procedure of presentation varied markedly. Four studies compared the neural responses to food between younger and older adults, providing no consensus on neural age-related changes to food cues; two studies utilised longitudinal scans. CONCLUSION This review identified significant extent, range and nature in the approaches used to assess neuronal activity in response to food cues in adults aged 50 years and over. Future studies are needed to understand the age-related appetite changes whilst considering personal preferences for food cues.
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Affiliation(s)
- Christie Bennett
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Tracy Burrows
- School of Health Sciences, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Kirrilly Pursey
- School of Health Sciences, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia
| | - Govinda Poudel
- Behaviour Environment and Cognition, Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Ker Wei Ng
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Kay Nguo
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Karen Walker
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Judi Porter
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, Victoria, Australia
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Bukman AJ, Ronteltap A, Lebrun M. Interpersonal determinants of eating behaviours in Dutch older adults living independently: a qualitative study. BMC Nutr 2020; 6:55. [PMID: 33292680 PMCID: PMC7656669 DOI: 10.1186/s40795-020-00383-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 09/20/2020] [Indexed: 11/10/2022] Open
Abstract
Background Eating behaviour of older adults is influenced by a complex interaction of determinants. Understanding the determinants of a specific target group is important when developing targeted health-promoting strategies. The aim of this study was to explore interpersonal determinants of eating behaviours in older adults living independently in a specific neighbourhood in the Netherlands. Methods In the neighbourhood of interest, populated by relatively many older adults, fifteen semi-structured interviews were conducted with independently living older adults (aged 76.9 ± 6.4y). Interviews were complemented with observations among the target group: three occasions of grocery shopping and three collective eating occasions in the neighbourhood. A thematic approach was used to analyse the qualitative data. Results When we asked the older adults unprompted why they eat what they eat, the influence of interpersonal determinants did not appear directly; respondents rather mentioned individual (e.g. habits) and environmental factors (e.g. food accessibility). Key findings regarding interpersonal factors were: 1) Behaviours are shaped by someone’s context; 2) Living alone influences (determinants of) eating behaviour via multiple ways; 3) There is a salient norm that people do not interfere with others’ eating behaviour; 4) Older adults make limited use of social support (both formal and informal) for grocery shopping and cooking, except for organised eating activities in the neighbourhood. In this particular neighbourhood, many facilities (e.g. shops at walking distance) are present, and events (e.g. dinners) are organised with and for the target group, which likely impact (determinants of) their behaviours. Conclusions The study showed that older adults do not directly think of interpersonal factors influencing their eating behaviour, but rather of individual or environmental factors. However, multiple interpersonal factors did appear in the interviews and observations. Moreover, neighbourhood-specific factors seem to play a role, which underlines the need to understand the specific (social) setting when developing and implementing intervention programmes. Insights from this study can assist in developing health-promoting strategies for older adults, taking into account the context of the specific neighbourhood.
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Affiliation(s)
- Andrea Johanna Bukman
- Knowledge Centre Healthy and Sustainable Living, University of Applied Sciences Utrecht, P.O. box 12011, 3501 AA, Utrecht, The Netherlands
| | - Amber Ronteltap
- Knowledge Centre Healthy and Sustainable Living, University of Applied Sciences Utrecht, P.O. box 12011, 3501 AA, Utrecht, The Netherlands.
