Bibliography of journal

AGING

Adequacy And Change Innutrient And Food Intakes With Aging In A Seven-Year Cohort Studyin Elderly Women

K.Zhu,A. Devine,A.Suleska,C.Y.Tan, C.Z.J.Toh, D. Kerr, R.L. Price

ABSTRACT

Objective:As women age total dietary intake falls which may increasethe risk of dietary deficiencies in some individuals. The aims of thisstudy were to investigate the changes in nutrient and dietary intakesthat occurred with aging in a seven-year longitudinal study of elderlyAustralian women and to evaluate the adequacy of their dietaryintakes.

Design:Longitudinal population based study on health withageing.Participants and setting:911free-livingelderly women aged 70-85years atbase line from a cohortof 1500 elderlywomen.Measurements:Atbaseline, 60 and 84 months, self-reported FoodFrequency Questionnaires (FFQ) and demographics were collected andanthropometry measured.

Results:During the 84 months ubjects lost height(1.8 cm) and bodyweight (1.9 kg). Intakes of energy and macronutrients carbohydrate,fat and protein declined significantly over the 84 months. Mean energyderived from saturated fat was above, whereas energy derived fromcarbohydrate was below, recommended levels of intake at all timepoints. Intakes of vitamins and minerals all declined with age andsubjects had sub optimal intakes of folate, vitamin E and calcium atall time points. The serve sizes for potato andmeat and theconsumption of milk, bread and variety of vegetables declinedsignificantly over time reflecting changes in nutrient intake.

Conclusions:Ageing is associated with reduced food intake resulting ininadequate intakes in energy, and some nutrients. Nutrition policy forelderly women should include advice to maintain or increase intakes ofcarbohydrate, milk, vegetables and fruit whilst continuing to reducefat intake.

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Key words: Nutrient intakes, Aging, Elderly women, Free-living, Longitudinal study.

The Journal of Nutrition, Health & Aging V olume 14, Number 9, 2010

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ALZHEIMER DISEASE

Nutritional And Psycho-Functional Status In Elderly Patients With Alzheimer's Disease

B. Saragat, R. Buffa, E. Mereu, V. Succa, S. Cabras, R.M. Mereu, D. Viale,P.F. Putzu, E. Marini

ABSTRACT

Objectives: Analysis of variations of nutritional status in relationto psycho-functional conditions in elderly patients with mild tomoderate Alzheimer’s disease (AD) by means of bioelectrical impedancevector analysis (BIVA).

Design: Cross-sectional study. Setting: Alzheimer Center, SS. TrinitàHospital, Cagliari (Italy). Participants: 83 free-living patients (29men, 54 women) with mild-moderate Alzheimer’s disease, aged 66 to 96years, and 91 age-matched controls (37 men and 54 women).Measurements:Nutritional status was evaluated by anthropometry (weight, height,waist and upper arm circumferences, triceps skinfold; body mass index,BMI; arm muscle area, AMA); Mini Nutritional Assessment, MNA®;bioelectrical impedance vector analysis, BIVA. Psycho-functionalstatus was assessed by the Mini Mental State Examination (MMSE),

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http://www.springer.com/medicine/family?SGWID=0-40055-0-0-0

http://www.springer.com/medicine?SGWID=0-10054-0-0-0

http://www.springer.com/?SGWID=0-102-0-0-0

Geriatric Depression Scale (GDS), Activities of Daily Living (ADL),and Instrumental Activities of Daily Living (IADL).

Results:Compared to the control groups, patients with Alzheimer’sdisease had a worse psycho-functional and nutritional status. BIVAdetected lower body cell mass in Alzheimer’s patients with respect tocontrols (men: T2= 23.4;women: T2=27.3; p<0.01), as well as in thefemale patients with lower levels of IADL and MMSE (respectively,T2=8.0; T2=7.4; p<0.05). In patients with AD, a worse psycho-functionalstatus was associated with obesity.

Conclusion: The psycho-functional decline of patients with AD isrelated to body composition variations, with a relative increase offat mass with respect to the muscle component. The BIVA techniquedistinguished patients from controls and patients with differentlevels of cognitive decline. Therefore, it is a suitable tool for thescreening and monitoring of nutritional status in Alzheimer’s disease.

Key words: Mini nutritional assessment, Bioelectrical impedance vectoranalysis, Anthropometry.

The Journal of Nutrition, Health & Aging Volume 16, Number 3, 2012


BODY COMPOSITION

Cognitive function is associated with body composition and nutritionalrisk of geriatric Patients

R. Wirth, C. Smoliner, C.C. Sieber, D. Volkert

ABSTRACT

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Background: most patients with dementia lose body weight over thecourse of the disease. Yet it is not known whether this weight loss ispredominantly in the form of fat-free mass (FFm) or fat mass (Fm), thelatter of which one would expect if the weight loss were caused simplyby a chronic decrease of energy intake.Objectives: to determine bodycomposition and nutritional risk in geriatric patients and theirassociation with cognitive function. Design: A retrospective, cross-sectional single-center database analysis.

Methods: We analyzed 4,095 consecutive geriatric hospital patients forbody composition, nutritional risk, need of care and cognitivefunction using bioelectric impedance analysis, nRS 2002, barthel indexand mini mental State examination.

Results: Subjects with cognitive dysfunction showed significant lowerbody weight, body mass index (bmi), Fm, fat mass index, FFm and fat-free mass index and a higher nRS score compared to cognitively intactsubjects. mean body weight decreased 10.2%, mean Fm decreased 21.1%,mean FFm decreased 5.9% and mean nRS 2002 score increased from 2.1 to3.0 points with increasing cognitive deterioration. A multivariateanalysis revealed that cognitive dysfunction, age and female genderwere all significant risk factors for a low body mass index and a lowfat mass index. Age, male gender and need of care, but not cognitivedysfunction, were risk factors for a low fat-free mass index.

Conclusion: ementia patients seem to lose predominantly fat mass withweight loss. Female dementia patients are at a higher nutritional riskthan male patients, presumably as a result of their different socialsituation in old age. that is why the nutritional state of femalepatients with dementia requires special attention.

key words: Bioelectric impedance, Body composition, Cognitive function, Dementia, Malnutrition.

the Journal of Nutrition, health & Aging volume 15, Number 8, 2011


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BODY MASS INDEX

Estimated Height From Knee-Height In Caucasian Elderly: Implications On Nutritional Status By Mini Nutritional Assessment

E. Cereda, S. Bertoli, A. Vanotti, A. Battezzati

ABSTRACT

Objectives: To investigate if the use of estimeted height (EH) by currently available prediction formulas might affect the screening andoutcome prediction attitudes of both the Mini Nutritional Assessment (MNA) and its short-form version (MNA-SF).

Design: A 6-month observational study. Setting: Two long-term C0ares of the province of Como. Participants: 266 resident elderly (102 men, 164 women; mean age±SD: 80.4±8.6 years). Measurements: Subjects were studied by anthropometry (weight, standing height, knee-height, arm and calf circumferences, triceps skinfold) and biochemistry (albumin and prealbumin). Nutritional status was assessed using both MNA and MNA-SF. At 6 months, major outcome were: death, infections and bedsores.

Results: In overall population, prediction formulas significantly underestimated real height. The bias by Italian-specific equation was higher than that by nationally-representative formulas for white Americans. The use of Ehs produced significant differences in body mass index (BMI) but these did not affect nutritional status scoring by MNA and MNA-SF (r≥0.99, p<0.0001). Cohen’s kappa statistic also showed an almost perfect concordance ( >0.9). Moreover, similar degrees of correlation were found between nutritional parameters and both MNA and

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MNA-SF scores by BMI from SH and EHs. After 6 months, major complications occurred in twenty-eight patients (11.6%). The use EHs did not affect the distribution of events among MNA and MNA-SF nutritional classes.

Conclusion: In Italian elderly, height prediction by nationally representative equations for white Americans should be preferred to that by ethnic-specifc formula. However, the use of both models does not seem to affect nutritional screening and outcome prediction by MNAand MNA-SF.

Key words: Estimated height, Body mass index (BMI), Mini Nutritional Assessment (MNA), Nutritional status, Outcome.



BEVERAGES

School Nutritional Capacity, Resources And Practices Are Associated With Availability Of Food

Beverage Items In Schools

Louise C Mâsse, Judith E de Niet

Background:The school food environment is important to target as lesshealthful food and beverages are widely available at schools. Thisstudy examined whether the availability of specific food/beverageitems was associated with a number of school environmental factors.

Methods:Principals from elementary (n = 369) and middle/high schools(n = 118) in British Columbia (BC), Canada completed a surveymeasuring characteristics of the school environment. Our measurementframework integrated constructs from the Theories of OrganizationalChange and elements from Stillman’s Tobacco Policy Framework adapted

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for obesity prevention. Our measurement framework included assessmentof policy institutionalization of nutritional guidelines at thedistrict and school levels, climate, nutritional capacity andresources (nutritional resources and participation in nutritionalprograms), nutritional practices, and school community support forenacting stricter nutritional guidelines. We used hierarchical mixed-effects logistic regression analyses to examine associations with theavailability of fruit, vegetables, pizza/hamburgers/hot dogs,chocolate candy, sugar-sweetened beverages, and french fried potatoes.

Results:In elementary schools, fruit and vegetable availability wasmore likely among schools that have more nutritional resources (OR =6.74 and 5.23, respectively). In addition, fruit availability inelementary schools was highest in schools that participated in the BCSchool Fruit and Vegetable Nutritional Program and the BC Milk program(OR = 4.54 and OR = 3.05, respectively). In middle/high schools,having more nutritional resources was associated with vegetableavailability only (OR = 5.78). Finally, middle/high schools that havehealthier nutritional practices (i.e., which align with upcomingprovincial/state guidelines) were less likely to have the followingfood/beverage items available at school: chocolate candy (OR = .80)and sugar-sweetened beverages (OR = .76).

