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Vol. 35. Núm. 6.
Páginas 350-357 (Noviembre 2000)
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Vol. 35. Núm. 6.
Páginas 350-357 (Noviembre 2000)
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1

EVALUATIONOF MICRONUTRIENT INTAKES OF ELDERLY AUSTRALIANS: THE NATIONALNUTRITION SURVEY-1995

Bannerman,E.; Magarey, A.; Daniels, L.

Department ofPublic Health. Nutrition Unit. School of Medicine. FlindersUniversity of SA. Adelaide. Australia.


This paperpresents secondary analysis of the latest Australian NationalNutrition Survey (NNS)1 to evaluate the dietarymicronutrient intakes of older Australians in relation to nationalRecommended Dietary Intakes (RDI)2. The NNS was across-sectional study of dietary intakes & physicalmeasurements of a nationally representative sample (Feb. 95-Mar.96), including n= 1960 Australians >= 65 years old. Dietaryintakes were determined by 24 hour recall & nutrient intakeswere calculated using «Ausnut». The proportion ofadults whose dietaryintake of micronutrients was ¾ 2/3rds ofthe Australian RDIs was determined.

The dietaryintakes of niacin, thiamin, iron, riboflavin, & vitamin C wereconsidered not a cause for concern, with 73-97% of male's &female's intakes in excess of the RDI. However, the distribution ofdietary intakes of other micronutrients (vitamin A, calcium, zinc& potassium) showed a significant proportion of the populationhad intakes ¾ 2/3rds of the RDI (Table 1).

  

Thesefindings will be discussed with respect to the current RDI values& in terms of their implications for nutrition interventionstrategies for older Australians.

1Australian Bureau of Statistics 1995 National Nutrition Survey (NNS(%) Confidentialised Unit Record File (CURF) CD-ROM Canberra1999.

2NHMRC (1991) «Recommended dietary intakes in for use inAustralia».


2

MEDICINEUSE AND SUPPLEMENTATION PRACTICE AMONG PARTICIPANTS OF SENECASTUDY

Brzozowska, A.*; Enzi, G.**; Amorim Cruz, J.A.***

* Departmentof Human Nutrition. Warsaw Agricultural University. Poland. **University of Padua. Padua. Italy. *** National Institute ofHealth. Lisbon. Portugal.


The aim ofthis study was to assess six-year changes in medicine use andsupplementation practice of elderly Europeans born between1913-1918 who participated in the SENECA surveys. Data wascollected by oral interview in 12 towns in spring 1993 (1403participants) and in 10 centres in 1999 (621participants).

In 1993 morethan 83% of subjects used medicine and almost 26%used nutritionalsupplements. During six year period negligible changes wereobserved i.e. increase in medicine use (87%) and decrease insupplement use (23,5%). In 1999 more participants than earlier tookin long-term order (> 2 years) antihypertensive drugs (33% vs20%), anticoagulants (17% vs. 6%), nitroglycerine (13% vs. 5%),psychotropic drugs (15% vs 10%) and diuretics (18% vs.14%).

In 1999supplements more frequently taken were calcium (12% of all thesubjects, 7% of men and 17% of women), vitamin D (10% of all thesubjects, 6% of men and 14% of women) and ascorbic acid (10%).During six year period no changes in percentage of vitamin D andvitamin C users were observed while calcium in finale survey wastaken by more respondents (12% vs. 8%).

Medicine andnutritional supplement use was more frequent by women than by manin both 1993 and 1999.

Detailcharacteristic of medicine use and supplementation practice of 1993and 1999 for different SENECA centers by sex will bepresented.

This study ispart of the EU/SENECA study on Nutrition and Health of the Elderlyin Europe.


3

MICRONUTRIENT SUPPLEMENTATION RECOMMENDATIONS FOR THEELDERLY SUGGESTED BY A PUBLIC COMMITTEE

Dror, Y.*;Stern, F.*; Berner, Y. N.**; Kaufman, N.***; Berry, E.***; Maaravi,Y.***; Altman, H.****; Cohen A.****; Leventhal, A.****;Nitzan-Kaluski, D****.

* Faculty ofAgriculture-Rehovot. ** Meir Hospital-Kfar Saba. *** HaddassaMedical Center-Jerusalem. ****Ministry of Health.Israel.


Objectives: To evaluate the needs for micronutrientsupplementation for institutionalized elderly and to suggest anappropriate preparatory composition.

Methods: DRI (Dietary Recommended Intakes) for the totaldaily intake of micronutrients has been well accepted by themajority of the nutritionists. No recommendations for supplementalpreparatories have been so far issued. A public committee wasappointed by the Israeli Ministry of Health to recommend anappropriate preparatory for the elderly.