| | - Mila Lebrun
- Alimentation Science Department, Danone Research, Palaiseau, France
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Changes in Appetite During the Heart Failure Trajectory and Association With Fatigue, Depressive Symptoms, and Quality of Life. J Cardiovasc Nurs 2020; 36:539-545. [PMID: 33136703 DOI: 10.1097/jcn.0000000000000756] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Decreased appetite can contribute to malnutrition in patients with heart failure (HF). Little is known about the trajectory of appetite over time in patients with HF and the factors associated with decreased appetite after discharge from the hospital. OBJECTIVE The aims of this study were to investigate changes in appetite over time and explore how fatigue, depressive symptoms, and quality of life are associated with decreased appetite. METHODS Data from the multicenter randomized Coordinating study evaluating Outcomes of Advising and Counseling in Heart Failure were used. Logistic regression and mixed-effects logistic regression were used to investigate changes in appetite over time and to explore the relationship between appetite and fatigue, depressive symptoms, and quality of life. RESULTS A total of 734 patients with HF (mean age, 69 years) were included. Decreased appetite was present at all follow-up measurements; however, decreased appetite was significantly lower at the 1-month (odds ratio [OR], 0.43; confidence interval [CI], 0.29-0.63), 6-month (OR, 0.31; CI, 0.20-0.47), 12-month (OR, 0.22; CI, 0.14-0.34), and 18-month (OR, 0.24; CI, 0.15-0.37) follow-ups compared with baseline. Decreased appetite was associated with fatigue (OR, 3.09; CI, 1.98-4.84), depressive symptoms (OR, 1.76; CI, 1.35-2.29), and low quality of life (OR, 1.01; CI, 1.01-1.02) across all measurement points adjusted for covariates. CONCLUSIONS Appetite improved after discharge; however, at all time points, at least 22% of patients reported decreased appetite. Fatigue, depressive symptoms, and low quality of life are factors associated with decreased appetite. Decreased appetite is a long-standing problem in that it does not disappear spontaneously after an acute HF deterioration.
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Sharma R, Bansal P, Garg R, Ranjan R, Kumar R, Arora M. Prevalence of potentially inappropriate medication and its correlates in elderly hospitalized patients: A cross-sectional study based on Beers criteria. J Family Community Med 2020; 27:200-207. [PMID: 33354151 PMCID: PMC7745783 DOI: 10.4103/jfcm.jfcm_175_20] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 06/28/2020] [Accepted: 08/07/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The increase in the prescription of potentially inappropriate medication (PIM) in older adults with significant health consequences is a global concern. This study aimed to determine the prevalence of PIM prescription in older adults as identified by Beers criteria 2015 and 2019. MATERIALS AND METHODS A cross-sectional study was carried out in older adults aged >65 years at a tertiary care postgraduate teaching hospital. All patients aged ≥65 years irrespective of their gender, admitted in the medical ward of the hospital with single/multiple comorbidities, and prescribed at least one daily medication, were included in the study. Data of patient history, patient case sheet, medication charts, laboratory reports, as well as radiological examinations test reports were retrieved from their files and were captured in a prevalidated data collection form. SPSS used for data analysis; multivariate logistic regression was used to determine the predictors of PIM prescribing and odds ratios (ORs) and 95% confidence intervals for ORs were computed. RESULTS Study included 323 patients; 61.3% were male, 74% patients were 65-70 years of age, and 78% patients were illiterate. The overall prevalence of PIM uses according to the Beers criteria 2015 and 2019 was 60.1% and 61.9%, respectively. No association found between PIMs prescribes and diagnosis category. Male gender, age 76-80 years, and education 10-12th class were found to be significantly related to PIM prescription. CONCLUSION This study reflects a critical view of noncompliance of Beers criteria for geriatric healthcare even in tertiary care hospitals in India. Creatinine clearance rate should be kept in view when prescribing medicines for elderly inpatients.