Conclusions:School nutritional capacity, resources, and practices wereassociated with the availability of specific food/beverage items in BCpublic schools. Policies targeting the school environment areincreasingly being considered as one of the strategies used to addresschildhood obesity, as a result it is important to further understandthe factors associated with the availability of specific food/beverageitems at school.

Keywords: Nutrition, School environment, Organizational support, School policy, Availability of food, Availability of sweetened beverages, Fruit, Vegetables, Junk food, Less healthful food

Mâsse and de Niet International Journal of Behavioral Nutrition and Physical Activity Page 2 of 12

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http://www.ijbnpa.org/content/10/1/26

CALORIE TEST

Looking At The Label And Beyond: The Effects Of Calorie Labels, HealthConsciousness, And

Demographics On Caloric Intake In Restaurants

Brenna Ellison, Jayson L Lusk, David Davis

ABSTRACT

Background:Recent legislation has required calorie labels onrestaurant menus as a means of improvingAmericans’ health. Despite thegrowing research in this area, no consensus has been reached on theeffectiveness of menu labels. This suggests the possibility ofheterogeneity in responses to caloric labels across people withdifferent attitudes and demographics. The purpose of this study was toexplore the potential relationships between caloric intake and diners’socio-economic characteristics and attitudes in a restaurant fieldexperiment that systematically varied the caloric information printedon the menus.

Methods:We conducted a field experiment in a full service restaurantwhere patrons were randomly assigned toone of three menu treatmentswhich varied the amount of caloric information printed on the menus(none, numeric, or symbolic calorie label). At the conclusion of theirmeals, diners were asked to complete a brief survey regarding theirsocio-economic characteristics, attitudes, and meal selections. Usingregression analysis, we estimated the number of entrée and extracalories ordered by diners as a function of demographic andattitudinal variables. Additionally, irrespective of the menutreatment to which a subject was assigned, our study identified whichtypes of people are likely to be low-, medium-, and high-caloriediners.

Results:Results showed that calorie labels have the greatest impact onthose who are least health conscious. Additionally, using a symboliccalorie label can further reduce the caloric intake of even the most

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health conscious patrons. Finally, calorie labels were more likely toinfluence the selection of the main entrée as opposed to supplementalitems such as drinks and desserts.

Conclusions:If numeric calorie labels are implemented (as currentlyproposed), they are most likely to influence consumers who are lesshealth conscious–probably one of the key targets of this legislation.Unfortunately,numeric labels did little for those consumers who werealready more knowledgeable about health and nutrition. To reach abroader group of diners, a symbolic calorie label may be preferred asit reduced caloric intake across all levels of health consciousness.

Keywords: Numeric vs. Symbolic calorie labeling, Health consciousness,Full service restaurant

Ellisonet al. International Journal of Behavioral Nutrition and Physical Activity 2013,10:21


CARDIOVASCULAR DISEASE

How Is The Risk Of Under Nutrition Associated With Cardiovascular Disease Among Individuals Of Advanced Age?

R. Teh, C.Wham,N. Kerse,E. Robinson, R.N.Doughty

ABSTRACT

Background:The oldest old(85+) arethe fastestgrowing population segment in New Zealand. Cardiovascular disease (CVD)is themain cause of death and is associated with various risk factors including risk ofunder nutrition.Objectives:Todetermine if there is an association between CVD and nutrition risk in advanced age.

Setting:Three North Island locations (rural and urban areas)in New Zealand. Participants:108 participants aged85 years(75-79 for Maori). M easurem ents:Comprehensive health assessments were undertaken. Clinically manifest CVD waspre-defined and as certained from

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interviews and hospitalisation records. Nutrition risk was assessed using a validated questionnaire–Seniors in theCommunity: Risk evaluationfor eatingandnutrition, Version II (SCREEN II).

Results:72participants (67%) had CVD(49% men); 52% ofparticipantshadaSCREEN IIscore <50. Those with CVD had lower HDL level [median(IQR)] [1.4(0.7) vs. 1.6(0.6)] (p=0.041), and higher waist circumference[97.5(19.1) vs. 89.3(20.6)] (p=0.043) Compared to those without CVD.Those with CVD were at no greater nutrition risk than thosewithout CVD (SCREENII score: [49(7) vs.51(10)] (p=0.365). Using logistic regression controlling for confounders, SCREENII scorestrended towards an inverse association withCVD (p=0.10).

Conclusion:Two thirds of the study participants had CVDandhalf were atrisk of undernutrition. Nutrition riskwas mildly associated with CVD.This study provides further evidence that those in advanced age are at risk of under nutrition. Further research isneeded to establishhow the causes and consequences of CVD are related to nutrition risk.

Keywords: Cardiovascular disease, Nutrition risk, Aged

The Journal of Nutrition, Health & A ging Volume 14, Number 9, 2010


DENTURES

Association Of Dental Prosthetic Condition With Food Consumption And The Risk Of Malnutrition And Follow-Up 4-Year Mortality Risk In Elderly Taiwanese

A.C. Tsai,T.L. Chang

ABSTRACT10



Objective:To determine the impact of dental prosthetic condition onfood consumption, risk of malnutrition and follow-up 4-year mortalityrisk in elderly Taiwanese.

Design and setting:Analyzing the data sets of the 1999 and 2003“Survey of Health and Living Status of the Elderly in Taiwan”, alongitudinal cohort study. Participants: Anational probabilitysampleof2766 men and women 65 years of age or older.

Measurements:Self-reported intake frequencies of major foodcategories, masticatory ability, food consumption, and the risk ofmalnutrition assessed with the Mini Nutritional Assessment (short-form) stratified by dental prosthetic condition. Cox regression wasused to compare follow-up mortality risk.

Results:Non-denture wearers and removable-denture wearers had poorermasticatory ability and greater nutritional risk and consumed fruitsand vegetableless often comparedto fixed-denture wearers. Removable-denture wearers also had lower self-perceived nutritional status andBMI compared to fixed-denture wearers. Survival analysis showedthatnon-denture wearer sand removable-denture wearers hadlower follow-up4-year survival.Coxregression analysis showed that removable-denturewearers had increased follow-up 4-year mortality risk compared tofixed-denture wearers adjusted forsociodemographic, lifestyle andhealth-related factors.

Conclusions:Based on data of a national sample of a longitudinalcohort study, dental prosthetic condition is a significant factor ofnutritional healthin the elderly. It can affect food pattern andtherisk of malnutrition and mortality of elderly persons. Dental careshould be an important part of geriatric health promotion program andfixed-denture is a preferred choice over removable-denture.

Key words: Denture, Removable-denture, Fixed-denture, Nutrient intake,Nutritional status.



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DIETARY FATS

Caregiver´S Education Level, Not Income, As Determining Factor Of Dietary Intake And Nutritional Status Of Individuals Cared For At Home

B. Correa, V.A. Leandro,Merhi K,Pagotto Fogaca, M.R. Marques De Oliveira

ABSTRACT

Introduction: Home care should intervene in the nutritional status ofthe elderly.Objective: To analyze the nutritional status of theelderly assisted by a Home Care Program (PAD) and associate it withincome and education level of the caregiver.

Casuistic and Method: Thirty-four individuals of both genders whoreceived home care from PAD. The MNA (Mini Nutritional Assessment) wasused along with arm circumference. Dietary intake assessment was donewith three 24-hour recalls in non-consecutive days. We collected dataon income, education level of the caregiver and user in years offormal education and autonomy of user. The differences between theproportions of the nominal variables were tested by the chi-squaretest. The continuous variables were tested for normality and ifnormal, the Student’s t-test or ANOVA was applied. The adoptedsignificancelevel was P < 0.05.

Results: The studied sample represented individuals older than 65years, assisted by PAD and 100% dependent on the caregiver. MNArevealed that 38.2% of the users were malnourished and 61.8% were atrisk for malnourishment. Energy, fiber, vitamin E, calcium and zincintakes were inadequate. Education level of the caregivers was a

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determining factor (P=0.01) for the nutritional status of the elderlywhile no association was found with respect to income.

Conclusion: These findings allows us to conclude that the nutritionalstatus of this population is worrisome and that it may be associatedwith low quality of life influenced by the education level of thecaregiver, but also by age, economic conditions and limited autonomyof this population.

Key words: Nutritional status, Dietary intake, Education level, Caregiver, Home care.



DEMENTIA

Health And Nutrition Promotion Program For Patients With Dementia (Nutrialz): Cluster Randomized Trial

A. Salva, S. Andrieu, E. Fernandez, E.J. Schiffrin, J. Moulin, B. Decarli, X. Rojano I Luque, Y. Guigoz,B.Vellas, The Nutrialz Group

ABSTRACT

Objective: To assess the effectiveness of health and nutrition program(NutriAlz) versus usual care on functional level in elderly peoplewith dementia living at home, as well as on clinical practice relatedto nutrition and on the caregiver’s burden.

Design: Cluster randomized multi-centre study with one-year follow-up.Setting: 11 Alzheimer outpatients and day care centres (Barcelona,

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Spain). Participants: Nine hundred and forty six home-living Alzheimerpatients with identified caregiver were consecutively recruited(intervention group: 6 centres, 448 patients vs control group: 5centres, 498 patients). Intervention: The intervention was a teachingand training intervention on health and nutrition program, Nutrialz,directed both to physician and main caregiver, as well as personsaffected by Alzheimer's disease or other dementias, including astandardised protocol for feeding and nutrition. Main OutcomeMeasures: The main outcome measure was the reduction in the loss ofautonomy (Activities of daily living (ADL/IADL) scales) assessed at 6and 12 months. Secondary outcomes measures were Improvement innutritional status (Mini Nutritional Assessment (MNA), BMI, and weightchanges), and caregiver burden (Zarit scale).