Results: The committee recommended a composition ofabout half the RDA (as issued by the American Health Authorities)for most of the micronutrients. Some micronutrients wererecommended at a level of 1 RDA. No macronutrients, such as Ca, Pand Mg were included. Vitamin K and Fe were also excluded. F wasrecommended at a minimal amount.

Discussion: Macronutrients comprise the main bulk of thepreparatory preventing consumption by mani subjects. Thesemacronutrients may be supplied by another preparatory. For themajority of the elderly population food supplies above half of theRDA. Therefore, the committee suggested a daily supplementation ofa half of the RDA for most of the micronutrients. Fesupplementation should be treated individually, because for somesubjects iron might increase the risk of oxidative stress. VitaminK might interfere with the activity of anticoagulant drugs consumedby many subjects. Water flourine concentration in some areas inIsrael is quite high and supplemental consumption must becautious.


4

PREDICTORSOF IRON, FOLATE AND VITAMIN C DEFICIENCY IN PEOPLE OVER75Y

McNeill,G.; Vyvyan, J. P.; O'Hanrahan, B. T.; Peace, H. S.; Wyness,L.

Department ofMedicine & Therapeutics. University of Aberdeen. Foresterhill.Aberdeen. UK.


Objective: To assess whether anthropometric measurementsand responses to simple questions on diet and health are able toidentify individuals with marginal deficiency of iron, folate orvitamin C.

Design: Observational study on a random sample of menand women aged 75y or over living in the community.

Methods: 95 men and 77 women were interviewed in theirown homes. 1-2 weeks later they were visited by a nurse who tookheight and weight measurements for calculation of body mass index(BMI) and a fasting blood sample for analysis of ferritin, folateand vitamin C. Marginal deficiency was defined as below20µg/l for serum ferritin, 160µg/l for red cell folateand 17µmol/l for plasma vitamin C.

Results: Of the subjects studied, 14% had marginaldeficiency in iron, 18% in folate and 14% in vitamin C. There wasno difference in age, sex, BMI, appetite, weight loss or medicationuse between those who were deficient and those who were notdeficient for any of the three nutrients. For vitamin C, low fruitand vegetable intake was associated with an increased risk ofdeficiency, while use of multivitamins was associated with adecreased risk of deficiency.

Discussion: The lack of association between BMI,appetite or weight loss and deficiency suggests that traditionalmeasures of nutritional status may fail to identify micronutrientdeficiencies. We are currently extending this work to a totalsample of 200 men and 200 women on whom data will be available forpresentation.


5

SERUMSTATUS OF CAROTENOIDS AND TOCOPHEROL IN CATARACT PATIENTS: ACASE-CONTROL STUDY

Olmedilla,B.; Granado, F.; Vaquero, M.*; Blanco, I.; Herrero,C.

Unidad deVitaminas (Sección de Nutrición). * Servicio deOftalmología. Clínica Puerta de Hierro. Madrid.Spain.


Cataracts arean important public health problems being responsible for abouthalf the 30-50 millions cases of blindness throughout the world.Epidemiological studies have shown an inverse association betweenantioxidant and/or carotenoids intake and blood levels and risk ofcataract and age-related macular degeneration. Specifically,citamin E, b-carotene, lycopene and lutein plus zeaxanthin havebeen shown to be inversely associated with the risk of eyedisease.

To assess theserum status of carotenoids, retinol and tocopherols in subjectswith clinically diagnosed cataracts, we compared 56 patients (21men, 35 women, age > 40 y) and 110 controls (49 men, 61 women,age > 40 y). Fasting blood samples were collected throughout theyear and analysed by a quality-controlled HPLC method (NIST, USA).Univariate and multivariate analysis were performed using SPSSStatistical package (v. 8.0).

Patientsshowed significant lower serum levels of lutein (p< 0.000) andb-cryptoxanthin (p< 0.000) and higher of lycopene (p= 0.013) butnot for a-tocopherol, a-toc./chol. ratio, zeaxanthin, a- andb-carotene. Some of these differences may be related to differentdietary intake of major contributors (i.e. lycopene-tomatoproducts; b-cryptoxanthin-oranges), although in lutein (provided bygreen vegetables) are not only due to dietary habits because itshould be also expected in other co-ingested carotenoids providedby green vegetables (b-carotene). Lower serum levels ofxanthophylls and higher of lycopene are present in patients withcataracts and these differences seem to be not only related todietary factors. Whether these carotenoids play a role in theaetiology and/or evolution of human cataracts deserve furtherinvestigation.


