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Berendsen AAM, van Lieshout LELM, van den Heuvel EGHM, Matthys C, Péter S, de Groot LCPGM. Conventional foods, followed by dietary supplements and fortified foods, are the key sources of vitamin D, vitamin B6, and selenium intake in Dutch participants of the NU-AGE study. Nutr Res 2016; 36:1171-1181. [PMID: 27422456 DOI: 10.1016/j.nutres.2016.05.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 05/03/2016] [Accepted: 05/24/2016] [Indexed: 12/11/2022]
Abstract
With aging, energy needs decrease, necessitating a more nutrient-dense diet to meet nutritional needs. To bridge this gap, the use of nutrient-dense foods, fortified foods, and dietary supplements can be important. This observational study aims to describe current micronutrient intakes of Dutch elderly and to identify the contribution of nutrient-dense foods, fortified foods, and dietary supplements to the intake of micronutrients that are often inadequately consumed in Dutch elderly. Data of 245 Dutch volunteers from the NU-AGE study aged 65 to 80 years were used. Dietary intake was assessed by means of 7-day food records, and dietary supplement use was recorded with an additional questionnaire. Information on fortified foods was obtained from the Dutch Food Composition Table 2011. Nutrient density of foods was evaluated using the Nutrient Rich Food 9.3 score. The percentages of participants not meeting their average requirement were high for vitamin D (99%), selenium (41%), and vitamin B6 (54%) based on conventional foods and also when taking into account fortified foods (98%, 41%, and 27%, respectively) and vitamin and mineral supplements (87%, 36%, and 20%, respectively). Conventional foods were the main source of vitamin D, vitamin B6, and selenium intake (42%, 45%, and 82%, respectively), followed by vitamin and mineral supplements (41%, 44%, and 18%) and fortified foods (17%, 11%, and 1%). Foods with the highest nutrient density contributed most to total vitamin B6 intake only. To optimize nutrient intakes of elderly, combinations of natural food sources, fortified foods, and dietary supplements should be considered.
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Affiliation(s)
- Agnes A M Berendsen
- Division of Human Nutrition, Wageningen University, 6700 EV Wageningen, the Netherlands
| | | | | | - Christophe Matthys
- Department of Clinical and Experimental Endocrinology, KU Leuven, 3000 Leuven, Belgium; Department of Endocrinology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Szabolcs Péter
- DSM Nutritional Products, Ltd, 4303 Kaiseraugst, Switzerland
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Rolland Y, de Souto Barreto P, Abellan Van Kan G, Annweiler C, Beauchet O, Bischoff-Ferrari H, Berrut G, Blain H, Bonnefoy M, Cesari M, Duque G, Ferry M, Guerin O, Hanon O, Lesourd B, Morley J, Raynaud-Simon A, Ruault G, Souberbielle JC, Vellas B. Vitamin D supplementation in older adults: searching for specific guidelines in nursing homes. J Nutr Health Aging 2013; 17:402-12. [PMID: 23538667 DOI: 10.1007/s12603-013-0007-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The prevalence of vitamin D insufficiency is very high in the nursing home (NH) population. Paradoxically, vitamin D insufficiency is rarely treated despite of strong clinical evidence and recommendations for supplementation. This review aims at reporting the current knowledge of vitamin D supplementation in NH and proposing recommendations adapted to the specificities of this institutional setting. DESIGN Current literature on vitamin D supplementation for NH residents was narratively presented and discussed by the French Group of Geriatrics and Nutrition. RESULT Vitamin D supplementation is a safe and well-tolerated treatment. Most residents in NH have vitamin D insufficiency, and would benefit from vitamin D supplement. However, only few residents are actually treated. Current specific and personalized protocols for vitamin D supplementation may not be practical for use in NH settings (e.g., assessment of serum vitamin D concentrations before and after supplementation). Therefore, our group proposes a model of intervention based on the systematic supplementation of vitamin D (1,000 IU/day) since the patient's admission to the NH and throughout his/her stay without the need of a preliminary evaluation of the baseline levels. Calcium should be prescribed only in case of poor dietary calcium intake. CONCLUSION A population-based rather than individual-based approach may probably improve the management of vitamin D insufficiency in the older population living in NH, without increasing the risks of adverse health problems. The clinical relevance and cost effectiveness of this proposal should be assessed under NH real-world conditions to establish its feasibility.
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Affiliation(s)
- Y Rolland
- Department of Geriatric Medicine, CHU Toulouse, Institute of aging, F-31059 Toulouse, France.
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Kalus U, Pruss A, Wodarra J, Kiesewetter H, Salama A, Radtke H. Influence of blood donation on levels of water-soluble vitamins. Transfus Med 2009; 18:360-5. [PMID: 19140819 DOI: 10.1111/j.1365-3148.2008.00897.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Iron depletion is a well-known side effect of blood donation. Research evidence also suggests an increasing prevalence of vitamin deficiency in apparently healthy subjects, but there is little information regarding the relationship between blood donation and vitamin status. A total of 217 volunteers (80 first-time and 137 repeat blood donors) were consecutively enrolled in the study. All subjects completed self-administered medical history and food intake forms, which included questions regarding alcohol consumption and smoking as well as on vitamin supplement, iron and contraceptive use (females). Vitamin B6, folic acid, vitamin B12 and biotin levels were measured using standard techniques. The mean vitamin levels of first-time and repeat blood donors did not significantly differ. Vitamin deficiencies occurred in both first-time and repeat blood donors but not on vitamin supplements. Vitamin status was affected by alcohol, nicotine and contraceptives. Blood donation does not decrease the level of water-soluble vitamins. Vitamin deficiencies occur in apparently healthy first-time as well as in repeat blood donors and can be prevented by vitamin supplementation.
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Affiliation(s)
- U Kalus
- Institute of Transfusion Medicine, Charité - University Medicine Berlin, Berlin, Germany.