Results: The one-year assessment was completed for 293 patients(65.4%) in the intervention group and 363 patients (72.9%) in thecontrol group (usual care). The annual rate of ADL change was -0.83 vs-0.62 (p=0.984), and the caregiver’s subjective burden 0.59 vs 2.36(p=0.681) in intervention and control group, respectively. MNA,however, showed an improvement (+0.46 vs -0.66, p=0.028), suggestingan effective nutritional behaviour. Conclusion: The Nutrialz programhad no effect on functional decline in Alzheimer disease patientsliving at home over one year, but reduced the risk for malnutrition,as recommendations concerning diet and exercise were provided.

Key words: Alzheimer disease, Dementia, Nutritional program.



Nutrition And Vascular Dementia

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L. Perez, L. Heim, A. Sherzai, K. Jaceldo Siegl,Loma Linda University.corr

ABSTRACT

Objective: The objective of this review was to elucidate the relationship between Vad and various nutritional factors based on epidemiological studies. Background: Vascular dementia (Vad) is the second most common type of dementia. The prevalence of Vad continues to increase as the US population continues to grow and age. currently,control of potential risk factors is believed to be the most effectivemeans of preventing Vad. Thus, identification of modifiable risk factors for Vad is crucial for development of effective treatment modalities. Nutrition is one of the main modifiable variables that mayinfluence the development of Vad.

Methods: a systematic review of literature was conducted using the Pubmed, Web of Science, and ciNaHL Plus databases with search parameters inclusive of vascular dementia, nutrition, and vascular cognitive impairment (Vci).

Results: Fourteen articles were found that proposed a potential role of specific nutritional components in Vad. These components included antioxidants, lipids, homocysteine, folate, vitamin B12, and fish consumption. antioxidants, specifically Vitamin e and c, and fatty fish intake were found to be protective against Vad risk. Fried fish, elevated homocysteine, and lower levels of folate and vitamin B12 wereassociated with increased Vad. evidence for dietary lipids was inconsistent, although elevated midlife serum cholesterol may increaserisk, while late-life elevated serum cholesterol may be associated with decreased risk of Vad.

Conclusion: currently, the most convincing evidence as to the relationship between Vad and nutrition exists for micronutrients, particularly Vitamin e and c. exploration of nutrition at the macronutrient level and additional long term prospective cohort studies are warranted to better understand the role of nutrition in Vad disease development and progression. at present, challenges in this research include limitations in sample size, which was commonly cited. also, a variety of diagnostic criteria for Vad were employed inthe studies reviewed, indicating the need for constructing a correct nosological definition of Vad for consistency and conformity in futurestudies and accurate clinical diagnosis of Vad.

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Key words: Vascular dementia, Nutrition, Diet.



DEPRESSION

Depression, Nutritional Risk And Eating Behaviour In Older Caregivers

S.J. Torres, M. Mccabe, C.A. Nowson

ABSTRACT

Objective:This study investigated the relationship between depression,nutritional risk and dietary intake in a population of oldercaregivers.

Design:Mailed questionnaire with sub group participating in a home-based interview.Participants and setting: Seventy-six communitydwelling caregivers aged 50 y or over from Victoria,Australia.Measurements:Questionnaires provided information on weight,height, hours of care, depressive symptoms, nutritional risk andappetite. The home-based interview assessed dietary intake andshopping, cooking and meal consumption habits.

Results:The sample had a mean±SD age of 70.3±12.8 y, BMI of 27.2±4.8kg/m2 and the time spent caring was 101.8±68.1 h/wk. Overall, 32% ofcaregivers had depressive symptoms, 21% were at risk of malnutritionand 21% reported their appetite was fair/bad/very bad. Caregivers withdepressive symptoms (32%) compared to those with no depressivesymptoms (53%) had a poorer appetite (p<0.05). Of the 20 caregiverswho participated in the home interview, 25% reported they ate theirmeals alone.

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Conclusion:A significant proportion of community dwelling oldercaregivers had depressive symptoms, were at risk of malnutrition andhad poor appetites, although the majority were overweight or obese.

Key words: Caregiver, Depression, Nutrition, Dietary intake.



EATING

The Number And Type Of Food Retailers Surrounding Schools And Their Association With Lunchtime

Eating Behaviours In Students

Laura Seliske, William Pickett, Andrei Rosu,Ian Janssen

ABSTRACT

Background:The primary study objective was to examine whether thepresence of food retailers surrounding schools was associated withstudents’ lunchtime eating behaviours. The secondary objective was todetermine whether measures of the food retail environment around

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schools captured using road network or circular buffers were morestrongly related to eating behaviours while at school.

Methods:Grade 9 and 10 students (N=6,971) who participated in the2009/10 Canadian Health Behaviour in School Aged Children Survey wereincluded in this study. The outcome was determined by students’ self-reports of where they typically ate their lunch during school days.Circular and road network-based buffers were created for a 1 kmdistance surrounding 158 schools participating in the HBSC. Theaddresses of fast food restaurants, convenience stores andcoffee/donut shops were mapped within the buffers. Multilevel logisticregression was used to determine whether there was a relationshipbetween the presence of food retailers near schools and studentsregularly eating their lunch at a fast food restaurant, snack-bar orcafé. The Akaike Information Criteria (AIC) value, a measure ofgoodness-of-fit, was used to determine the optimal buffer type.

Results:For the 1 km circular buffers, students with 1–2 (OR= 1.10,95% CI: 0.57-2.11), 3–4 (OR=1.45, 95% CI: 0.75-2.82) and≥5 nearby foodretailers (OR=2.94, 95% CI: 1.71-5.09) were more likely to eat lunchat a food retailer compared to students with no nearby food retailers.The relationships were slightly stronger when assessed via 1 km roadnetwork buffers, with a greater likelihood of eating at a foodretailer for 1–2 (OR=1.20, 95% CI:0.74-1.95), 3–4 (OR=3.19, 95% CI:1.66-6.13) and≥5 nearby food retailers (OR=3.54, 95% CI: 2.08-6.02).Road network buffers appeared to provide a better measure of the foodretail environment, as indicated by a lower AIC value (3332 vs. 3346).

Conclusions:There was a strong relationship between the presence offood retailers near schools and students’ lunchtime eating behaviours.Results from the goodness of fit analysis suggests that road networkbuffers provide a more optimal measure of school neighbourhood foodenvironments relative to circular buffers.

Keywords: Eating behaviours, Youth, Food retail environment, Schools

Seliskeet al. International Journal of Behavioral Nutrition andPhysical Activity2013,10:19 Page 3 of 9

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ELDERLY

Ankle- Brachial Pressure Index And Mini Nutritional Assessment In Community Dwelling Elderly People

B.A. Muzembo, Y. Nagano, N. Dumavibhat, N.R. Ngatu, T. Matsui, S.A. Bhatti, M. Eitoku, R. Hirota, K. Ishida, N. Suganuma

ABSTRACT

Background: A low ankle-brachial pressure index (an ABPI value <0.90)is considered predictive ofcardiovascular disease, and is widelythought to increase morbidity and mortality in the elderly. However,good nutrition is beneficial both for the health and the ability toresist and recover from the disease.

Objective:The aim of the present study was to evaluate therelationship between the ankle-brachial pressure index and thenutritional status of the elderly in a city of Kochi prefecture,Japan. Methods:This was a cross-sectional study in which a total of100 elderly people, both males and females, were screened for ankle-brachial pressure index (ABPI), nutritional status (through the use ofthe short form of the mini nutritional assessment), activities ofdaily living, lifestyle, gait speed (10MWT), postural stability(OLST), and functional mobility (TUg).

Results:About 67% of the participants were found to have a normalnutritional status, 27% were at risk of malnutrition, and six percentwere classified as malnourished. The mean ABPI of the participants was1.08±0.10, and three participants had an ABPI lower than 0.90. TheABPI was statistically higher in well nourished participants comparedwith those at risk of malnutrition or the malnourished. The mean ABPIwas significantly higher in non-smokers compared with former smokers.The ABPI was found to correlate negatively with gait speed and withTUg score.

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Conclusion: Well-nourished elderly had a higher normal ankle-brachialpressure index as compared with the malnourished elderly. This studyprovides supportive evidence for the necessity of adequate nutritionfor elderly people.

key words: ABPI, MNA, Functional mobility, Elderly.



Anthropometricparameters Of Nutritional Assessment As Predictive Factors Of The Mini Nutritional Assessment (Mna)Of Hospitalized Elderly Patients

V.A. Leandro Merhi,J.L. Braga De Aquino

ABSTRACT

Objective:The objective of this study was to identify nutritionalindicators that predict MNA (mini nutritional assessment)classification in hospitalized elderly patients.

Method:This cross-sectional study assessed the nutritional status of109 elderly patients at the beginning of their hospitalstay withAnthropometri candlaboratory indicators and the MNA. Habitual energyintake(HEI) was also determined.The assessed nutritional indicatorswere investigated by univariate and multivariate logistic regressionanalysis to verify if they can predict MNA classification. The oddsratio(OR) and its respective confidence interval(CI) of 95% were alsocalculated, and the significance level was set at 5% (p<0.05).

Results:The nutritional status ofmost patients (61.47%) wasappropriatebut 30.28%were at risk of malnourishment and 8.26% were

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malnourished. Statistical differences were found forthoseaged morethan 70 years and for arm circumference,body mass index, calfcircumference, triceps skinfold thickness and mid-arm musclecircumference. Initially, the predictive factors identified byunivariate logistic regression were body mass index(BMI) (p=0.0001;OR=0.825), calf circumference(CC) (p=0.0026; OR=0.832), armcircumference (AC)(p<0.0001;OR=0.787), triceps skinfold thickness(TST)(p=0.0014;OR=0.920) and mid-arm muscle circumference (MAMC)(p=0.0003;OR=0.975); later, multiple logistic regression analysesrevealed that first AC (p=0.0025; OR=0.731(0.597 –0.895)), then BMI(p=<0.0001; OR=10.909(3.298–36.085)) and finally TST(p=0.0040;OR=0.924(0.876 –0.975))and MAMC(p=0.0010; OR=0.976(0.962 –0.990))were factors that predict MNA classification.