Oral communications 2


6

WEIGHTCHANGE AND MORTALITY IN THE ELDERLY. A POPULATION STUDY OF70-YEAR-OLDS

Kumar Dey,D.*; Rothenberg, E.*, **; Sundh V.*; Bosaeus, I.**;Steen, B.*

Departmentsof Geriatric Medicine* and Clinical Nutrition**. GöteborgUniversity. Sweden.


Objectives: To examine the relationship between weightchange from age 70 to 75 and subsequent 5- and 10-yearmortality.

Design: Longitudinal cohort study with a representativesample of 973 individuals (449 males and 524 females) aged70.

Methods: Weight change was expressed as percent (%)change (in kg) between age 70 and 75 years and was divided intofive weight change groups: loss ≥ 10%, los 5-9.9%, loss 0-4.9%,gain 0.1-4.9% and gain ≥ 5%. Te relative risk (RR) and 95%confidence interval (CI) for 5-year (75-80) and 10-year (75-85)mortality were estimated with «weight loss 0-4.9%» or«stable» weight change group as reference.

Results: Individuals who lost >= 10 percent of theirinitial body weight between age 70 and 75 had a significantlyincreased risk for subsequent 5-year mortality (males, RR= 2.54,95% CI: 1.78, 3.61 and females, RR= 2.25, 95% CI: 1.14, 4.45). Therisk was also significantly higher in both sexes who lost 5-9.9% oftheir initial weight during age 70 to 75. For the 10-year mortalityrisk, such a trend was only significant for males of two weightchange groups (lost ≥ 10 and 5-9.9%, respectively). The RR for10-year mortality after 75 was found to be lowest among males (RR=0.88, 95% CI: 0.52, 1.05) and females (RR= 0.76, 95% CI: 0.46,1.23) who had gained ≥ 5% of their body weight between age 70and 75.

Discussion: In elderly individuals weight loss is a riskfactor for subsequent mortality in both sexes and a moderate weightgain seems to be protective for survival in this higher age group.Thus in clinical practice weight loss should be considered as analarm signal and moderate weight gain rather a health indicator inthe elderly.


7

AUSTRALIANLONGITUDINAL STUDY OF AGEING: II PROSPECTIVE EVALUATION OFANTHROPOMETRIC INDICES IN TERMS OF MORBIDITY IN COMMUNITY-LIVINGOLDER ADULTS

Miller,M.*, **; Bannerman, E.**; Crotty, M.**; Daniels, L.**; Giles, L.**;Whitehead, C.*; Cobiac, L.***; Andrews, G.**

*Repatriation General Hospital. ** Flinders University of SouthAustralia. *** CSIRO Division of Human Nutrition. Adelaide.Australia.

Nutritionalstatus may influence an individual's ability to functionindependently which is positively associated with improved healthoutcomes & quality of life. This study evaluates the predictivevalue of selected nutritional indices in terms of physical function& mobility in community-living older adults.

Weight,height, skinfolds (triceps, abdominal, supra-spinale, sub-scapular,medial calf, front thigh, metacarpal) & girth (arm, waist, hip,calf) measurements were performed on a community-living sample ofolder Australians (Australian Longitudinal Study of Ageing ­ALSA; 772 men & 624 women; age ≥ 70 years). Waist: Hip, %weight loss, corrected-arm-muscle area (CAMA) & BMI werecalculated. These measures were categorised according to commonlyadopted definitions of nutritional status. Logistic regressionanalysis was used to determine the predictive value of theseanthropometric indices of physical function & mobility at2-year follow-up, adjusting for potential confoundeers (age,gender, marital status, smoking, alcohol status, self-rated health,ADL & co-morbidity).

A BMI of <20 kg/m2 or < 22 kg/m2 was associated withgreater physical function (RR= 0.29 CI= 0.13-0.64 & RR= 0.59CI= 0.37-0.94); weight loss of > 10% was predictive of increasedphysical dysfunction (RR= 2.51, CI= 1.23-5.12). BMI > 29.9kg/m2 or > 30 kg/m2 was predictive ofreduced physical function (RR= 1.60, CI= 1.00-2.56 & RR= 1.79,CI= 1.12-2.86) & reduced mobility (RR= 2.10, CI= 1.35-3.27& RR= 2.13, CI= 1.36-3.32) as was waist girth of ≥102 cm (m)&≥ 88 cm (f) (RR= 1.81, CI= 1.26-2.59).