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Wagner KH, Haber P, Elmadfa I. Thanks to body exercise, getting mobile and being less dependent. ANNALS OF NUTRITION AND METABOLISM 2008; 52 Suppl 1:38-42. [PMID: 18382077 DOI: 10.1159/000115347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The study was aimed at determining the influence of aerobic endurance exercise and the intake of a multivitamin beverage (MV) on institutionalized people in their 8th and 9th decades of life. The study comprised 4 groups: exercise + MV (n = 16 completer, age: 83 +/- 8 years), exercise (n = 8, age: 82 +/- 8 years), MV (n = 8, age: 83 +/- 5 years), control (n = 7, age: 83 +/- 5 years). The period of exercise, 'aqua training', lasted 17 weeks, two times a week for 25 min. During this period, 250 ml/day of a commercially available multivitamin drink was administered in two of the four groups. At the outset and after the intervention, status of lipophilic antioxidants, vitamin C, malondialdehyde (MDA), cholesterol (total, LDL, HDL), triglycerides and uric acid was assessed. The influence on physical activity was evaluated via spiroergometry. The initial status of nutritive antioxidants was very satisfactory for this population group, only plasma beta-carotene was borderline. Plasma levels of total-cholesterol (243 +/- 42 mg/dl), LDL-cholesterol (161 +/- 35 mg/dl) and uric acid (5.8 +/- 1.4 mg/dl) were slightly above the reference value. Endurance exercise neither increased MDA nor decreased plasma antioxidants or changed plasma lipids. Moreover, plasma levels of beta-carotene (all MV intervention) and cryptoxanthin (group: exercise + MV) increased after intervention (p < 0.05). Physical performance did not enhance, only in the group exercise + MV the respiratory ratio (p < 0.05) and lactate (p = 0.072) increased.
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Affiliation(s)
- Karl-Heinz Wagner
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria.
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Plasma pyridoxal phosphate and pyridoxic acid and their relationship to plasma homocysteine in a representative sample of British men and women aged 65 years and over. Br J Nutr 2007. [DOI: 10.1017/s0007114599000380] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Concentrations of pyridoxal phosphate and pyridoxic acid were measured in fasting plasma samples from British men and women aged 65 years and over, participating in a National Diet and Nutrition Survey during 1994–5, selected to be representative of the population of mainland Britain. In this population, the concentration of pyridoxal phosphate declined, whereas pyridoxic acid rose, with increasing age and frailty; however, both status indicators were strongly and directly (with a positive coefficient) correlated with estimates of vitamin B6intake. This was little affected by the inclusion of food energy and protein intakes in the model. Forty-eight percent of the participants living in the community and 75% of those living in institutions had plasma pyridoxal phosphate concentrations below a range considered normal from other studies. In a univariate regression model, plasma pyridoxal phosphate concentrations were inversely correlated with plasma homocysteine concentrations, consistent with the hypothesis that vitamin B6status may influence plasma homocysteine levels, and hence vascular disease risk. However, this relationship was partly attenuated in a multiple regression model including age, sex, domicile and biochemical status indices, including those of folate and vitamin B12. There was evidence that plasma pyridoxal phosphate was sensitive to metabolic conditions associated with inflammation and the acute-phase reaction, and that plasma pyridoxic acid was sensitive to renal function. Thus, neither index is an ideal predictor of vitamin B6status in older people, unless these confounding factors are allowed for. Since poor vitamin B6status may have health implications, e.g. for immune function, cognition, and for essential intermediary metabolic pathways in older people, it needs to be investigated as a possible public health problem.
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Essed NH, van Staveren WA, Kok FJ, de Graaf C. No effect of 16 weeks flavor enhancement on dietary intake and nutritional status of nursing home elderly. Appetite 2006; 48:29-36. [PMID: 16914226 DOI: 10.1016/j.appet.2006.06.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2006] [Accepted: 06/07/2006] [Indexed: 10/24/2022]
Abstract
There is a lack of data to support the long-term effect of flavor enhancement on food intake and nutritional status. Our aim was to determine if daily addition of 700 mg flavor and/or 300 mg monosodium glutamate (MSG) to the animal protein part of the cooked meal for 16 weeks leads to an increase in energy intake and in body weight in nursing home elderly. We performed a single blind randomized 16 weeks parallel study consisting of a control group (n=23), a MSG group (n=19), a flavor group (n=19) and a flavor plus MSG group (n=22). Main outcome measures were intake of the cooked meal, which was measured by weighing back leftovers during 14 days and body weight. Both were measured before and at the end of the intervention period. After 16 weeks, energy intake and body weight did not increase within the control group, the flavor group, the flavor plus MSG group and the MSG group. Between the groups, no differences were found in changes in energy intake and body weight. Enhancing the taste of a cooked meal with flavor and/or MSG does not lead to a higher energy intake and body weight among nursing home elderly. More research is needed to determine the efficacy of flavor enhancement on intake and nutritional status.
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Affiliation(s)
- Natasja H Essed
- Division of Human Nutrition, Wageningen University, PO Box 8129, 6700 EV Wageningen, The Netherlands.
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Mitsui T, Shimaoka K, Takagi C, Goto Y, Kagami H, Ito A. Small bowel bacterial overgrowth may not affect bone mineral density in older people. Clin Nutr 2005; 24:920-4. [PMID: 16298023 DOI: 10.1016/j.clnu.2005.05.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2005] [Accepted: 05/30/2005] [Indexed: 11/28/2022]
Abstract
BACKGROUND & AIMS Small bowel bacterial overgrowth (SBBO) may be associated with malnutrition, diarrhea, and weight loss. Recently, bone mineral density (BMD) in patients with SBBO was reported to be lower, and SBBO may be an important factor in the development of metabolic bone disease. However, the subjects in these studies were relatively young patients with intestinal diseases. There is no information on the effect of SBBO on BMD in older people. METHOD Seventeen relatively active and 33 disabled older people participated in this study. SBBO was determined by a breath hydrogen (H2) test after ingestion of a glucose solution. BMD of the lumbar spine and femur were measured using a dual energy X-ray absorptiometry scan (DEXA). RESULTS One healthy control and 11 disabled subjects were SBBO-positive. The Z-scores of the lumbar spine were not statistically different between groups, and a high incidence of disorders, >70%, was seen in all groups. On the other hand, there were significant differences in the femoral BMD between the healthy controls and the SBBO-negative (P<0.001) and SBBO-positive (P<0.05) groups. No significant difference was seen in femoral BMD between SBBO-positive and SBBO-negative institutionalized people. CONCLUSION SBBO seems to have little effect on BMD in people approximately 80 years old.