Conclusion:In the conditions of this study, first AC,then BMI andfinally TST and MAMC together were capable of predicting MNAclassification.

Key words: Elderly, Mini nutritional assessment, Nutritional indicators, Predictive factors.



ENERGY INTAKE

Effects Of Nutritional Intervention And Physical Training On Energy Intake, Resting Metabolic Rate And Body Composition In Frail Elderly A Randomised,Controlled Pilot Study

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E. Lammes, E. Rydwik, G. Akner

ABSTRACT

Objectives: To analyse the effect of nutritional intervention andphysical training on energy intake,resting metabolic rate (RmR) andbody composition in the frail elderly. Design: Open, randomised,controlled pilot treatment study. Setting: Community-based researchcentre. Participants: ninety-six community-dwelling frail elderlypeople aged 75 and older, 40% men. Intervention: Four treatment arms:i) individual nutritional advice and group sessions on nutrition forthe elderly, ii) physical training 2 x 45 minutes per week for 3months,iii) combined nutritional and physical intervention and iv)control group.

Measurements: The outcomes were energy intake (4-day food diary);resting metabolic rate (indirect calorimetry) and bodycomposition(anthropometry) performed at baseline, after 3 months’intervention (completed by 79 individuals), and as a follow-up at 9months (completed by 64 individuals). Results: The training groupshowed a significantly increased RmR at 3 months. Otherwise, therewere no observed differences within or between the four groups. Therewas no correlation over time between energy intake, RmR and fat freemass. The participants with a low energy intake who managed toincrease their energy intake during the study (‘responders’) had astatistically significantly lower Bmi (21 vs. 24) and a lower fatpercentage (23 vs. 30) at baseline than the ‘non-responders.’ The‘non-responders’ showed a small but statistically significant decreasein body fat percentage at F1, and in body weight, Bmi and FFm at 9months (F3).

Conclusion: individual nutrition counselling and physical exercisehadno effect on energy intake, RmR or fat free mass in community-dwellingfrail elderly people aged 75 andolder. interventions in frail elderlypeople should be targeted according to the needs of the individualpatients. The issues of randomisation, targeting and responders in areproblematised and discussed.

22

Key words: Energy intake, Frail elderly, Resting metabolic rate, Body composition, Physical training.



EXERCISE

Nutrition Coupled With High-Load Or Low-Loadblood Flow Restricted Exercise During Human LimbSuspension

Kyle J Hackney, Meghan E Everett, Lori L Ploutz Snyder

ABSTRACT

Background:High-load resistance exercise (HRE) and low-load blood flowrestricted (BFR) exercise have demonstrated effi-cacy for attenuatingunloading related muscle atrophy and dysfunction. Protein consumptionimmediately before and/or after exercise has been shown to increasethe skeletal muscle anabolic response to resistance train-ing. Thepurpose of this study was to compare the ske-letal muscle adaptationswhen chocolate milk intake was coupled with HRE or low-load BFRexercise during simulated lower limb weightlessness.

Methods:Eleven subjects were counterbalanced to HRE (31 ± 14 yr, 170 ±13 cm, 71 ± 18 kg) or low-load BFR exercise (31 ± 12 yr, 169 ± 13 cm,66 ± 14 kg) during 30 days of unilateral lower limb suspension (ULLS);a ground based space flight analog. Both HRE and BFR completed 3 setsof supine, single leg press and calf raise exercise during ULLS. BFRexercise intensity was 20% of repetition maxi-mum (1RM) with a cuffinflation pressure of 1.3 × systo-lic blood pressure (143 ± 4 mmHg).Cuff pressure was maintained during all 3 sets including restintervals (90s). HRE intensity was 75% 1RM and was performed withoutcuff inflation. Immediately (<10 min) before and after exercise 8 fl

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oz of chocolate milk (150 kcal, 2.5g total fat, 22g CHO, 8g protein)was consumed to optimize acute exercise responses in favor of muscleanabolism. Muscle cross-sectional area (CSA), 1RM strength, andmuscular endurance were determined pre and post-ULLS. Data wereanalyzed with condition x time (between-within) ANOVA with repeatedmeasures using alpha of 0.05.

Results:Unloaded limb work performed during leg press (1514 ±334 vs.576 ± 103) and calf raise (2886 ± 508 vs. 1233 ±153) sessions wasgreater in HRE vs. BFR, respectively. Leg press training loads were 44± 7 kg in HRE compared significantly different vs. pre;†significantlydifferent vs. HRE; p < 0.05. Mean ± SE, KE= Knee Extensors,Preproduction in any medium, provided the original work is properlycited.to 11 ± 1 kg in BFR. Similarly, calf raise training loads were81 ± 11 kg in HRE and 16 ± 1 kg in BFR. Pre to post-ULLS trainingadaptations in the unloaded leg are shown in the table below.

Conclusions:When HRE is optimized for muscle anabolism duringunloading muscle size and strength are preserved (or enhanced) at theexpense of muscle endurance. In con-trast, when BFR exercise isoptimized for muscle anabo-lism during unloading muscle endurance ispreserved (or enhanced) at the expense of muscle size and strength.

Keyword : Exercise,Low blood, Human limb, Suspesion

Hackneyet al. Journal of the International Society of Sports Nutrition2012,9(Suppl 1):P8http://www.jissn.com/content/9/S1/P8Self-Reported Nutritional Supplement Usage Among Professional Mixed Martial Artists–

Preliminary Findings

Paul La Bounty, Elfego Galvan, Jeremy Reid, Bill I Campbell, Jeremy McElroy, Eva Doyle, Tony Boucher

ABSTRACT

Background: Although mixed martial arts (MMA) has been around fordecades in other countries such as Brazil, it is still a relatively

24

new sport for most of the world. Research on com-bative sport athleteshas focused primarily on the various individual sports that composeMMA such as judo, boxing, and wrestling. To date, there is limitedpeer-reviewed research investigating professional mixed martialartists. More specifically, there is very limited informationregarding the dietary supplement habits of current professional mixedmartial arts fighters. Thus, the purpose of this study was toinvestigate various dietary habits, beliefs, and nutri-tionalsupplement usage, in professional mixed martial artists.

Methods:Male professional mixed martial artists (18-50 y/o) in everyrecognized weight class (i.e., bantam weight,featherweight,lightweight, welterweight, middleweight, light-heavyweight, and heavy weight) were eligible to participate in this thisstudy. Participants were recruited from various mixed martial art gymsprimarily from, but not limited to, the states of Texas and Nevada.The investigators devel-oped a new questionnaire that addressedvarious aspects ofnutritional intake, sport supplement beliefs andusage, as well as weight cutting strategies. Once developed, the ques-tionnaire was reviewed by 2 registered dietitians who have expertisein exercise nutrition, 3 exercise physiologists (2 of which areCertified Strength and Conditioning Specialists), and a physicaltherapist. Before the questionnaire was administered, a copy of thequestionnaire was given to the participant so that they could visuallyread along as the questions were being asked to them by theinvestigators.The investigators verbally asked the participants theques-tions included in the questionnaire and wrote downtheirresponses. The data presented in this abstract focuses on sportsupplement usage and weight cutting in the 48 hours prior tocompetition. Averages and standard deviations were calculated onMicrosoft Excel.

Results:To date, 11 male professional mixed martial artists (29.9 ±3.6 y/o; range: 23-37 y/o) participated in this ongoing study. Onaverage, the participants have been competing professionally for 5.3 ±4.6 years (range: ~ 0.7–12 years) and have had 14.2 ± 15.9professional MMA fights (range:

25

2-42). Featherweight (~145 lbs), lightweight (~155 lbs), welterweight(~ 170 lbs), light heavyweight (~ 205 lbs) and heavyweight (> 205 lbs)weight classes were represented in this sample. Out of the 11participants who completed the questionnaire, 27.3% reported that theyregularly consume creatine at least five to six times per week. Beta-alanine was consumed by 36.4% of the participants at least two to fourtimes per week. Fish oil was consumed by 63.6% of the participants atleast two to four times per week, while one participant reportedconsuming fish oil less often than once per month. Additionally, 36.4%of the participants consumed a thermogenic supplement five to sixtimes per week. Furthermore, hydroxyl-methylbutyrate (HMB) was notconsumed by any of the respondents. Regarding weight cuttingpractices, the respondents lost an average of 12.73 ± 7.2 lbs. (range:0-22 lbs) during the forty-eight hours prior to competition.

Conclusions:The results of the study report common dietary supple-ments consumed by professional mixed martial artists. Current researchregarding the dietary habits of profes-sional mixed martial artists iscurrently lacking and thus more research is needed.

Keyword : Exercise,Nutritional supplements, Martial art

La Bountyet al. Journal of the International Society of Sports Nutrition2012,9(Suppl 1):P18

http://www.jissn.com/content/9/S1/P18

EYE DISEASE

Nutrition And Age-Related Eye Diseases: The Alienor(Antioxydants, Lipides Essentiels, Nutrition Et Maladies Oculaires) Study

C.Delcourt ,J.F.Korobelnik,P.Barberger Gateau, M.N. Delyfer ,M.B.Rougier,M. Le Goff, F. Malet, J. Colin, J.F.Dartigues

Background: Worldwide, degenerativeeye diseases (age-relatedmaculopathy(ARM), cataract, glaucoma) are themaincauses ofvisualimpairment and blindness, which contributeto disabilityin the

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elderly. Mainlythreetypes of nutritional factors are investigated fortheir potential protection against eye ageing: antioxidants; luteinand zeaxanthin (carotenoids which accumulate specificallyin the eye);omega 3 polyunsaturated fatty acids. Few epidemiological studieshavebeen conducted inthis field, particularlyin Europe.Objective:TheAlienor (Antioxydants, Lipides Essentiels, NutritionetmaladiesOculaiRes) Study aims at assessing the associations of eyediseases with nutritional factors, determinedfromplasma measurementsan destimation of dietary intakes.