Some but notall definitions of under & over=nutrition independently predictthe risk of physical dysfunction & mobility in community-livingolder adults. Establishment of relevant anthropometric indices& cut=off values for nutritional assessment of this populationis required.


8

PREDICTORSOF CHANGES IN LEAN BODY MASS IN VERY OLD FREE-LIVING MEN AND WOMEN:THE FRAMINGHAM HEART STUDY

Payette,H.*, **; Roubenoff, R.**; Jacques, P.**; Harris, T.***; Wilson,P.

* ResearchCentre. Sherbrooke Geriatrics University Institute. Québec(CND). ** USDA Jean Mayer Human Nutrition Research Centre on Agingat Tufts University. Boston. MA (USA). *** National Institute ofAging, Bethseda (USA).


Objective: To assess the prognostic role of cytokinesand IGF-1 in 2-year changes in lean body mass ( LBM) while controlling forpotential confounders and factors associated with changes in bodycomposition.

StudySubjects: 232 males and 326 females [x= 78± 4 (72-92)yrs] from the FHS cohort able to attend the study center for the22nd and 23nd biennial examinations andhaving complete body composition data in both cycles as well asIL-6 and IGF-1 data at baseline (22nd).

Methods: LBM was estimated from bioimpedance data usinga validated population-specific equation. Total cellular IL-6synthesis and serum IGF-1 were measured by radioimmunoassay.Baseline health, functional and nutritional variables associatedbivariately with LBM weresimultaneously entered into gender-specific, age-adjustedmultivariate linear regression models to predict  LBM. Adjustment was alsomade for baseline LBM index [LBM/heigh (m)2].

Results: Participants were not obese or malnourished(x­ BMI= 27.0± 4.6 kg/m2). Mean  LBM was -0.86± 2.24kg in men and -0.73± 1.78 kg in women. In men, LBM loss wasassociated (adj. R2= .09, p< .0001) with higherbaseline LBM index (p= .02), better perceived health status (p=.006) and lower baseline IGF-1 serum levels (p= .002). Inwomen,  LBM were negativelyassociated (adj. R2= ..22, p< .0001) with LBM index(p< .001), IL-6 (p= .02) and the occurrence of health eventduring the follow-up period (p= .03) and positively related toIGF-1 (p< .0001).

Conclusion: Cytokine and hormonal status are significantindependent predictors of  LBM in the community-living elderly.


9

NUTRITIONAL STATUS OF 80-YEAR-OLD MEN AND WOMEN AND ITSRELATION TO MUSCLE STRENGTH

Pedersen,A. N.*; Ovesen, L.*; Schroll, M.**; Era, P.**; Rasmussen, K.***;Nielsen, F.***

* Departmentof Nutrition. Danish Veterinary and Food Administration. ** Unitfor Dietary Studies at the Center for Preventive Medicine. GlostrupUniversity Hospital. *** Skejby Hospital. **** Odense UniversityHospital.


Objective: To examine nutritional status and itsrelationship to muscle strength as a reflection of functionalcapacity in home dwelling 80-year-old Danes.

Design: A cross-sectional study of 121 men and 113 womenwho participated in the longitudinal 1914-population study1964-1994 in Glostrup, Denmark.

Methods: Food intake was measured as a modified dietaryhistory (the SENECA method), blood samples were non-fasting. Musclestrength was measured a maximal isometric strength of handgrip, armflexion, knee extension, trunk flexion and extension.

Results: Blood levels of β-carotene correlatedsignificantly with the intake of β-carotene,fruit andvegetables. Blood levels of homocysteine correlated significantlynegatively with the intake of cereals and fish and positively withfats, while there was a tendency to negative correlations to fruitand vegetables. All muscle strength values correlated significantlywith blood levels of β-carotene, while homocysteine showed atendency towards a negative association with muscle strengthvalues. A diet score showed a tendency towards better musclefunction with a higher score.

Conclusion: Blood levels of β-carotene and homocysteineseem to reflect a healthy diet. There is a tendency towards highermuscle strength values with biomarkers of a healthy diet and a dietscore.


10

RESTINGENERGY EXPENDITURE (EE), ACTIVITY EE AND TOTAL EE AT AGE91-96

Rothenbeerg, E. M.; Bosaeus, I. G.; Westertep, K. R.; Steen,B. C.


Department ofClinical Nutrition. Sahlgrenska University Hospital. Gothenburg.Sweden.

Objectives: There is a limited knowledge concerningenergy requirements of the elderly, especially the oldest old (>80 yr). Energy requirements should be estimated from measurementsof energy expenditure.