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Affiliation(s)
- Takahiro Mitsui
- Research Center of Health, Physical Fitness and Sports, Nagoya University, and Masuko Memorial Hospital, Nagoya 464-8601, Japan.
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Biesalski HK. Meat as a component of a healthy diet - are there any risks or benefits if meat is avoided in the diet? Meat Sci 2005; 70:509-24. [PMID: 22063749 DOI: 10.1016/j.meatsci.2004.07.017] [Citation(s) in RCA: 208] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2004] [Revised: 07/15/2004] [Accepted: 07/15/2004] [Indexed: 01/10/2023]
Abstract
Meat is frequently associated with a "negative" health image due to its "high" fat content and in the case of red meat is seen as a cancer-promoting food. Therefore, a low meat intake, especially red meat is recommended to avoid the risk of cancer, obesity and metabolic syndrome. However, this discussion overlooks the fact, that meat is an important source for some of micronutrients such as iron, selenium, vitamins A, B12 and folic acid. These micronutrients are either not present in plant derived food or have poor bioavailability. In addition, meat as a protein rich and carbohydrate "low" product contributes to a low glycemic index which is assumed to be "beneficial" with respect to overweight, the development of diabetes and cancer (insulin resistance hypothesis). Taken together meat is an important nutrient for human health and development. As an essential part of a mixed diet, meat ensures adequate delivery of essential micronutrients and amino acids and is involved in regulatory processes of energy metabolism.
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Affiliation(s)
- H-K Biesalski
- Universität Hohenheim, Institut für Biologische Chemie und Ernährungswissenschaft, Garbenstrasse 30 70593 Stuttgart, Germany
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Gaggiotti G, Orlandoni P, Ambrosi S, Onorato G, Piloni S, Amadio L, Spazzafumo L, La Rocca R. The influence of age and sex on nutritional parameters in subjects aged 60 years and over. Arch Gerontol Geriatr 2005; 20:117-28. [PMID: 15374240 DOI: 10.1016/0167-4943(94)00578-u] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/1994] [Revised: 08/23/1994] [Accepted: 08/25/1994] [Indexed: 10/27/2022]
Abstract
The nutritional assessment of the elderly shows several interpretative difficulties due to the lack of standard parameters. Moreover chronic age-related diseases can interfere with the physiological nutritional status. Anthropometric (triceps skinfold, arm muscle area, total body muscle mass, fat mass and Body Mass Index (BMI)), biochemical (serum prealbumin, transferrin, ceruloplasmin, total protein and albumin) and immunological (serum lymphocytes) parameters were measured in 583 out-patients aged 60 years or over selected on the basis of clinical and biochemical criteria and with BMI </= 30. The subjects were classified into four age-groups (60-64, 65-69, 70-74, >/= 75) for each sex. The F-test analysis for all anthropometric parameters except BMI showed significant differences with respect to age (P < 0.05) and sex (P < 0.05). Among biochemical parameters, prealbumin showed a significant difference for age (P < 0.05) and sex (P < 0.05) (males, 30.3 +/- 8.2; females, 29.1 +/- 7.5) while ceruloplasmin showed a significant difference for sex only (P < 0.05) (males, 40.9 +/- 9.3; females, 43.8 +/- 8.2). When the biochemical mean values obtained in this study were compared with those utilized in the daily routine of the hospital central laboratory, ceruloplasmin and prealbumin resulted in significantly higher (P < 0.05) while total protein and albumin were significantly lower values (P < 0.05).
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Affiliation(s)
- G Gaggiotti
- Unità Operativa di Chirurgia Generate e di Ricerca Chirurgica - Terapia Nutrizionale, INRCA - IRCCS, Via della Montagnola 164, 60100 Ancona, Italy
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Arinzon Z, Fidelman Z, Peisakh A, Adunsky A. Folate status and folate related anemia: a comparative cross-sectional study of long-term care and post-acute care psychogeriatric patients. Arch Gerontol Geriatr 2004; 39:133-42. [PMID: 15249150 DOI: 10.1016/j.archger.2004.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2003] [Revised: 02/09/2004] [Accepted: 02/14/2004] [Indexed: 10/26/2022]
Abstract
Aging is associated with increased risk of anemia, poor nutrition, chronic illness, and impaired folate status. We aimed to investigate and compare folate status in long-term care psychogeriatric patients (LTCPP) and in post-acute care psychogeriatric patients (PACPP). This is a cross-sectional study conducted in a psychogeriatric medical center with long-term care and post-acute care wards. A total number of 553 LTCPP and 373 PACPP were studied. Low serum folic acid levels were found in 10% of LTCPP and in 13% of PACPP. Folic acid anemia (FAA) was found in 67% of LTCPP and 87% of PACPP (P = 0.046) with low serum folate levels. Mean levels of serum folate were similar but red blood cells folate (RBC-folate) was higher in PACPP (P = 0.025) and in males compared with women (P = 0.009). 56% of PACPP and 68% of LTCPP who had folic acid anemia presented with another type of anemia. Anemia of chronic disease was the most frequent coexisting anemia and was found in 65% of LTCPP and 52% of PACPP, followed by B12 deficiency anemia and iron deficiency anemia. We conclude that PACPP represent only a slightly different group, compared with LTCPP, with regard to the folate status. These high rates of folate and RBC-folate deficiencies, as well as of FAA and coexisting anemia, call for a routine evaluation of folate status in all psychogeriatric patients, whether LTCPP or PACPP.