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Affiliation(s)
- Rishabh Sharma
- Department of Pharmacy Practice, ISF College of Pharmacy, Moga, India
| | - Parveen Bansal
- University Centre of Excellence in Research, Baba Farid University of Health Sciences, Lucknow, Uttar Pradesh, India
| | - Ravinder Garg
- Department of Medicine, Guru Gobind Singh Medical College and Hospital, Lucknow, Uttar Pradesh, India
| | - Ravi Ranjan
- Amity Institute of Pharmacy, Amity University, Lucknow, Uttar Pradesh, India
| | - Rakesh Kumar
- Department of Psychiatry, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
| | - Malika Arora
- Multi- Disciplinary Research Unit, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
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Health and Nutritional Beliefs and Practices among Rural Elderly Population: An Ethnographic Study in Western Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165923. [PMID: 32824078 PMCID: PMC7459967 DOI: 10.3390/ijerph17165923] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 12/20/2022]
Abstract
Background: Demographic transition is causing an increasingly aged society, which has a significant impact on public health strategies. Increases in the size of the elderly cohort create a wider stratification and pose specific challenges. Nutrition and diet are one key issue. This study aims to describe food-related practices, beliefs, and representations of non-institutionalized older adults in rural communities in Extremadura (Western Spain). Method: The ethnographic-based fieldwork was conducted from January to July 2019. Empirical material was collected through different research relationships (semi-structured interviews and informal conversations) and direct observation in various locations in Extremadura―involving a variety of agents associated with different aspects of the nutritional process. Results: Data analysis revealed four major themes: (1) Limitations on choice and quality of food available; (2) food preferences and cooking methods; (3) the role of nostalgia in the construction of taste preferences; and (4) perceptions of what “healthy” food is and how respondents relate to the advice provided by health professionals. Conclusions: Nutritional choices among the group studied presented significant differences from medical advice―which was seen as a series of “bans” that did not carry enough authority to alter the symbolic value attached to their traditions.
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Cox NJ, Morrison L, Ibrahim K, Robinson SM, Sayer AA, Roberts HC. New horizons in appetite and the anorexia of ageing. Age Ageing 2020; 49:526-534. [PMID: 32043144 DOI: 10.1093/ageing/afaa014] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 11/15/2019] [Indexed: 01/27/2023] Open
Abstract
Appetite drives essential oral nutritional intake. Its regulation is complex, influenced by physiology, hedonism (the reward of eating) and learning from external cues within a person's society and culture. Appetite loss is common in the older population and not always attributable to medical conditions or treatment. Although the physiological basis of the anorexia of ageing (loss of appetite due to the ageing process) has been established, the effect of ageing on hedonism and external cues, which may be equally important, is less well understood. The anorexia of ageing is associated with reductions in dietary diversity and oral intake, and increased risk of malnutrition, sarcopenia and frailty. Early identification of poor appetite could allow timely intervention before weight loss occurs. There is no standardised tool for assessing appetite in clinical settings at present but the 4-item Simplified Nutritional Appetite Questionnaire (SNAQ) has the potential to be used in this way. This review, designed for clinicians, will discuss the regulation of appetite and the pathogenesis of the anorexia of ageing. It will describe the current evidence for interventions to manage the anorexia of ageing, which is limited, with little benefit reported from individual studies of education, physical activity and medication. There is some positive evidence for flavour enhancement, fortified food and oral nutritional supplements but mainly within single studies. Looking ahead, the aim is to develop multicomponent approaches to the treatment of the anorexia of ageing based on growing understanding of the role of physiological signalling, hedonism and external cues.
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Affiliation(s)
- Natalie J Cox
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Leanne Morrison
- Department of Psychology, Faculty of Social, Human, and Mathematical Sciences, University of Southampton, Southampton, UK
- Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Kinda Ibrahim
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Wessex, University of Southampton, Southampton, UK
| | - Sian M Robinson
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, UK
| | - Avan A Sayer
- AGE Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, Newcastle upon Tyne, UK
| | - Helen C Roberts
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) Wessex, University of Southampton, Southampton, UK
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Abstract
The present study aimed to investigate the effect of acute changes in serum C-reactive protein (CRP) on appetite and food intake among older hospitalised patients. A total of 200 patients (age range 65-94 years, 62·5 % women) participated in this prospective longitudinal observational study. Risk of malnutrition was measured according to the Mini Nutritional Assessment Short Form. The Simplified Nutritional Appetite Questionnaire (SNAQ) and Edmonton Symptom Assessment System (ESAS) were used to evaluate patients' appetite at the time of hospital admission (baseline) and after 7 d (follow-up). Food intake was measured according to the plate diagram and serum CRP was analysed at baseline and follow-up. At baseline, 30·5 % of the patients had moderate to severe inflammation, 31·0 % were malnourished and 48·0 % had food intake <75 % of the meals offered. Also, 32·5 and 23·5 % reported poor and very poor appetite or severe loss of appetite according to the SNAQ and ESAS, respectively. Of the patients, 40 % displayed a pronounced reduction in median CRP levels by -1·2 mg/dl and 19 % demonstrated an increase in median CRP levels by +1·2 mg/dl. Appetite significantly improved (P = 0·006) in patients with a decrease in CRP level and deteriorated in those with an increase in CRP level (P = 0·032). Changes in CRP levels did not show any significant impact on food intake. In a regression analysis, changes of inflammation were the major independent predictor for changes of patients' appetite. We conclude that inflammation has a significant impact on appetite and should therefore be considered in the diagnosis and treatment of malnutrition.