Design andmethods: 21 free-living individuals (8 males, 13 females),91-96 years of age, living in Göteborg, Sweden, were studiedby the doubly labelled water method (DLW) for measuring totalenergy and by a ventilated hood system for Resting metabolic rate(RMR).

Results: RMR averaged 5.36 (SD 0.71) MJ/d in females(n=12) and 6.09 (SD 0.91) MJ/d in males (n= 8). Difference betweenmeasured RMR and predicted basal metabolic rate (BMR) (n= 20) was0.015 (SD 0.86) MJ/d (NS). Total energy expenditure (TEE) measuredby DLW averaged 6.3 (SD 0.81) MJ/d in females and 8.1 (SD 0.73)MJ/d in males. Activity energy expenditure (AEE= TEE-RMR), thusincluding diet induced thermogenesis, DIT) averaged 0.95 (SD 0.95)MJ/d in females (n= 12) and 2.02 (1.13) MJ/d in males. Physicalactivity level (PAL= TEE/BMR) averaged 1.19 (SD 0.19) in femalesand 1.36 (SD 0.21) (p= 0.08) in males.

Discussion: If DIT is assumed to be 10 per cent of TEE,energy spent on physical activity will be very low in this very oldpopulation.


Oral communications 3


11

HEALTHYEATING IN EUROPEAN ELDERLY: CONCEPTS, BARRIERS ANDBENEFITS

DeAlmeida, M. D. V.; Graça, P.; Alfonso, C.; Kearney, J. M.**;Gibney, M. J.**

Faculdade deCiências da Nutriçâo da Universidade do Porto.Porto. Portugal.


Objectives: The objectives of this study were toidentify in the elderly European population, the attitudes to food,nutrition and health, in order to define adequate strategies ofhealth promotion.

Design: Cross-sectional survey using a face-to-faceinterview-assisted questionnaire.

Methods: This project belongs to the multicentric Pan-EUSurvey on Consumer Attitudes to Food, Nutrition and Health underthe leadership of the institute of European Food Studies - Dublin,with the cooperation of members from all EU countries. 1843European citizens, aged ≥ 65, were interviewed The data'sdescriptive analysis, was followed by univariate analysis tocharacterise the study's sample according to the definedobjectives. Results will be presented at European level as for eachcountry.

Results: The most important factors influencingelderly's food choice were quality and freshness (52%), trying toeat healthy (9.8%) and price (7.4%). Healthy eating was defined as«more fresh vegetables and fruit» (34.4%), «lessfat» (33.4%) and «balance and variety» (22.6%).To stay healthy (35%), to prevent disease (28%) and to promotequality of life (10%) were the major benefits associated to healthyeating. However several barriers to the adoption of healthy eatingwere identified, namely to give up the preferred foods (20%), theprice (15%) and willpower (13%). 19% of the elderly people didn'twant to change their eating habits.

Discussion: Results of this study will help to improveeating habits in the elderly, as health professionals will be ableto choose the most appropriate strategies for the different groupsand settings, and will provide a base for future interventions inEuropean countries for this growing age group.


12

INTERACTION BETWEEN TEXTURE AND TRIGEMINAL STIMULUS: EFFECTSON ELDERLY CONSUMERS PREFERENCES

Forde, C.;Ester, N.; Cantau, B.; Delahunty, C.; Morrissey, P.

NutritionalSciences. Department of Food Science and Technology. UniversityCollege. Cork.


Thechemosensory losses that accompany ageing are widely believed toinfluence food preferences and consumption in the elderly. Thepossibility that interactions between the residual senses cancompensate for losses was explored using a complex food system.Preferences for trigeminal and texture attributes of a food acrosstwo age groups were determined. A panel of twenty-four young people(20-35, mean age 27.7 ± 3.95 years) and twenty-four elderlypeople (> 65, mean age 73.6 ± 5.78 years) were recruited.Eight soups were prepared using a standardised recipe, with fourvariations in texture and two levels of trigeminal stimuli. Sampleswere administered initially in paired comparisons to determinerecognition thresholds for differences between both texture andtrigeminal stimulus. Samples were subsequently rated on a ninepoint hedonic scale to determine preferences. The results showedthat it may be possible to compensate for losses in chemosensoryfunction by careful manipulation of levels of interacting stimulito obtain improved preference.


13

FLAVOURSENHANCEMENT OF FOOD IMPROVES DIETARY INTAKE AND NUTRITIONAL STATUSOF NURSING HOME ELDERLY

Mathey, M.F.; Siebelink, E.; Graaf, C.; Van Staveren, W. A.

Division ofHuman Nutrition & Epidemiology. Wageningen University.Wageningen. The Netherlands.