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Affiliation(s)
- Zeev Arinzon
- Frieda Schiff Warburg, Geriatric Medical Center, Netanya 42420, Israel
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Abstract
BACKGROUND Micronutrient status can affect cognitive function at all ages. Vitamin deficiencies could influence memory function and might contribute to age-associated cognitive impairment and dementia. Vitamin B6, comprising three chemically distinct compounds pyridoxal, pyridoxamine, and pyridoxine, is involved in the regulation of mental function and mood. Vitamin B6 is also an essential homocysteine re-methylation cofactor, and deficiency is associated with increase in blood homocysteine levels. Homocysteine is a risk factor for cerebrovascular disease and may also have directly toxic effects on neurons of the central nervous system. Neuropsychiatric disorders including seizures, migraine, chronic pain and depression have been linked to vitamin B6 deficiency. Epidemiological studies indicate that poor vitamin B6 status is common among older people. Hyperhomocysteinaemia has been suggested as a cause or mechanism in the development Alzheimer's disease and other forms of dementia. Supplementation with B vitamins including vitamin B6 has been shown to reduce blood homocysteine levels. OBJECTIVES To assess the efficacy of vitamin B6 supplementation in reducing the risk of developing cognitive impairment by older healthy people, or improving cognitive functioning of people with cognitive decline and dementia, whether or not vitamin B6 deficiency has been diagnosed. SEARCH STRATEGY The Specialized Register of the Cochrane Dementia and Cognitive Improvement Group was searched on 20 May 2003 using the terms: vitamin B6, pyridoxine, pyridoxamine, pyridoxal. For relevant trials on healthy elderly people MEDLINE, EMBASE and CENTRAL were searched using the previously mentioned terms as well as the term cognit * SELECTION CRITERIA All unconfounded, double-blind randomized controlled trials in which the intervention with vitamin B6 was compared with placebo for healthy older people or people with cognitive decline or dementia. The primary outcome of interest was the efficacy of vitamin B6 supplementation on cognitive function. DATA COLLECTION AND ANALYSIS The two reviewers independently evaluated all studies identified as possibly meeting the criteria for inclusion. One reviewer independently extracted the data. Studies were rated for their overall quality. The weighted mean differences between treatment and placebo groups, with 95% confidence intervals, were calculated for each outcome. Review Manager version 4.2 was used to analyse the variance. MAIN RESULTS No trials of vitamin B6 involving people with cognitive impairment or dementia were found. The two trials included in the review (Bryan 2002; Deijen 1992) used a double-blind, randomized, placebo-controlled design and involved 109 healthy older people. One trial restricted enrolment to women and the other to men. Vitamin B6 supplementation and healthy older women: Bryan 2002 enrolled 211 healthy women from various age groups into a 5-week study. The trial was of multifactorial design with folic acid, vitamin B12, vitamin B6 and placebo in its four arms. Twelve healthy women aged 65 to 92 years received 75 mg vitamin B6 orally per day and were compared with 21 healthy women who were allocated to placebo. No statistically significant benefits from vitamin B6 on mood or cognition were observed. Vitamin B6 supplementation and healthy older men: Deijen 1992 recruited 76 healthy men aged 70 to 79 years. They were divided into 38 matched pairs, one member of each pair randomly allocated to 20 mg of vitamin B6 (pyridoxine hydrochloride) per day for 12 weeks the other to placebo. No statistically significant differences between treatment and placebo were found in their effects on cognition or mood. Effect of vitamin B6 supplementation on vitamin B6 status: Deijen 1992 reported that 20 mg of pyridoxine hydrochloride per day for 12 weeks increased blood vitamin B6 activity as assessed as by plasma pyridoxal-5'-phosphate (WMD 238, 95%CI 211.58 to 264.42, P<0.00001) and erythrocyte enzyme asparate aminotransferase (WMD 0.43, 95%CI 0.30 to 0.56, P<0.00001). Effect of vitamin B6 supplementation on blood homocysteine concentration: Neither of the included trials measured homocysteine levels. Drop-outs: All participants allocated to vitamin B6 or placebo completed the trial protocol. Adverse Events: No adverse effects were reported. Effect of vitamin B6 on carer burden, care costs and institutionalization rate: We found no trials in which these outcomes were assessed. REVIEWER'S CONCLUSIONS This review found no evidence for short-term benefit from vitamin B6 in improving mood (depression, fatigue and tension symptoms) or cognitive functions. For the older people included in one of the two trials included in the review, oral vitamin B6 supplements improved biochemical indices of vitamin B6 status, but potential effects on blood homocysteine levels were not assessed in either study. This review found evidence that there is scope for increasing some biochemical indices of vitamin B6 status among older people. More randomized controlled trials are needed to explore possible benefits from vitamin B6 supplementation for healthy older people and those with cognitively impairment or dementia.
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Affiliation(s)
- R Malouf
- Dept. of Clinical Geratology, Cochrane Dementia and Cognitive Improvement Group, Radcliffe Infirmary, Woodstock Road, Oxford, UK, OX2 6HE.