Design, setting and participants: Subjects were recruited inBordeaux(France) fromthe ongoing population-based3Cstudy. In 2006-2008,963subjectsfrom the 3CStudy, aged73 years or more, had an eyeexamination and will have follow-up eye examinations every 2 years.Measurements:Vascular, genetic and nutritional factors were assessedat baseline (1999-2001) and follow-up examinations of the3CStudy. Eyediseases were classified according to international classifications.

Results:Nutritional status and vascular disease andrisk factors weresimilar between participants and non participants, except fora slightdifference in plasma triglycerides and HDL-cholesterol. Asexpected,the prevalence of eyediseases washigh: early and late ARM (28.4%and5.6%, respectively), open-angleglaucomaandtreated ocular hypertension(4.8%and 10.0 %, respectively),cataract extraction(45.2 %),retinopathy (8.4 %), retinal veinocclusion(1.1 %), epiretinalmembrane(3.9%),current use of artificial tears(17.3%).

Conclusions:This study confirms the high prevalence of eye diseasesinthe elderly. Its main strength is the combinationofnutritional,vascular and genetic information,collectedovera 7 year periodof timebefore the first eye examination.It may help design futureinterventional studies, which might be common with other age-relateddisorders, because of common nutritional factors.

Key words: Macular degeneration, Glaucoma, Nutrition, Antioxidants, Fatty acids, Epidemiology.


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FLAVORING AGENTS

Effect Of Flavor Enhancers On The Nutritional Status Of Older Persons

E.N. Bautista, C.C. Tanchoco, M.G. Tajan, E.V. J. Magtibay

ABSTRACT

Objectives:This study on flavor enhancers aims to: 1) compare foodintake of older persons, 2)determine changes in body weight, bloodpressure and serum sodium and 3) determine tolerance/intolerance totheflavor enhancers.

Design: The project is a cross-over, double blind study design.Setting: A nursing home for the aged, Golden Acres Institution locatedin Quezon City, Philippines. Participants:Sixty eligible subjects (31males and 29 females), aged 60 years and over. Intervention: Subjectswere initially given: pouch A (0.5gram monosodium glutamate) or pouchB (0.5gram iodized salt) for lunch and supper for 2 months. Theintervention was switched after one week wash period.

Measurements:Before the start and during intervention, 24 hour foodintake of subjects was recorded and anthropometric and clinical datawere measured. Tolerance/intolerance to the flavor enhancer and dataon the quality of life were evaluated using a pre-tested structuredquestionnaire. Paired t-test was used to determine significant changesamong each period of dietary intervention betweendifferent groups.

Results:Energy intake and almost all nutrients increased for males andfemales for both interventions. Body weight and body mass indexincreased significantly for both gender with MSG usage but not withiodized salt. The diastolic blood pressure of all subjects was normalwhile the systolic blood pressure remained at pre-hypertension levelbefore and after both interventions. The sodium serum was withinnormal levels for both groups for both interventions. It was alsoobserved that systolic blood pressure increased in both groups while

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sodium levels did not. It was further observed that both MSG andiodized salt interventions were well tolerated by majority of theparticipants.

Conclusion:The use of flavor enhancers have increased food intake andwere well- tolerated among older persons. No difference in bloodpressure and sodium serum was noted in both MSG and iodized saltintake. Recommendation:People with less appetite, especially amongolder persons can use flavor enhancers to improve their food intakeand body weight. Sodium containing flavor enhancers canbe part of ahealthy diet for older persons when used in moderation.

Key words: Flavor enhancer, Msg, Iodized salt, Older persons.



FOOD HABITS

Food And Macronutrient Intake Of Elite Ethiopian Distance Runners

Lukas Y Beis, Lena Willkomm, Ramzy Ross, Zeru Bekele, Bezabhe Wolde, Barry Fudge,Yannis P Pitsiladis

ABSTRACT

Background:Explanations for the phenomenal success of East Africandistance runners include unique dietary practices. The aim of thepresent study was to assess the food and macronutrient intake of eliteEthiopian distance runners during a period of high intensity exercisetraining at altitude and prior to major competition.

Methods:The dietary intake of 10 highly-trained Ethiopian longdistance runners, living and training at high altitude (approximately2400 m above sea level) was assessed during a 7 day period of intensetraining prior to competition using the standard weighed intakemethod. Training was also assessed using an activity/training diary.

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Results:Body mass was stable (i.e., was well maintained) over theassessment period (pre: 56.7 ± 4.3 kg vs. post: 56.6 ± 4.2 kg,P= 0.54;mean ± SD). The diet comprised of 13375 ± 1378 kJ and was high incarbohydrate (64.3 ± 2.6%, 545 ± 49 g, 9.7 ± 0.9 g/kg). Fat andprotein intake was 23.3 ± 2.1% (83 ± 14 g) and 12.4 ± 0.6% (99 ± 13 g,1.8 ± 0.2 g/kg), respectively. Fluid intake comprised mainly of water(1751 ± 583 mL), while no fluids were consumed before or duringtraining with only modest amounts being consumed following training.

Conclusions:Similar to previous studies in elite Kenyan distancerunners, the diet of these elite Ethiopian distance runners met mostrecommendations of endurance athletes for macronutrient intake but notfor fluid intake.

Beiset al. Journal of the International Society of Sports Nutrition2011,8:7

http://www.jissn.com/content/8/1/7

GAIT

Gait Speed At Usual Pace As A Predictor Of Adverse Outcomes In Community-Dwelling Older People

An International Academy On Nutrition And Aging (Iana) Task Force

G. Abellan Van Kan, Y. Rolland, S. Andrieu, J. Bauer, O. Beauchet,M. Bonnefoy, M. Cesari, L.M. Donini, S. Gillette Guyonnet, M. Inzitari,F.Nourhashemi, G. Onder, P. Ritz, A. Salva, M. Visser, B. Vellas

ABSTRACT

Introduction: The use of a simple, safe, and easy to performassessment tool, like gait speed, to evaluate vulnerability to adverseoutcomes in community-dwelling older people is appealing, but itspredictive capacity is still questioned. The present manuscriptsummarises the conclusions of an expert panel in the domain ofphysical performance measures and frailty in older people, who

30

reviewed and discussed the existing literature in a 2-day meeting heldin Toulouse, France on March 12-13, 2009. The aim of the IANA TaskForce was to state if, in the light of actual scientific evidence,gait speed assessed at usual pace had the capacity to identifycommunity-dwelling older people at risk of adverse outcomes, and ifgait speed could be used as a single-item tool instead of morecomprehensive but more time-consuming assessment instruments.

Methods:A systematic review of literature was performed prior to themeeting (Medline search and additional pearling of reference lists andkey-articles supplied by Task Force members). Manuscripts wereretained for the present revision only when a high level of evidencewas present following 4 pre-selected criteria: a) gait speed, at usualpace, had to bespecifically assessed as a single-item tool, b) gaitspeed should be measured over a short distance, c) at baseline,participants had to be autonomous, community-dwelling older people,and d) the evaluation of on set of adverse outcomes (i.e. disability,cognitive impairment, institutionalisation, falls, and/or mortality)had to be assessed longitudinally over time. Based on the priorcriteria, a final selection of 27 articles was used for the presentmanuscript.

Results:Gait speed at usual pace was found to be a consistent riskfactor for disability, cognitive impairment, institutionalisation,falls, and/or mortality. In predicting these adverse outcomes overtime, gait speed was at least as sensible as composite tools.

Conclusions:Although more specific surveys needs to be performed,there is sufficient evidence to state that gait speed identifiesautonomous community-dwelling older people at risk of adverse outcomesand can be used as a single-item assessment tool. The assessment atusual pace over 4 meters was the most often used method in literatureand might represent a quick, safe, inexpensive and highly reliableinstrument to be implemented.



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GERIATRICS

Dependence Of The Geriatric Depression Scores On Age,Nutritional Status, And Haematologic Variables In Elderly Institutionalized Patients

C.H. Alves De Rezende, L.M. Coelho, L.M. Oliveira, N. Penha Silva

ABSTRACT

Objective: To evaluate the relationships between depression and ageing, nutrition, and selected haematologic variables.

Measurements: Across-sectional study was performed in elderly institutionalized patients (n=100) of all nursing homes in the Brazilian city of Uberlândia, with determination of the Geriatric Depression Scale (GDS) and the Mini-Nutritional Assessment (MNA) scores, and selected haematologicvariables.

Results: GDS had a significant negative dependence with the MNA for the entire institutionalized population. The prevalence of depression was higher among females, but significant correlations existed betweenGDS scores and erythrocytes counts, haemoglobin levels, or haematocritvalues for the males only. However, aborderline correlation existed between GDS and the mean corpuscular volume (MCV) values in the females.

Conclusions: Depression was associated with worsening of nutritional status and the degree of anemia of the entire elderly population and the male, but not the female subjects. The borderline correlation observed between the GDS and MCV for the female subjects suggests thatthe nutritional deficiencies responsible for the MCV increase are a cause, and not an effect, of depression.

Key words: Depression, Geriatric depression scale, Nutritional status,Mini-nutritional assessment, Haematologic variables.



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GASTROTOMY

Long-Term Nasogastric Tube Feeding In Elderly Strokepatients – An Assessment Of Nutritional Adequacy And Attitudes To Gastrostomy Feeding In Asians

F. Zaherah Mohamed Shah, H.S. Suraiya, P.J.H. Poi, K.S. Tan, P.S.M. Lai, K. Rama Krishnan, S. Mahadeva

ABSTRACT

Background: Gastrostomy feeding is superior to long-term nasogastric (nG) feeding in patients with dysphagic stroke, but this practice remains uncommon in asia. We sought to examine the nutritional adequacy of patients on long term nG feeding and identify barriers to gastrostomy feeding in these patients.