Taste andsmell losses occur with aging. These changes are supposed todecrease the enjoyment of food, reduced food consumption andnegatively influence the nutritional status of older adults,especially in the frail ones.

The studyaimed at determining if the addition of flavor enhancers to thecooked meal of nursing home elderly residents during 16 weeks wouldlead to an increase in food consumption and thereby providenutritional benefit to this population.

Sixty-sevennursing home elderly residents participated in a 16 weeks parallelgroup intervention study during which flavor enhancers weresprinkled over the cooked meal of the «enhanced» group.The control group received the same normally flavored meal.Appetite, daily dietary intake and anthropometry were assessedbefore and after 16 weeks of intervention. Dietary intake at thecooked meal was measured before, after 8 and 16 weeks ofintervention.

Mean bodyweight significantly increased (+1.1 kg, p< 0.05) in theenhanced group (n= 36) and these changes differed significantlyfrom those observed in the control group (­0.3 kg, n= 31).Daily dietary intake significantly decreased in the control group(­485 ± 1245 kJ, p< 0.05) and remained stable in theenhanced group (­208 ± 1115 kJ). Dietary intake at thecooked meal significantly increased in the enhanced group (133± 367 kJ) and remained stable in the control group (85± 392 kJ). Daily feelings of hunger also significantlyincreased in the enhanced group and remained unchanged in thecontrol group.

Resultsshowed that adding flavor enhancers to the cooked meal is a simplebut effective way to improve appetite and dietary intake, whichwill positively affect nutritional status in nursing homeelderly.


14

REDUCEDAPPETITE; IMPORTANT INFORMATION FOR IDENTIFYING ELDERLY WITHUNDERNUTRITION

Mowé, M.; Bohmer, T.

Department ofMedicine. Aker University Hospital. Oslo. Norway.


Introduction: Protein-energy undernutrition is commonamong aged people, but appears seldom in the discharge summarise.This may be due to a reduced focus on nutrition in an activeclinical setting. It is therefor important to have a simplescreening to identify undernourished patients.

Aim:We wanted to study the prevalence of reduced appetite in 311 acuteadmitted elderly patients. The difference in nutritional status,according to appetite, was also analysed.

Results: Reduced appetite is present in 43% ofhospitalised patients, compared to 15% in a free-living group.Patients with bad appetite have lower body weight: In men: 56 kgcompared to 69 kg (p < 0.000); in women: 52 kg compard to 58 kg(p < 0.002). The prevalence of reduced appetite (in%) correlatedto the clinical judgement of nutritional status: severeundernourished-77%; moderate undernourished-70%; notundernourished-33%; overweight.17% (p < 0.000).

Conclusion: Reduced appetite is common in old patients,and is an indicator of reduced nutritional status. Aged patientsshould always been asked about their previous appetite.


15

PERCEPTIONAND PLEASANTNESS OF FOODS OF VARYING LEVELS OF OLFACTORY ANDGUSTATORY STIMULI AMONG THE ELDERLY

Tuorila,H.; Maunuksela, E.; Niskanen, T.

Department ofFood Technology. University of Helsinki. Finland.


In theelderly, olfaction has been documented to decline more dramaticallythan gustation. We examined the extent to which the missing ordeclined olfactory perception cluld be compensated (in hedonicterms) by an intense odor or a strong taste. Subjects (n= 59) werefree-living women and men, age range 60-85 years. A control group(n= 39, age 21-38) consisted mainly of university students andstaff. All subjects participated in six sessions, in which they 1)were investigated for background, including olfactory and gustatorycapabilities, 2)-5) rated 18 sweet and savory cream cheese and 6)completed another olfactory test. The cream cheese samples weremade using 3x3 factorial designs (8, 16 or 32% sucrose and none,mild or strong vanillin; 0.6, 1.2 or 1.8% NaCl and none, mild orstrong basil extract). Prior tasting, subjects rated vanillin orherbal odor intensity and during tasting the overall flavorintensity and pleasantness; four or five samples were rated in asession. Unlike the young controls, the elderly rated the oderintensities similarly regardless of the concentration of vanillinor basil, but they detected large differences in flavorintensities. Hedonic ratings of both age groups were fairly similaralthough, in the case of vanillin, some tendency was observed amongthe elderly towards favoring strong vanilla. The olfactory testsshowed a decline in smell identification ability between thecontrols and the elderly, and within the age range of the elderlysubjects, but the test scores had little impact on olfactoryratings.

The study wascarried out with the financial support from EU Quality of Lifeprogramme, project QLK1-CT-1999-00010.