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Chin A Paw MJM, de Jong N, Schouten EG, van Staveren WA, Kok FJ. Physical exercise or micronutrient supplementation for the wellbeing of the frail elderly? A randomised controlled trial. Br J Sports Med 2002; 36:126-31. [PMID: 11916896 PMCID: PMC1724467 DOI: 10.1136/bjsm.36.2.126] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To examine the effects of 17 weeks of physical exercise and micronutrient supplementation on the psychological wellbeing of 139 independently living, frail, elderly subjects (inactive, body mass index < or =25 or experiencing weight loss). METHODS Participants (mean (SD) age 78.5 (5.7)) were randomly assigned to: (a) comprehensive, moderate intensity, group exercise; (b) daily micronutrient enriched foods (25-100% recommended daily amount); (c) both; (d) neither. A social programme and identical regular foods were offered as attention control and placebo. RESULTS At baseline, moderate to low but significant correlations were found between general wellbeing scores and physical fitness (r = 0.28), functional performance (r = 0.37), and blood concentrations of pyridoxine (r = 0.20), folate (r = 0.25), and vitamin D (r = 0.23) (all p values < or =0.02), but not with physical activity levels and other blood vitamin concentrations. General wellbeing score and self rated health were not responsive to 17 weeks of exercise or nutritional intervention. CONCLUSION Psychological wellbeing in frail elderly people was not responsive to 17 weeks of intervention with exercise and/or micronutrient enriched foods. The moderate but significant correlations between wellbeing and physical fitness and several blood vitamin concentrations at baseline suggest that changes in wellbeing may occur after long term interventions.
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Affiliation(s)
- M J M Chin A Paw
- Division of Human Nutrition and Epidemiology, Wageningen University, The Netherlands.
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Bates CJ, Thane CW, Prentice A, Delves HT. Selenium status and its correlates in a British national diet and nutrition survey: people aged 65 years and over. J Trace Elem Med Biol 2002; 16:1-8. [PMID: 11878747 DOI: 10.1016/s0946-672x(02)80002-5] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Plasma selenium (Se) concentrations were measured in 1134 British people aged 65 years and over, living in mainland Britain during 1994-1995. Eight hundred and eighty-three lived in the community ("free-living"), while the remainder lived in institutions (residential and nursing homes). The overall mean plasma Se concentrations was 0.90 micromol/l (inner 95% range 0.50-1.36 micromol/l). Free-living people had significantly higher values than counterparts living in institutions, and there was an overall inverse correlation with age. Plasma Se varied with season (lower from October to December than at other times of the year), while values were higher in southern Britain than in the North. Socio-economic associations also existed (lower plasma Se in people receiving state benefits or with poorer educational attainment), while smokers had lower values than non-smokers. Several indices of poor health status or of medicine use were correlated with lower plasma Se, which was also predicted by several biochemical or haematological indices of infection or inflammation. Plasma Se was strongly and directly correlated with plasma albumin, zinc, cholesterol, vitamin C, several carotenoids, alpha-tocopherol, pyridoxal phosphate, and with blood haemoglobin and several anthropometric indices. All relationships were independent of age and gender, and are consistent with the view that plasma Se levels are higher in fit and well-nourished elderly people and lower in those who are frail, poorly-nourished and unwell. Whole-blood glutathione peroxidase generally did not share these relationships, was only very weakly correlated with plasma Se, and appeared to be less useful as a status indicator in this population group.
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Affiliation(s)
- Christopher J Bates
- Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK
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Abstract
Not only is there a high prevalence of malnutrition among the elderly admitted to hospital and other institutions, but nutritional status seems to decline during admission, not only as a result of disease but also problems with catering and feeding policies, which are not well-geared to the needs of the sick. This results in high food wastage rates and inadequate macro- and micronutrient intakes to meet requirements. In the elderly, decreased portion size and increased energy, protein and micronutrient density have been shown to be effective in decreasing wastage and improving intake. Other strategies for improving intake are reviewed, including a better environment, a reduction in drugs causing anorexia, help with eating, and less interruption of meals by procedures and ward rounds. Targets for nutritional intake and aims of feeding are reviewed.
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Affiliation(s)
- Simon Allison
- Clinical Nutrition Unit, Queens Medical Centre, Nottingham NG7 2UH, UK.
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Mathey MF, Vanneste VG, de Graaf C, de Groot LC, van Staveren WA. Health effect of improved meal ambiance in a Dutch nursing home: a 1-year intervention study. Prev Med 2001; 32:416-23. [PMID: 11330991 DOI: 10.1006/pmed.2001.0816] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND The aim of this study was to determine the effect of an improved ambiance of food consumption on health and nutritional status of Dutch nursing home elderly residents (n = 38) in a 1-year intervention study. METHODS A parallel group intervention study was performed. Improvement of ambiance focused on three points: (1) physical environment and atmosphere of the dining room, (2) food service, (3) organization of the nursing staff assistance. Dietary intake, biochemical indicators of nutritional and health status and quality of life (Sickness Impact Profile and Philadelphia Geriatric Center Moral Scale) were assessed at baseline and after 1 year of intervention. Body weight, used as an indicator of compliance and nutritional status, was assessed every 4 months. RESULTS Twenty-two subjects completed the 1-year intervention trial. Mean body weight significantly increased (+3.3 kg, P < 0.05) in the experimental group (n = 12), not in the control group (-0.4 kg, P = 0.78; n = 10). Health status biochemical indicators and the SIP score remained stable in the experimental group, indicating relatively stable health conditions. On the contrary, negative changes in the control group suggested a decline in health status. Dietary intake, which was insufficient at baseline, increased in both groups. CONCLUSIONS This study showed that improving the ambiance of food consumption is a non-negligible issue for improving nutritional status and stabilizing health of nursing home residents.