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Choi YR, Park HR, Song KH, Lee Y, Lim YS. Disparities in dietary quantity and quality between the two different types of Korean family of older adults living with spouses and living alone: using data from the 6th Korea National Health and Nutrition Examination Survey. Nutr Res Pract 2020; 14:242-251. [PMID: 32528631 PMCID: PMC7263895 DOI: 10.4162/nrp.2020.14.3.242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 12/20/2019] [Accepted: 12/26/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/OBJECTIVES This study was conducted to examine disparities in food and nutrient intakes based on family types identified among 1,856 participants who were the Korean elderly people in the 6th Korea National Health and Nutrition Examination Survey (KNHNES) excluding those who were currently practicing the diet therapy. SUBJECTS/METHODS We separated the subjects into two groups: living alone (LA, n = 638) and living with a spouse (LS, n = 1,218). We also examined the disparities of dietary quantity and quality of those two groups using complex sampling design general linear regression analyses (CS GLM). RESULTS In the LA group, there was a higher percentage of females and average age in LA group was higher than the participants in the LS group. Household income and education level were significantly lower in LA compared to those of LS. The frequencies of skipping meals were higher in LA. LA's food and nutrient intakes showed lower consumption of vegetables, fruits, seaweeds, and of most nutrients. Even after adjusting for the confounding factors, the consumption of vegetables, seaweeds, carbohydrates, potassium, riboflavin, and vitamin C showed lower in LA than LS. Moreover, LA's nutrient intake ratios compared to the KDRIs were lower which turned out to be similar to their nutrient intakes. CONCLUSIONS These results show that dietary behavior and food intake of the elderly are associated with family types. Frequently skipping meals and less dietary variety are more common with elderly persons who were living alone. Therefore, it is necessary to integrate the supplementary food programs and nutrition education programs for the elderly living alone.
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Affiliation(s)
- Yu Rim Choi
- Department of Food and Nutrition, Myongji University, Yongin 17058, Korea
| | - Hae Ryun Park
- Department of Food and Nutrition, Myongji University, Yongin 17058, Korea
| | - Kyung Hee Song
- Department of Food and Nutrition, Myongji University, Yongin 17058, Korea
| | - Youngmi Lee
- Department of Food and Nutrition, Myongji University, Yongin 17058, Korea
| | - Young Suk Lim
- Department of Food and Nutrition, Myongji University, Yongin 17058, Korea
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Optimizing sensory quality and variety: An effective strategy for increasing meal enjoyment and food intake in older nursing home residents. Appetite 2020; 153:104749. [PMID: 32450092 DOI: 10.1016/j.appet.2020.104749] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/25/2020] [Accepted: 05/18/2020] [Indexed: 01/08/2023]
Abstract
A decline in appetite and consequently in food intake is often observed with ageing, particularly in older adults living in nursing homes. Several strategies have been tested in nursing homes to counter this phenomenon. However, the approaches have rarely focused on food improvement, and most studies have assessed the impact of flavor enhancement on eating behavior. The present experiment aimed to assess the impact of improving sensory quality versus increasing sensory variety on food intake and meal enjoyment in elderly individuals living in a nursing home. Four conditions were compared: control condition, a Quality+ condition (recipes were improved according to sensory preference of the target population), a Variety+ condition (participants were offered a variety of main dishes and several condiments throughout the meal) and a Quality&Variety+ condition combining the two previous conditions. Eighty-two residents (age range: 71-101 years) participated in eight lunchtime sessions (2 replicates × 4 conditions). Compared to control condition, our results showed that improving the sensory quality of the dishes and/or providing variety led to increased meal enjoyment and food intake (energy intake: +5% for Quality+; +7% for Variety+). No additional effect was observed when the two factors were combined (+7% for Quality&Variety+). These results suggest that meal improvement strategies can be used to increase food intake in order to prevent and treat malnutrition in dependent older adults.