Oral communications 4


16

NUTRITIONAL ASSESSMENT AND INTERVENTION IN US HOMEBOUNDELDERLY PEOPLE

Cavadini,C.; Kretser, A.; Kerr, W.; Voss, T.

NestléResearch Center, Nestec Ltd. Lausanne. Switzerland.


The studyaimed at identifying elderly homebound malnourished or at risk ofand tested the efficacy of a comprehensive rstorative nutritionintervention program.

Nutritionalrisk of subjects applying for meal services was determined via deMini Nutritional Assessment (MNA). Subjects were entered into twogroups. The control group (C) received one hot delivered meal, 5days/week. The experimental group (E) received 21 speciallyformulated frozen meals plus fortified snacks delivered once perweek. Nutritional risk (MNA), weight and BMI were measured at 0, 3and 6 months.

Atenrollment, in groups C and E respectively the mean age ± SDwas 76 ± 8y (n= 95) and 75± 8y (n= 97) (ns). Group Creceived approximately one third of daily requirements within theone meal. Group E received 100% of the daily requirements. Initialmean MNA was 18.6± 3.0 (C) and 18.9± 3.0 (E) (ns).MNA determined nutritional risk decreased with time (0< 3< 6month) (p< 0.001) without group difference. Initial mean weight:male, 80± 22 kg, female 70± 24 kg (p< 0.05).Weight increased with time in group E (p< 0.01) at 3 and 6months and decreased in group C (ns). Initial BMI was 26.2±0.9. The group (E) BMI increased at 3 mo and 6 mo (p< 0.05 andp< 0.01). No increase in group (C) BMI was observed.

MNA proved tobe effective as a risk screening tool. Weight gain is viewed asprotective in the elderly. Results suggest the need to reevaluatethe present concept of meals-on-wheels programs for those atnutritional risk.


17

DIETARYQUALITY AND HEALTH STATUS IN EUROPEAN AND AMERICANELDERLY

Haveman-Nies, A.*; De Groot, C. P. G. M.*; Tucker, K. L.**;van Staveren, W. A.*

* WageningenUniversity. Division of Human Nutrition & Epidemiology. TheNetherlands. ** Jean Mayer USDA Human Nutrition Research Center onAging at Tufts University. Boston. USA.


A predominantapproach for evaluating diet quality is the measurement of singledietary components. Given the complexity of human diets and themany interactions and correlations between nutrients, it isconsidered useful to examine global indices of food and nutrientintake as reflective for the total dietary pattern.

Two methodsto make dietary patterns operational are cluster analysis and thecalculation of diet scores. Both cluster analysis and diet scorescan be used to classify persons into groups differing innutritional status. In this study the Mediterranean Diet Score andthe Healthy Diet Indicator are calculated for elderly, aged 70-77y, of the Europe-wide SENECA Study and the Framingham HeartStudy.

From clusteranalysis, five dietary patterns were identified that correspondedto high consumption of sugar products, alcohol, meat & fat milk& fruit and fish & grain products. Further analysis showedthat these groups were associated with the diet scores and othernutritional indicators.


18

HEALTHSTATUS, QUALITY OF LIFE AND MORTALITY IN A RANDOMIZED SELECTEDITALIAN ELDERLY SAMPLE

Inelmen,E. M.; Jimenez, G.; Miotto, F.; Mazzucato, M.; Rossi, F.; Peruzza,S.; Sergi, G.; Enzi, G.

Department ofMedical and Surgical Sciences. University of Padua. Padova.Italy.


Although itis well known that the elderly are at much greater risk fordevelopment of chronic diseases than younger individuals, data onprevalence of common diseases in older Italians, are still few. Thepresent study includes a random sample of 89 elderly (43.8% males;56.2% females), born between 1913-1918, and constitutes the Italianpart of the SENECA Study. The aim is to evaluate health status,quality of life and mortality of our elderly population. Themethodology has been already described1. The great partof the subjects (84.6% of males; 76% of females) was able to moveoutdoors. The cognitive function of almost all the subjects wasgood. The opinion of the participants about their current healthstatus was worse in females (18%) than in males (5.1%). The mostfrequent chronic disease reported were: arthrosis and hypertension(28.2%), cardiovascular and respiratory diseases (20.5%), neoplasia(17.9%), diabetes (15.4%) in males; arthrosis (44%), osteoporosis(30%), hypertension (22%), cardiovascular and respiratory diseases(10%), neoplasia disease (8%) in females. Mortality was 28.9% ofthe initial sample (190). The most frequent causes of death wereneoplasia (47.3% in males, 40% in females), cardiovascular disease(28.2% in males; 40% in females), stroke (7.7% in males),respiratory diseases (5.1%) in males; stroke, respiratory diseases,hip fracture (6.6%) in females. In conclusion, although the opinionof our subjects about their health status was good, they sufferedfrom a high prevalence of chronic diseases. Arthrosis was the mostfrequent chronic disease. Neoplasia was the first cause of death inboth genders.