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Affiliation(s)
- M F Mathey
- Division of Human Nutrition and Epidemiology, Wageningen University, Dreijenlaan 1, 6703 HA Wageningen, The Netherlands
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Mathey MF, Siebelink E, de Graaf C, Van Staveren WA. Flavor enhancement of food improves dietary intake and nutritional status of elderly nursing home residents. J Gerontol A Biol Sci Med Sci 2001; 56:M200-5. [PMID: 11283191 DOI: 10.1093/gerona/56.4.m200] [Citation(s) in RCA: 180] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Taste and smell losses occur with aging. These changes may decrease the enjoyment of food and may subsequently reduce food consumption and negatively influence the nutritional status of elderly persons, especially those who are frail. The objective of this study was to determine if the addition of flavor enhancers to the cooked meals for elderly residents of a nursing home promotes food consumption and provides nutritional benefits. METHODS We performed a 16-week parallel group intervention consisting of sprinkling flavor enhancers over the cooked meals of the "flavor" group (n = 36) and not over the meals of the control group (n = 31). Measurements of intake of the cooked meals were taken before and after 8 and 16 weeks of intervention. Appetite, daily dietary intake, and anthropometry were assessed before and after the intervention. RESULTS On average, the body weight of the flavor group increased (+1.1 +/- 1.3 kg; p <.05) compared with that of the control group (-0.3 +/- 1.6 kg; p <.05). Daily dietary intake decreased in the control group (-485 +/- 1245 kJ; p <.05) but not in the flavor group (-208 +/- 1115 kJ; p =.28). Intake of the cooked meal increased in the flavor group (133 +/- 367 kJ; p <.05) but not in the control group (85 +/- 392 kJ). A similar trend was observed for hunger feelings, which increased only in the flavor group. CONCLUSION Adding flavor enhancers to the cooked meals was an effective way to improve dietary intake and body weight in elderly nursing home residents.
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Affiliation(s)
- M F Mathey
- Division of Human Nutrition and Epidemiology, Wageningen University, The Netherlands
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Chin A Paw MJ, de Jong N, Pallast EG, Kloek GC, Schouten EG, Kok FJ. Immunity in frail elderly: a randomized controlled trial of exercise and enriched foods. Med Sci Sports Exerc 2000; 32:2005-11. [PMID: 11128843 DOI: 10.1097/00005768-200012000-00006] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the effects of 17-wk physical exercise and enriched foods on cellular immune response (CIR) in frail elderly. METHODS A total of 112 independently living, frail elderly men and women (mean age 79.2 +/- 5.9) received: twice weekly comprehensive, moderate intensity, progressive group exercise (group A, N = 26); daily enriched foods (group B, N = 31); both (group C, N = 29); or neither (group D, N = 26). Exercises focused on skills training. Foods were enriched with micronutrients with a high prevalence of deficiency in older people (at 25-100% the RDA). A social program and identical regular foods were offered as a control. CIR was measured by delayed-type hypersensitivity skin test response (DTH) against seven recall antigens expressed as the total number of positive responses and sum of diameters of all positive responses. RESULTS No independent or interactive effect of enriched foods was observed. Therefore, exercise (groups A + C) was compared with no exercise (groups B + D). Nonexercising subjects showed an average decline of 0.5 responses compared with an unchanged responsiveness among exercising subjects (difference = 0.5, 95% CI: 0.04-0.89, P = 0.03 adjusted for baseline DTH, activity level, and micronutrient status). Nonexercising subjects had a larger decline in the sum of diameters of all positive responses than exercising subjects but the difference did not reach significance (adjusted difference = 2.1 mm, 95% CI:-1.0-4.8). CONCLUSION Exercise may prevent or slow the age-related decline in immune response. Micronutrient enriched foods showed no effect. As infectious diseases can have debilitating or even fatal consequences for the elderly, prevention of the age-related decline in CIR could significantly improve their quality of life.
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Affiliation(s)
- M J Chin A Paw
- Division of Human Nutrition and Epidemiology, Wageningen University, The Netherlands.
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Tébi A, Belbraouet S, Chau N, Debry G. Plasma vitamin, β-carotene, and α-tocopherol status according to age and disease in hospitalized elderly. Nutr Res 2000. [DOI: 10.1016/s0271-5317(00)80021-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cynober L, Alix E, Arnaud-Battandier F, Bonnefoy M, Brocker P, Cals MJ, Cherbut C, Coplo C, Ferry M, Ghisolfi-Marque A, Kravtchenko T, Lesourd B, Mignot C, Patureau Mirand P. Apports nutritionnels conseillés chez la personne âgée. NUTR CLIN METAB 2000. [DOI: 10.1016/s0985-0562(00)80002-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Essama-Tjani JC, Guilland JC, Potier de Courcy G, Fuchs F, Richard D. Folate status worsens in recently institutionalized elderly people without evidence of functional deterioration. J Am Coll Nutr 2000; 19:392-404. [PMID: 10872902 DOI: 10.1080/07315724.2000.10718936] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To follow folate status, hematological and cognitive changes during the first year of institutionalization among elderly subjects. DESIGN Prospective study. SETTING Long-stay unit of the Dijon University Geriatric Hospital. SUBJECTS Twenty women and four men older than 65 years admitted consecutively. MAIN OUTCOME MEASURES Folate and vitamin B-6 dietary intake was evaluated by a five-day record on admission (day 1 or d 1), at day 45 (d 45), day 90 (d 90), day 135 (d 135), day 180 (d 180), day 360 (d 360). Circulating levels of folate, vitamin B-6, total homocysteine (tHcy), blood counts and cognitive performance were determined in parallel. RESULTS From d 1 to d 360, mean folate and vitamin B-6 intakes remained below the French RDA and mean folate intakes decreased significantly (delta = 10.2%, p < 0.05). Mean plasma or erythrocyte folate decreased significantly (delta = 33.7%, p <0.05 and delta = -30.2%, p < 0.001, respectively) from d 1 to d 360; no significant change was observed for the other blood parameters. The incidence of folate deficiency increased (8% vs. 37% for plasma folate <6.8 nmol/L and 8% vs. 17% for erythrocyte folate <340 nmol/L) from d I to d 360. Mean plasma pyridoxal 5'-phosphate (PLP) remained <20 nmol/L during the one-year follow-up. There was no difference between genders for plasma tHcy. Although mean plasma tHcy was <14 micromol/L. plasma tHcy was >14 micromol/L in about one-third of the subjects. At each period, 50% or more subjects were anemic (Hct <35% in women and Hct <40% in men), but the anemia was normocytic (MCV <100 fL). Subjects had a moderate dementia at admission, and no change was observed during the study. CONCLUSIONS Subjects were already vitamin B-6 deficient at admission. Folate status was impaired during the study. Low vitamin intakes were the main cause of vitamin B-6 deficiency and folate status deterioration. Hematology and mental status capacity were not aggravated by folate status deterioration. Plasma tHcy didn't appear to be an earlier predictor of folate deficiency.