Methodology: a prospective comparison of Subjective Global assessment (SGa), and anthropometry (mid-arm muscle circumference, MaMC; triceps skinfold thickness, TST) between elderly stroke patients on long-term nG feeding and matched controls was performed. Selected clinicians andcarers of patients were interviewed to assess their knowledge and attitudes to gastrostomy feeding.

Results: 140 patients (70 nG, 70 oral) were recruited between September 2010 and February 2011. nutritional status was poorer in thenG compared to the oral group (SGa grade C 38.6% nG vs 0% oral, p<0.001; TST males 10.7 + 3.7 mm nG vs 15.4 + 4.6 mm oral, p<0.001; MaMCmales 187.9 + 40.4 mm nG vs 228.7 + 31.8 mm oral, p<0.001). 45 (64.3%) patients on long-term nG feeding reported complications, mainly consisting of dislodgement (50.5%), aspiration of feed content (8.6%) and trauma from insertion (4.3%). among 20 clinicians from relevant speciliaties who were interviewed, only 11 (55%) clinicians would routinely recommend a PeG. all neurologists (100%) would recommend a PeG, whilst the response was mixed among non-neurologists.among carers, lack of information (47.1%) was thecommonest reason stated for not choosing a PeG.

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Conclusion:elderly patients with stroke on long term nG feeding have apoor nutritional status. Lack of recommendation by clinicians appears to be a major barrier to PeG feeding in these patients.

Key words: Stroke, Dysphagia, Nasogastric tube, Gastrostomy, PeG, Elderly, Malnutrition



HEALTH STATUS

A Survey Of Nutrition And Health Status Of Solitary And Non Solitary Elders In Taiwan

Y.M. Hsieh, T.S. Sung, K.S. Wan

ABSTRACT

Objectives: To compare the effects of living alone versus living in agroup setting on the health, nutrition, personal cognition and generalliving function of a group of elderly Taiwanese. We also hypothesizedthat older adults living alone would have poorer indices of functionand health than would elderly persons living in a group setting.

Design and participants: We conducted a cross-sectional validationstudy of 360 men and women older than 65 y. The subjects were 120solitary (living alone) elders and 240 were non-solitary elders.

Measurements: Both groups completed a series of questionnaires,including the Nutrition Screening Initiative (NSI), Mini NutritionalAssessment (MNA), Activities of Daily Living (ADLs/Barthel scales),Instrumental Activities of Daily Living (IADLs/Lawton scales), ShortPortable Mental State Questionnaire (SPMSQ), and Geriatric DepressionScale (GDS). The participants were then administered by speciallytrained field workers. Blood samples were taken and body mass index,and mid-arm and calf circumferences were measured. The results for

34



each group were statistically analyzed. A p-value < 0.05 wasconsidered significant.

Results: The nutritional and health status of the solitary elders,especially males, was poor compared to that of the non-solitaryelders. In the solitary elders group, the average scores on the NSI,MNA, ADL, IADL, SPMSQ, and GDS were: 4.6, 23.7, 95.6, 7.6, 0.5, and13%, respectively.

Conclusion: Solitary elders, especially males, have a significantlyincreased risk of poor nutrition (MNA< 24), poor health status,impaired cognition, and impaired activities of daily living.

Key words: Elderly, Housing for elderly, Health status, Nutritionalassessment.



IRON, DIETARY

Nutrient Intake, Serum Lipids And Iron Status Of Colligiate Rugby Players

Hiroyuki Imamura, Kazuhide Lide, Yoshitaka Yoshimura, Kenya Kumagai, Reika Oshikata, Keiko Miyahara,Kazuto Oda, Noriko Miyamoto, Anthony Nakazawa

ABSTRACT

Background:There are two main playing positions in rugby (backs andforwards), which demonstrate different exercise patterns, roles, andphysical characteristics. The purpose of this study was: 1) to collectbaseline data on nutrient intake in order to advise the athletes aboutnutrition practices that might enhance performance, and 2) to compareserum lipids, lipoproteins, apolipoproteins (apo),lecithin:cholesterol acyltransferase (LCAT) activity, and iron statusof forwards and backs.

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Methods:The sporting group was divided into 18 forwards and 16 backsand were compared with 26 sedentary controls. Dietary information wasobtained with a food frequency questionnaire.

Results:There were significant differences among the three groups. Theforwards had the highest body weight, body mass index, percentage ofbody fat (calculated by sum of four skinfold thicknesses), as well asthe highest lean body mass, followed by the backs and the controlgroup. The mean carbohydrate intake was marginal and protein intakewas lower than the respective recommended targets in all three groups.The mean intakes of calcium, magnesium, and vitamins A, B1,B2, and Cwere lower than the respective Japanese recommended dietary allowancesor adequate dietary intakes for the rugby players. The forwards hadsignificantly lower high-density lipoprotein cholesterol (HDL-C) andHDL2-C than the backs and had significantly higher apo B and LCATactivity than the controls. The backs showed significantly higher HDL-C, HDL3-C, low-density lipoprotein cholesterol, and apo A-I, and LCATactivity than the controls. Four forwards (22%), five backs (31%), andthree controls (12%) had hemolysis. None of the rugby players hadanemia or iron depletion.

Conclusion:The findings of our study indicate that as the athletesincreased their carbohydrate and protein intake, their performance andlean body mass increased. Further, to increase mineral and vitaminintakes, we recommended athletes increase their consumption of greenand other vegetables, milk and dairy products, and fruits. Theforwards showed more atherogenic lipid profiles than the backs,whereas the backs showed not only anti-atherogenic lipid profile, butalso showed more atherogenic lipid profile relative to the controlgroup. Additionally, our study showed none of the rugby playersexperienced anemia and/or iron depletion.

Imamura et al. Journal of the International Society of Sports Nutrition2013,10:9


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MALNUTRITION

Malnutrition: A Highly Predictive Risk Factor Of Short-Term Mortality In Elderly Presenting To The Emergency Department

S. Gentile, O. Lacroix, A.C. Durand, E. Cretel, M. Alazia, R. Sambuc, S. Bonin Guillaume

ABSTRACT

Objectives:To identify independent risk factors of mortality amongelderly patients in the 3 months after their visit (T3) to anemergency department (ED). Design:Prospective cohort study.

Setting:University hospital ED in an urban setting in France.Participants:One hundred seventy-three patients aged 75 and older wereadmitted to the ED over two weeks (18.7% of the 924 ED visits). Ofthese, 164 patients (94.8%) were included in our study, and 157(95.7%) of them were followed three months after their ED visit.Measurements: During the inclusion period (T0), a standardizedquestionnaire was used to collect data on socio-demographic andenvironmental characteristics, ED visit circumstances, medicalconditions and geriatric assessment including functional andnutritional status. Three months after the ED visits (T3), patients ortheir caregivers were interviewed to collect data on vital status, andED return or hospitalization.

Results:Among the 157 patients followed at T3, 14.6% had died, 19.9%had repeated ED visits, and 63.1% had been hospitalized. The twoindependent predictive factors for mortality within the 3 months afterED visit were: malnutrition screened by the Mini NutritionalAssessment short-form (MNA-SF) (OR=20.2; 95% CI: 5.74-71.35; p<.001)and the Cumulative Illness Rating Scale for Geriatrics (CIRS-G) score(OR=1.1; 95% CI: 1.01-1.22; p=.024).

Conclusion: Malnutrition is the strongest independent risk factorpredicting short-term mortality in elderly patients visiting the ED,and it was easily detected by MNA-SF and supported from the ED visit.



Malnutrition And Falls Risk In Community-Dwelling Older Adults

E. Isenring, J. Baker, G. Kerr

ABSTRACT

Background and Aims:Falls and fall-related injuries result in reducedfunctioning, loss of independence, premature nursing home admissionsand mortality. Malnutrition is associated with falls in the acutesetting, but little is known about malnutrition and falls risk in thecommunity. The aim of this study was to assess the association betweenmalnutrition risk, falls risk and falls over a one-year period incommunity-dwelling older adults.

Methods: Two hundred and fifty four subjects >65 years of age wererecruited to participate in astudy in order to identify risk factorsfor falls. Malnutrition risk was determined using the Mini NutritionalAssessment–Short Form.

Results:28.6% had experienced a fall and according to the MiniNutritional Assessment-Short Form 3.9% (n=10) of subjects were at riskof malnutrition. There were no associations between malnutrition risk,the risk of falls, nor actual falls in healthy older adults in thecommunity setting.

Conclusions:There was a low prevalence of malnutrition risk in thissample of community-dwelling older adults and no association betweennutritional risk and falls. Screening as part of a falls preventionprogram should focus on the risk of developing malnutrition as this isassociated with falls.

Key words: Malnutrition, Falls, Elderly, MNA-SF, Nutritional status.



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Malnutrition In Community-Dwelling Adults With Dementia (Nutrialz Trial)

M. Roque, A. Salva, B. Vellas

ABSTRACT

Objectives:The objective of this study is to assess the nutritionalstatus, measured by the MNA, in community-dwelling elderly individualswith dementia and to identify clinical risk factors for nutritionalrisk or malnutrition.

Design: Cross-sectional analysis of a cluster randomized clinicaltrial (Nutrialz). Setting: Community-dwelling individuals attendingdementia clinics. Participants:940 individuals. Measurements: Theclinical scales assessed were Mini Nutritional Assessment (MNA),Eating Behaviour Scale (EBS), Charlson comorbidity index, ClinicalDementia Rating (CDR), Mini-Mental State Examination (MMSE), BasicActivities of Daily Living (BADL) score, Instrumental Activities ofDaily Living (IADL) score, Neuropsychiatric Inventory Questionnaire(NPI-Q), Cornell depression scale and Zarit Caregiver BurdenInterview.