1De Groot C. P. G. M. & Van Staveren W. A. (1998). Nutrition andthe Elderly: Manual of Operations. Euronut Report 11. Wageningen,The Netherlands.


19

NUTRITIONAL STATUS AND LENGTH OF STAY IN GERIATRICHOSPITALIZED PATIENTS

Audivert,S.; Burgos, R.; Pérez-Portabella, C.; Jiménez, G.;Planas, M.

NutritionalSupport Unit. Hospital Vall d'Hebron. Barcelona.


The aims ofour study were: 1) to analyse the prevalence of malnutrition ingeriatric (>= 65 y) and non-geriatric (< 65 y) patientsadmitted to an university hospital, and 2) to study the lenght ofstay (LOS) according to the nutritional status in both groups ofpatients.

Prospectiveand randomized study of 329 patients. The admission was scheduledor through the emergency room. Nutritional status on admission wasdetermined using: objective (O) (body mass index, triceps skinfoldthickness, and mid-arm circumference) and subjetive (S) (SubjectiveGlobal Assessment). LOS was reported for all the patients studied.Statistics: Student t-test and Chi-Square.

We studied140 geriatric patients and 189 non-geriatric patients. Using Omethod, we found a similar prevalence of malnutrition in geriatricand non-geriatric patients (11.4% and 10.6%, respectivelly). With Smethod higher prevalence of malnutrition was observed in bothgroups of patients (44.2% in geriatric and 40.7% in non-geriatric,respectivelly).

LOS wassignificantly longer in malnurished vs normonourished non-geriatricpatients using both methods of nutritional assessment (O:8.8± 7 vs 5.2± 5 d; and S: 6.5± 5 vs4.7± 5 d, both p< .05). In the geriatric group ofpatients, while no modifications were observed according to theirnutritional status when we use S method (6.6± 6 vs6.3± 5 d). LOS was longer in normonourished patients using Omethod (4.4± 2 vs 6.7± 5, p< .05).

Nodifferences in prevalence of malnutrition between geriatric andnon-geriatric patients, neither according to their admission wereobserved. Subjetive nutritional method allow to detect more numberof malnourished patients in both groups. Non-geriatric malnourishedpatients have LOS longer than normanourished ones.


20

ASSESSMENTOF RISK FACTORS (RF) FOR MALNUTRITION AND OF NUTRITIONAL STATUS INHEALTHY ELDERLY PEOPLE IN GERMANY

Volkert,D.; Junk, K.; Mensing, S.; Stehle, P.

Department ofNutrition Science. University of Bonn. Bonn.


Littleinformation is available about the nutritional status and the riskof malnutrition in healthy elderly people in Germany. Aim of thiscross-sectional study was thus to assess the prevalence of RF formalnutrition as well as the nutritional status in healthy elderlyliving in an urban area in the Rhineland.

Participantswere randomly selected (based on local registration list).Inclusion criteria were: age >= 65 years (y), living in aprivate household, being independent in basic activities of dailyliving, no severe mental impairment. Presence of different RF formalnutrition was asked in a standardised personal interview. Bodyweight and height were measured and BMI calculated.

From the 291participants (115 men, mean age 74.3 ± 7.2 y; 176 women,mean age 76.7± 7.3 y) 32% were free of RF, 34% reported 1out of 10 RF. Four % of the participants had ≥ 4 RF (high riskof malnutrition), prevalence being dependent on age (65-74 y: 1%,75-84 y: 5%; ≥  85 y: 11%). Living alone (36%), chewingproblems (29%) and life event (22%) were the dominant RF, beinghomebound (1%). no daily cooked meal (2%) and poor appetite (3%)were reported only occasionally. Six % of all subjects had a BMI< 22 kg/m2 (65-74 y: 4%; 75-84 y; 6%, ≥ 85 y:11%). Only one person had a BMI < 20 kg/m2. There wasno association between nutritional status and the risk ofmalnutrition.

In summary,prevalence of malnutrition and the risk of malnutrition were low inthis group of healthy elderly. Only in old elderly a high risk ofmalnutrition was observed. Physical functions as well as livingconditions allow sufficient nutritional intake in the youngerelderly.

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