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Aiello M, Parma V, De Carlo S, Hummel T, Rumiati RI. Cognitive, Olfactory, and Affective Determinants of Body Weight in Aging Individuals. Arch Clin Neuropsychol 2020; 34:637-647. [PMID: 30272124 DOI: 10.1093/arclin/acy072] [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] [Received: 02/12/2018] [Revised: 07/12/2018] [Accepted: 08/09/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE A complex interplay of factors including cognitive, sensory and affective aspects has been associated in a controversial way with anthropometric measures related to body weight. METHODS Here we propose two studies to investigate whether and how cognitive, olfactory and affective variables resulted associated with body weight during healthy aging. In Study 1, we investigated the cognitive status, the odor identification skills, and the BMI of 209 individuals (50-96 yo). In Study 2 an extensive evaluation of cognitive functions (in particular executive functions and memory), odor threshold, discrimination and identification and affective skills (i.e., depression and anxiety) was performed in a group of 35 healthy, free-living aging individuals (58-85 yo). RESULTS In Study 1, greater BMI was not associated with performance on the odor identification task but was significantly associated with better cognitive skills. In Study 2, we observed that executive functions seemed to favor a successful managing of body weight, and individuals with greater BMI and waist circumference showed significantly better odor discrimination skills. Finally, lower waist circumference (but not BMI) was found significantly associated with greater levels of anxiety. CONCLUSIONS These results confirm that cognitive, olfactory and affective factors may influence body weight during healthy aging.
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Affiliation(s)
| | - Valentina Parma
- Area of Neuroscience, SISSA, Trieste, Italy.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,William James Research Center, Lisbon, Portugal
| | | | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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Venditti C, Musa-Veloso K, Lee HY, Poon T, Mak A, Darch M, Juana J, Fronda D, Noori D, Pateman E, Jack M. Determinants of Sweetness Preference: A Scoping Review of Human Studies. Nutrients 2020; 12:nu12030718. [PMID: 32182697 PMCID: PMC7146214 DOI: 10.3390/nu12030718] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 02/26/2020] [Accepted: 03/04/2020] [Indexed: 11/16/2022] Open
Abstract
Factors associated with sweetness preference are multi-faceted and incredibly complex. A scoping review was undertaken to identify determinants of sweetness preference in humans. Using an online search tool, ProQuest ™, a total of 99 publications were identified and subsequently grouped into the following categories of determinants: Age, dietary factors, reproductive hormonal factors, body weight status, heritable, weight loss, sound, personality, ethnicity and lifestyle, previous exposure, disease, and 'other' determinants. Methodologies amongst studies were heterogenous in nature (e.g., there was variability across studies in the sweetness concentrations tested, the number of different sweetness concentrations used to assess sweetness preference, and the methods utilized to measure sweetness preference), rendering interpretation of overall findings challenging; however, for certain determinants, the evidence appeared to support predictive capacity of greater sweetness preference, such as age during certain life-stages (i.e., young and old), being in a hungry versus satiated state, and heritable factors (e.g., similar sweetness preferences amongst family members). Recommendations for the design of future studies on sweetness preference determinants are provided herein, including an "investigator checklist" of criteria to consider.