Results: 5.2% of participants were classified as being malnourished,42.6% as being at risk of malnutrition and 52.2% as well nourished.Malnutrition by type of dementia was more frequent in Lewy bodiesdementia (18.2%) than in the other types. Worse nutritional status issignificantly related to more advanced age and worse cognitive,functional and behavioural profile, as well as increased burden forcaregivers. Presence of behavioural symptoms is significantly relatedto worse nutritional level for all NPI-Q symptoms but depression,exaltation, lack of inhibition and irritability. The items morestrongly related to malnutrition are appetite/feeding andhallucinations. Dependence in any basic or instrumental ADL issignificantly related to higher risk of malnutrition. Dependence on

39

feeding is a strongly related risk factor, while food preparation isonly a moderate one. A logistic regression model to predict atrisk/malnutrition kept as significant risk factors EBS (Odds Ratio(OR) 0.84, 95%CI 0.78 to 0.91), Cornell (OR 1.12, 95%CI 1.09 to 1.16),the number of dependent BADL (OR 1.29, 95%CI 1.17 to 1.42), age (OR1.04, 95%CI 1.02-1.06), MMSE (OR 0.95, 95%CI 0.92 to 0.98) andCharlson (OR 1.18, 95%CI 1.05 to 1.34). A similar model built forprediction of malnutrition retained as significant covariables onlyEBS, Cornell and the number of dependent BADL.

Conclusion:These results will allow a better understanding of theclinical stage previous to malnutrition. An adequate diagnosis andtreatment of identified modifiable factors like functional impairment,eating behaviours and depression could delay or avoid malnutrition.

Key words: Dementia, Elderly, Malnutrition, MNA.



Malnutrition In Elderly: Social And Economic Determinants

L.M. Donini, P. Scardella, L. Piombo, B. Neri, R. Asprino, A.R. Proietti, S. Carcaterra, E. Cava, S. Cataldi, D. Cucinotta, G. Di Bella, M. Barbagallo, A. Morrone

ABSTRACT

Objectives:Malnutrition occurs frequently in the frailest groups of the population, especially in people who are on a low income and elderly subjects, overall if they are institutionalized. the aim of this study was to assess the prevalence of malnutrition in a sample ofelderly people living in different settings and to identify the determinants of malnutrition.

Methods:a total of 718 subjects, 472 females (F) and 246 males (M), were recruited from nursing homes or were free living in three

40



different regions in italy. nutritional status, depression,social, functional and cognitive status, were evaluated.

Results:according to the Mini nutritional assessment (Mna), a high prevalence of malnutrition was found out in both genders: 26% of F and16.3% of M were classified as being malnourished (Mna<17); 40.9% of F and 35% of M were at risk of malnutrition (Mna 17-23,5). the prevalence of malnutrition was significantly higher in nH subjects in both sexes.

Moreover, a relationship was shown between malnutrition and inability to shop, prepare and cook meals because of a low income, distance frommarkets or supermarkets as well as impossibility to drive the car or to use public transportation. this study confirms the necessity to routinely perform nutritional status evaluation in elderly subjects, to carry out training courses for health workers (doctors, nurses, psychologists, dietitians), to implement nutritional education of the geriatric population, to develop tools and guidelines for health workers and caregivers, to identify and reduce clinical, functional, social or economic risk factors for malnutrition.

Key words: Malnutrition, Elderly, Poverty.



MICRONUTRIENTS

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Micronutrients-Incorporated Calcium Phosphate Particles With Protective Effect On Osteoporotic Bone Tissue

X. Chen, L. Zhang, X. Yang, Z. Li, X. Sun, M. Lin, G. Yang, Z. Gou

ABSTRACT

Background: Supplementation of individual micronutrient is inadequate for maintaining bone function because single micronutrient can not contribute significantly a positive remodeling balance. Objective:We developed the highly integrated, stably dietary multi-micronutrients with good bioavailability and low adverse effect on the improvement ofbone consolidation in osteoporosis.

Methods:The trace element-codoped calcium phosphate (teCaP) particles were prepared in the modified body fluid and carefully evaluated. Rats, aged 3 months, were ovariectomized and when 6 month intervened with the conditioned, low, moderate, and high teCaP diets.

Results:The teCaP particles showed highly dissolvable in stomach juice-mimicing acidic solutions. Three months after intervention, the body weight increase showed remarkable differences among the low teCaPdiet (~52 g), moderate teCaP diet (~34 g) and high teCaP diet (~23 g) group. In particular, the intake of moderate teCaP greatly improved the retention of trace elements in femural bone for better protection against the skeletal weakening, and resulted in a significant increaseof bone mineral density (104.06%) in comparison with the conventional high calcium plus vitamin D3 diet (Control group).

Conclusions:These investigations improve our understanding of micronutrient retention on bone consolidation in osteoporotic bone tissue, and also provide new mild wet-chemical approach to prepare potent nutritionally effective edible complements to synergistically relieve bone degeneration and prevent osteoporosis.

Key words: Micronutrient, Trace element, Calcium phosphate, Dietary supplement, Antiosteoporosis.

Journal Nutrition Health Aging 22 Oktober 2012

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MORTALITY

Nutritional Assessment In An Asian Nursing Home And Its Association With Mortality

M. Chan, Y.P. Lim, A. Ernest, T.L. Tan

ABSTRACT

Objective: To study the nutritional status of nursing home residents in a multi-racial Asian society andits role in predicting short-term mortality independent of functional status and comorbidities.

Design: Cross-sectional study with prospective collection of mortalitydata. Setting: Nursing home facility in Singapore.Subjects: A total of154 patients (mean age 77 ± 12 years, 53.2% women). Methods: We evaluated the demographic details, Mini Nutritional Assessment (MNA) scores, body mass index (BMI) and anthropometric measurements of the participants. Functional status and comorbidities were characterized by the modified Barthel Index and Charlson’s comorbidity index respectively.

Results: Prevalence of undernutrition were 52% (n= 80) and 39% (n=60)when determined by BMI <18.5kg/m2 and MNA <17 respectively. Mortality was 25.3% (n= 39) over 2 years. Baseline factors associated with mortality include increased age, low Barthel’s score, BMI <18.5kg/m2and MNA <17 (OR= 1.05, 1.01, 3.08 and 3.03 respectively, allp<0.05). The association between low BMI and mortality remained significant (p=0.027) after adjustment for patient’s age, gender,

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Barthel’s and Charlson’s scores, and prior nutritional intervention, but the association between MNA and mortality was diminished (p=0.106).

Conclusion: There was a high prevalence of undernutrition in this nursing home population, and the diagnosis is an important predictor of mortality. Formal nutritional screening and targeted interventions may improve important clinical outcomes.

Key words: Nutrition, Mortality, MNA, Nursing home.



MUSCLES CONTRACTION

Influence Of Nutrient Intake On Antioxidant Capacity, Muscle Damage And White Blood Cell

Count In Female Soccer Players

Leyre Gravina, Fatima Ruiz, Elena Diaz, Jose Antonio Lekue, Aduna Badiola, Jon Irazusta,Susana Maria Gil

ABSTRACT

Background:Soccer is a form of exercise that induces inflammatoryresponse, as well as an increase in free radical spotentially leadingto muscle injury. Balanced nutritional intake provides important

44



antioxidant vitamins, including vitamins A, C and E, which may assistin preventing exercise-related muscle damage. The purpose of thepresent study was to determine the effect of macro/micronutrientintake on markers of oxidative stress, muscle damage, inflammatory andimmune response in female soccer players.

Methods:Twenty-eight female players belonging to two soccer teams ofthe same professional soccer club participated in this study afterbeing informed about the aims and procedures and after deliveringwritten consent. Each team completed an 8-day dietary record andplayed one competition match the same week. Participants were dividedinto two groups: the REC group (who complied with recommended intakes)and the NO-REC group(who were not compliant). Laboratory blood testswere carried out to determine hematological, electrolytic and hormonalvariables, as well as to monitor markers of cell damage and oxidativestress. Blood samples were obtained 24 h before, immediately after and18 h after official soccer matches. Studentt-test or Mann–Whitney U-test was used to compare both groups through out the match.

Results:At rest, we observed that the REC group had higher levels oftotal antioxidant status (TAS), glutathione peroxidase (GPx), andlower levels of creatine kinase (CK) and lactate dehydrogenase (LDH)in comparison to the NO-REC group. Immediately after the match, levelsof TAS, GPx, superoxide dismutase (SOD), LDH and % lymphocytes werehigher and the % of neutrophils were lower in the REC group comparedto the NO-REC group. These differences were also maintained 18 h post-match, only for TAS and GPx.

Conclusions:Our data reveal an association between nutritional intakeand muscle damage, oxidative stress,immunity and inflammation markers.The benefit of the intake of specific nutrients may contribute topreventing the undesirable physiological effects provoked by soccermatches.

Gravinaet al. Journal of the International Society of Sports Nutrition2012,9:32


45

MUSCLE STRENGTH

Effect Of Vitamin D Nutritional Status On Muscle Function And StrengthIn Healthy Women Aged Over Sixty-Five Years

S.R. Mastaglia, M. Seijo, D. Muzio, J. Somoza, M. Nunez, B. Oliveri

ABSTRACT

Background: vitamin D insufficiency is common in elderly adults, andleads to secondary hyperparathyroidism, bone loss, muscle weakness,and osteoporotic fractures. objective: to evaluate the relationbetween vitamin D nutritional status and muscle function and musclestrength in women aged over 65 years.

Methods: ifty-four postmenopausal women from Buenos aires (latitude34° S), average age (X±DS) 71±4, were included in the study.Determinations of serum calcium, phosphate, 25 hydroxyvitamin D(25oHD), intact parathormone (iPtH) and calciuria / creatininuriaratio in 24-hour urine samples were performed. Muscle function wasassessed by means of walking-speed test, standing balance, and sit-to-stand tests. lower extremity muscle strength was determined using amanual dynamometer.