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Bates CJ, Pentieva KD, Prentice A. An appraisal of vitamin B6 status indices and associated confounders, in young people aged 4-18 years and in people aged 65 years and over, in two national British surveys. Public Health Nutr 1999; 2:529-35. [PMID: 10656472 DOI: 10.1017/s1368980099000713] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To compare vitamin B6 status indices with each other and with potential confounding factors, in the datasets from two national British surveys and associated studies. DESIGN Vitamin B6 status was measured by plasma pyridoxal phosphate (PLP) and plasma pyridoxic acid (PA) in both surveys, and also by erythrocyte aspartate aminotransferase activation coefficient (EAATAC) in one of the surveys. Plasma alpha1-antichymotrypsin was measured as an index of acute phase status; plasma creatinine was measured as an index of renal function; and plasma total alkaline phosphatase activity was measured as a proxy for PLP hydrolase activity. SETTING The survey of people aged 65 years and over was carried out in 80 postcode sectors across mainland Britain during 1994-95 and the survey of young people was carried out in 132 postcode sectors across mainland Britain during 1997. SUBJECTS Blood samples from c. 1,000 subjects of both sexes in each survey permitted measurements of plasma PLP and PA. There were also measurements of EAATAC in the young people's survey. RESULTS According to published limits of normality, only 5% or less of the young people had unacceptable vitamin B6 status as measured by plasma PLP. About half had apparently unacceptable status by EAATAC, but this observation is difficult to interpret. The young people had considerably higher plasma concentrations of PLP and lower concentrations of PA than the older people. In both surveys, plasma PLP was strongly correlated with plasma PA and in the young persons' survey it was also correlated, although much less strongly, with the basal activity and activation coefficient of aspartate aminotransferase. Both plasma PLP and EAATAC (but not PA nor basal aspartate aminotransferase activity) were influenced by acute phase status in young people, as indicated by significant correlations with alpha1-antichymotrypsin. In people aged 65 years and over, PA (but not PLP) was correlated with renal function, as indicated by its relation with plasma creatinine; however PLP (but not PA) was correlated with plasma alkaline phosphatase activity. CONCLUSIONS Several potential confounders - acute phase reaction, kidney malfunction and hydrolase activity - may influence vitamin B6 status indices, although differently for different indices and different age groups. Since older people have relatively poor vitamin B6 status, which may have important health implications for them, more reliable vitamin B6 status indices are needed.
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Affiliation(s)
- C J Bates
- MRC Human Nutrition Research, Cambridge, UK.
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de Jong N, Chin A Paw MJ, de Groot LC, de Graaf C, Kok FJ, van Staveren WA. Functional biochemical and nutrient indices in frail elderly people are partly affected by dietary supplements but not by exercise. J Nutr 1999; 129:2028-36. [PMID: 10539780 DOI: 10.1093/jn/129.11.2028] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A decline in dietary intake due to inactivity and, consequently, development of a suboptimal nutritional status is a major problem in frail elderly people. However, benefits of micronutrient supplementation, all-round physical exercise or a combination of both on functional biochemical and hematologic indicators of nutritional and health status in frail elderly subjects have not been tested thoroughly. A 17-wk randomized controlled trial was performed in 145 free-living frail elderly people (43 men, 102 women, mean age, 78 +/- 5.7 y). Based on a 2 x 2 factorial design, subjects were assigned to one of the following: 1) nutrient-dense foods, 2) exercise, 3) both (1) and (2) or 4) a control group. Foods were enriched with micronutrients, frequently characterized as deficient [25-100% of the recommended daily allowance (RDA)] in elderly people. Exercises focused on skill training, including strength, endurance, coordination and flexibility. Dietary intake, blood vitamin levels and nutritional and health indicators, including (pre)albumin, ferritin, transferrin, C-reactive protein, hemoglobin and lymphocytes were measured. At baseline, 28% of the total population had an energy intake below 6.3 MJ, up to a maximum of 93% having vitamin intakes below two thirds of the Dutch RDA. Individual deficiencies in blood at baseline ranged from 3% for erythrocyte glutathione reductase-alpha to 39% for 25-hydroxy vitamin D and 42% for vitamin B-12. These were corrected after 17 wk in the two groups receiving the nutrient-dense foods, whereas no significant changes were observed in the control or exercise group. Biochemical and hematologic indicators at baseline were within the reference ranges (mean albumin, 46 g/L; prealbumin, 0.25 g/L; hemoglobin, 8.6 mmol/L) and were not affected by any of the interventions. The long-term protective effects of nutrient supplementation and exercise, by maintaining optimal nutrient levels and thereby reducing the initial chance of developing critical biochemical values, require further investigation. Other indicative functional variables for suboptimal nutritional status, in addition to those currently selected, should also be explored.
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Affiliation(s)
- N de Jong
- Division of Human Nutrition and Epidemiology, Wageningen Agricultural University, Dreÿenlaan 6703 HA Wageningen, The Netherlands
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Lamy M, Mojon P, Kalykakis G, Legrand R, Butz-Jorgensen E. Oral status and nutrition in the institutionalized elderly. J Dent 1999; 27:443-8. [PMID: 10399411 DOI: 10.1016/s0300-5712(99)00002-0] [Citation(s) in RCA: 127] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To evaluate, in an elderly population, whether poor oral status might be a contributing factor to the development of undernutrition and might be associated with less eating pleasure, more subjective eating difficulty and increased mashed food consumption. METHODS An oral examination and an evaluation of masticatory capacity were performed on 120 institutionalized elderly subjects. The nutritional assessment included serum albumin concentration, the Mini Nutritional Assessment and a questionnaire on eating habits. RESULTS Edentulous subjects without dentures or with only one complete denture had significantly lower MNA scores than edentulous subjects with two complete dentures (p < 0.05). Edentulous subjects with two complete dentures more frequently reported taking pleasure from eating (p = 0.05), and had less frequent difficulties with hard foods (p = 0.01) than edentulous subjects without dentures or with only one complete denture. Mashed food consumption (p < 0.01) was also reported more frequently in edentulous subjects without dentures or with only one complete denture. Subjects with two complete dentures had similar or better MNA scores as dentate subjects with relatively few remaining teeth (10.4 +/- 7.8 teeth). About half of the subjects (53%) could not perform the masticatory test. These subjects had lower MNA scores (p = 0.001) and a larger proportion ate mashed food (p < 0.001) compared to those who were able to perform the test. CONCLUSIONS Poor oral status (edentulous without dentures or with only one complete denture) increased difficulty in eating hard foods, increased mashed food consumption and decreased eating pleasure. It seemed also to put institutionalized subjects at higher risk of undernutrition.