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Affiliation(s)
- Carolina Venditti
- Intertek Health Sciences, Inc., Suite 201, 2233 Argentia Road, Mississauga, ON L5N 2X7, Canada
- Correspondence:
| | - Kathy Musa-Veloso
- Intertek Health Sciences, Inc., Suite 201, 2233 Argentia Road, Mississauga, ON L5N 2X7, Canada
| | - Han Youl Lee
- Intertek Health Sciences, Inc., Suite 201, 2233 Argentia Road, Mississauga, ON L5N 2X7, Canada
| | - Theresa Poon
- Intertek Health Sciences, Inc., Suite 201, 2233 Argentia Road, Mississauga, ON L5N 2X7, Canada
| | - Alastair Mak
- Intertek Health Sciences, Inc., Suite 201, 2233 Argentia Road, Mississauga, ON L5N 2X7, Canada
| | - Maryse Darch
- Intertek Health Sciences, Inc., Suite 201, 2233 Argentia Road, Mississauga, ON L5N 2X7, Canada
| | - Justine Juana
- Intertek Health Sciences, Inc., Suite 201, 2233 Argentia Road, Mississauga, ON L5N 2X7, Canada
| | - Dylan Fronda
- Intertek Health Sciences, Inc., Suite 201, 2233 Argentia Road, Mississauga, ON L5N 2X7, Canada
| | - Daniel Noori
- Intertek Health Sciences, Inc., Suite 201, 2233 Argentia Road, Mississauga, ON L5N 2X7, Canada
| | - Erika Pateman
- Intertek Health Sciences, Inc., Suite 201, 2233 Argentia Road, Mississauga, ON L5N 2X7, Canada
| | - Maia Jack
- American Beverage Association, Science and Regulatory Affairs, 1275 Pennsylvania Ave. NW, Washington, DC 200042, USA
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Peters R, White DJ, Scholey A. Resting state fMRI reveals differential effects of glucose administration on central appetite signalling in young and old adults. J Psychopharmacol 2020; 34:304-314. [PMID: 31909672 DOI: 10.1177/0269881119894540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Healthy aging has been associated with reduced appetite and lower energy intake, which can lead to loss of bodyweight, undernutrition and related health problems. The causes for the decline in caloric intake are multifactorial, involving physiological and non-physiological processes. AIMS Here we examined the effect of glucose on brain function in healthy adults as well as age-related, physiological changes in brain responses associated with macronutrient intake. METHODS Using a randomized, double-blind, balanced cross-over design, younger (n = 16, aged 21-30) and older (n = 16, aged 55-78) adults received a drink containing glucose and a taste-matched placebo after an overnight fast. Blood glucose and hunger were assessed at baseline and 20 min post-ingestion, after which participants underwent resting state functional magnetic resonance imaging. RESULTS Frequency-dependent changes associated with glucose administration in slow-5 (0.01-0.027 Hz) and slow-4 (0.027-0.073 Hz) amplitude of low-frequency fluctuations (ALFF) and fractional ALFF (fALFF) of the blood oxygen level-dependent (BOLD) signal were investigated within the young healthy adults, and then extended to the older age group. Consistent with previous reports, glucose decreased amplitude in slow-5 fALFF within the left orbitofrontal cortex and insular cortex in the young adults. We observed a significant interaction in slow-5 ALFF and fALFF in the left insula, such that younger participants showed a decrease in BOLD amplitude, whereas older participants showed an increase, after glucose administration. We further observed an interaction in slow-4 ALFF in the occipital region and precuneus, with older participants showing an increase in magnitude of slow-4 ALFF and younger participants showing a decrease in the same measure. CONCLUSION These age-related, frequency-dependent changes in the magnitude of the BOLD signal in the insula, a key region related to energy homeostasis following feeding, may point to a change in satiety or homeostatic signalling contributing to behavioural changes in energy intake during senescence.
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Affiliation(s)
- Riccarda Peters
- Centre for Human Psychopharmacology, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - David J White
- Centre for Human Psychopharmacology, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Andrew Scholey
- Centre for Human Psychopharmacology, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
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Pedersen JL, Pederen PU, Damsgaard EM. Patient-Reported Fatigue Is Associated with Poor Energy Intake and Readmission to Hospital. Health (London) 2020. [DOI: 10.4236/health.2020.123021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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