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Affiliation(s)
- M Lamy
- Division of Oral Surgery and Oral Implantology, CHU, University of Liège, Sart-Tilman, Belgium.
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Löwik MR, Hulshof KF, Brussaard JH, Brants HA. Nutrition assessment and dietary guidelines: experience from the Dutch Nutrition Surveillance System. Proc Nutr Soc 1996; 55:705-23. [PMID: 8884960 DOI: 10.1079/pns19960067] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- M R Löwik
- Department of Consumer Research and Epidemiology, TNO Nutrition and Food Research Institute, The Netherlands
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Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: The Mini Nutritional Assessment as part of the geriatric evaluation. Nutr Rev 1996; 54:S59-65. [PMID: 8919685 DOI: 10.1111/j.1753-4887.1996.tb03793.x] [Citation(s) in RCA: 786] [Impact Index Per Article: 28.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- Y Guigoz
- Nutrition Department, Nestec Ltd., Lausanne, Switzerland
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31
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Fenton J, Eves A, Kipps M, O'Donnell CC. Menu changes and their effects on the nutritional content of menus and nutritional status of elderly, hospitalized, mental health patients. J Hum Nutr Diet 1995. [DOI: 10.1111/j.1365-277x.1995.tb00335.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Fenton J, Eves A, Kipps M, O'Donnell CC. The nutritional implications of food wastage in continuing care wards for elderly patients with mental health problems. J Hum Nutr Diet 1995. [DOI: 10.1111/j.1365-277x.1995.tb00317.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cals MJ, Bories PN, Devanlay M, Desveaux N, Luciani L, Succari M, Duche JC, de Jaeger C, Blonde-Cynober F, Coudray-Lucas C. Extensive laboratory assessment of nutritional status in fit, health-conscious, elderly people living in the Paris area. Research Group on Aging. J Am Coll Nutr 1994; 13:646-57. [PMID: 7706600 DOI: 10.1080/07315724.1994.10718461] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Nutritional status-related biological indexes were measured in fit, health-conscious elderly subjects in order to establish reference values for people over 70 years. SUBJECTS 103 men and 90 women aged 70-89 years living freely in the Paris area volunteered to participate. METHODS Nutritional status was assessed by anthropometric and biochemical methods. RESULTS Serum protein and amino acid status was similar to that of young adults, with only 5.2% of the elderly subjects showing transthyretin concentrations < 0.20 g/L, as well as decreased essential amino acid levels. Iron status, assessed in terms of serum and erythrocyte ferritin levels, total iron binding capacity and erythrocyte protoporphyrin tended to be satisfactory, but iron depletion was detected in 8.8% of the subjects. Serum ferritin levels were elevated in 19.7% of the subjects. Folate and vitamin B12 status was satisfactory, while hypovitaminosis D was observed in 48.2% of cases. CONCLUSION Our findings suggest that, in aging uncomplicated by disease, nutritional status is similar to that in younger adults, although the range of values tended to be wider, with a higher risk of certain nutrient deficiencies.
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Affiliation(s)
- M J Cals
- Hôpital Corentin Celton, Assistance Publique-Hôpitaux de Paris, France
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Wielen RPVD, Groot LCD, Staveren WAV. Dietary intake of water soluble vitamins in elderly people living in a western society (1980–1993). Nutr Res 1994. [DOI: 10.1016/s0271-5317(05)80224-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Löwik MR, Hulshof KF, Schneijder P, Schrijver J, Colen AA, van Houten P. Vitamin C status in elderly women: a comparison between women living in a nursing home and women living independently. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 1993; 93:167-72. [PMID: 8423281 DOI: 10.1016/0002-8223(93)90833-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The vitamin C status in blood fractions in 135 elderly women aged 65 years and older was studied within the framework of the Dutch Nutrition Surveillance System. Mean (+/- standard deviation) vitamin C intake (mg/day) was lower among women living in a nursing home (54 +/- 27 mg/day) than among women living in service flats (97 +/- 55 mg/day) and women living independently (132 +/- 44 mg/day). (Service flats are apartments in which the rent includes housekeeping and, when ordered, meal service.) Marginal vitamin C values (< 23 mumol/L) in blood fractions and even levels as low as those found in clinical scurvy (< 11 mumol/L) were frequently observed. In the nursing home, 35% of the women had plasma vitamin C values below 11 mumol/L, and 23% had values between 11 and 23 mumol/L. Blood levels were not significantly affected by age, smoking status, or use of particular drugs but were strongly (r = .47 or, after logarithmic transformation, r = .64) associated with daily intake of vitamin C. Low intake of vitamin C resulted from an overall low food consumption and selective restriction of food products rich in vitamin C. Vitamin C losses caused by food preparation practices and distribution in the nursing home's catering system reduced actual vitamin C intake levels but these losses were not substantially greater than those that are assumed to occur as a result of preparation practices by women living independently.
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Affiliation(s)
- M R Löwik
- Department of Nutrition, TNO Toxicology and Nutrition Institute, Zeist, The Netherlands
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