Results: 25oHD levels ≥20ng/ml were found to be associated with betterlower extremity muscle function and strength. Forty- six % ofparticipants had 25oHD levels ≥20ng/ml. Women with 25oHD levels≥20ng/ml scored higher on the muscle function tests (11.2±0.9vs.10.0±2.1; p<0.003) and had stronger knee extensor (13.4±2.7vs.11.6±2.5 Kg.; p<0.03) and hip abductor (8.3±2.7 vs. 7.3±3.1 Kg;p<0.04) muscles; strength of their hip flexors tended to be higher butdid not reach significantly different values (17.0±3.3 vs. 15.4±2.8Kg.; 0.1>p>0.05). Negative correlation was observed between iPtH andmuscle function (r= -0.436; p<0.02).

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Conclusion: 25oHD levels ≥20ng/ml are needed for abetter musclefunction and strength. assessing vitamin D nutritional status inadults aged ≥ 65 years would allow correcting hypovitaminosis D andimprove muscle function and strength.

Key words: Vitamin D, Muscle strength, Muscle function, Osteoporotic fractures.

the Journal of Nutrition, Health & Aging Volume 15, Number 5, 2011


MUSCULAR ATROPHY

Nine Weeks Of Supplementation With A Multi-Nutrient Product Augments Gains In Lean Mass, Strength, And Muscular Performance In Resistance Trained MenStephen M Schmitz, Jennifer E Hofheins, Robert Lemieux

ABSTRACT

Background:The purpose of this study was to compare the effects ofsupplementation with Gaspari Nutrition’s SOmaxP MaximumPerformance™(SOmaxP) versus a comparator product (CP) containing anequal amount of creatine (4 g), carbohydrate (39 g maltodextrin), andprotein (7 g whey protein hydrolysate) on muscular strength, muscularendurance, and body composition during nine weeks of intenseresistance training.

Methods:Using a prospective, randomized, double-blind design, 20healthy men (mean ± SD age, height, weight, % body fat: 22.9 ± 2.6 y,178.4 ± 5.7 cm, 80.5 ± 6.6 kg, 16.6 ± 4.0%) were matched for age, bodyweight, resistance training history, bench press strength, bench pressendurance, and percent body fat and then randomly assigned via the

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ABBA procedure to ingest 1/2 scoop (dissolved in 15 oz water) ofSOmaxP or CP prior to, and another ½ scoop (dissolved in 15 oz water)during resistance exercise. Body composition (DEXA), muscularperformance (1-RM) bench press and repetitions to failure [RTF: 3 sets× baseline body weight, 60-sec rest between sets]), and clinical bloodchemistries were measured at baseline and after nine weeks ofsupplementation and training. Subjects were required to maintain theirnormal dietary habits and follow a specific, progressive overloadresistance training program (4-days/wk, upper body/lower body split)during the study. An intent-to-treat approach was used and data wereanalyzed via ANCOVA using baseline values as the covariate.Statistical significance was seta prioriat p≤0.05.

Results:When adjusted for initial differences, significant betweengroup post-test means were noted in:1-RM bench press (SOmaxP: 133.3 ±1.3 kg [19.8% increase] vs. CP: 128.5 ± 1.3 kg [15.3% increase]; p <0.019);lean mass (SOmaxP: 64.1 ± 0.4 kg [2.4% increase] vs. 62.8 ± 0.4kg [0.27% increase], p < 0.049); RTF (SOmaxP: 33.3 ± 1.1 reps [44.8%increase] vs. 27.8 ± 1.1 reps [20.9% increase], p < 0.004); and fatmass (SOmaxP: 12.06 ± 0.53 kg [9.8% decrease] vs. 13.90 ± 0.53 kg[4.1% increase], p < 0.024). No statistically significant differencesin vital signs (heart rate, systolic and diastolic blood pressures) orclinical blood chemistries were noted.

Conclusions:These data indicate that compared to CP, SOmaxPadministration augments and increases gains in lean mass, bench pressstrength, and muscular performance during nine weeks of intenseresistance training. Studies designed to confirm these results andclarify the molecular mechanisms by which SOmaxP exerts the observedsalutary effects have begun. Both SOmaxP and the CP were well-tolerated, and no supplement safetyissues were identified.

Schmitzet al. Journal of the International Society of Sports Nutrition2010,7:40http://www.jissn.com/content/7/1/40

NURSING HOMES

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Bioelectrical Impedance Vector Analysis And Mini Nutritional Assessment In Elderly Nursing Home Residents

F.Santomauro, N. Olimpi, L. Baggiani,N.Comodo,S. Mantero,G. Bonaccorsi

ABSTRACT

Objective:The aim of this studywas to establish the presence ofmalnutrition in elderly Institutionalized people through MiniNutritional Assessment (MNA) scores and to observe the changes ofnutritional status through the BioelectricalImpedance VectorAnalysis(BIVA).

Design:Observational study.Setting:Nursing home locatedin theterritory of Florence(Italy). Participants: 463 elderly individualsfrom twelve nursing homes, all aged 65 yrs or over.Measurements: Wecarried out the MNA and measured the bioelectrical parameters ofresistance(R) and reactance(Xc), with standard, tetrapolar analysis at50 kHz frequency; the sebioelectrical parameters were interpretedaccording to BIVA analysis.

Results:According to the MNAscore,23.1%of the women and 20.4% of themales are malnourished(MNA<17), 60.0% and 52.8%,respectively, are atrisk for malnutrition(17≤MNA≤23.5). Malnourished, at-riskandwell-fedsubjects differ significantly(p<0.05) in their mean scores obtained ineach of the MNA areas. Fifteen of eighteen MNA items show asignificant correlation to the total MNA score (p<0.001). The itemsnot significantly related tothe MNA global score were those concerningprotein intake, independence and number of medicinal drugs taken. Inboth genders, the decrease of the MNA score increases the proportionof subjects Placed outside the 95% confidence ellipse on theBIVAtolerancegraph.

Conclusion: Aroutine assessment of nutritional status through BIVAanalysis combined withmore“traditional” tools like the MNA could beuseful for recognizing malnutrition and the risk of malnutrition inthe elderly asthese instruments provide complete information and areeasy to use even with heavily impaired subjects.

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Key words: Bioelectrical impedance, Elderly, Mini Nutritional Assessment, Nursing home.



Comparison Of Two Different Approaches For The Application Of The MiniNutritional Assessment In Nursing Homes: Resident Interviews Versus Assessment By Nursing Staff

R. Kaiser, K. Winning, W. Uter, S. Lesser, P. Stehle, C.C. Sieber, J.M. Bauer

ABSTRACT

Background:When the Mini Nutritional Assessment (MNA©) was developed,the authors did not specifically focus on the nursing home setting.Due to a number of particularities of nursing home residents, such ascognitive and linguistic disabilities, a number of uncertainties withregard to its application await clarification.Aims and objectives: Theaim of this study was to compare the results of two different modes ofMNA application in nursing homes: resident interviews versusassessment by nursing staff.

Method:The MNA was applied to 200 residents of two municipal nursinghomes in Nuremberg, Germany. First one-on-one interviews of theresidents were conducted by two researchers from our group. Next, theMNA was applied by the attending nursing staff who was blinded to theresults of the first MNA. To evaluate the prognostic properties of thetwo different approaches, data on mortality of the screened residentswere collected during a six-month follow-upperiod.

Results:Among 200 residents (f 147 m 53, f 86.5±7.4 y. m 83.0±8.5 y.),the MNA could be applied to 138 residents (69.0%) by one-on-one

50



interviews and to 188 residents (94.0%) by the nursing staff. 15.2% ofthe residents were categorised as malnourished by the interviews and8.7% by the nursing staff’s assessment. The agreement of the two formswas low for the MNA short form (weighted kappa = 0.31; 95% CI: 0.14 -0.47) as well as for the full MNA (weighted kappa = 0.35; 95% CI: 0.27- 0.44). After exclusion of residents with cognitive impairment(n=89), agreement for the full version increased (weighted kappa =0.47, 95% CI 0.25 -0.68). 25 (12.5%) study participants deceasedduring the follow-up period. Mortality was significantly associatedwith the mortality for both approaches, while the MNA application bythe nursing staff proved to be superior(nursing staff p<0.001,residents p<0.05).

Conclusions:The results of the MNA in nursing home residents maydiffer substantially when resident interviews are compared toassessment by nursing staff. The authors recommend that the MNA shouldbe routinely applied by the nursing staff. The application rate ishigher and interference with cognitive as well as linguistic deficitsis lower. In future studies, the mode of MNA application in nursinghome residents should be clearly stated to facilitate comparability ofresults.

Key words: Nutrional screening, Mini Nutritional Assessment, Malnutrition, Nursing home.



Cost-Effectiveness Of Nutrition Interventions In Nursing Home Residents: A Pilot Intervention

S.F. Simmons, X. Zhuo, E. Keeler

ABSTRACT

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Objectives:Unintentional weight loss is a prevalent and costlyclinical problem among nursing home(NH) residents. One of the mostcommon nutrition interventions for residents at risk for weight lossis oral liquid nutrition supplementation. The purpose of this studywas to determine the cost effectiveness of supplements relative tooffering residents’ snack foods and fluids between meals to increasecaloric intake.

Design: Randomized, controlled trial.Setting:Three long-term carefacilities.Participants:Sixty-three long-stay residents who had anorder for nutrition supplementation.Intervention:Participants wererandomized into one of three groups: (1) usual NH care control; (2)supplement, or (3) between-meal snacks. For groups two and three,trained research staff provided supplements or snacks twice dailybetween meals, five days per week, for six weeks with assistance andencouragement to promote consumption.Measurements:Research staffobserved residents during and between meals for two days at baseline,weekly, and post six weeks to estimate total daily caloric intake. Forboth intervention groups, research staff documented residents’ caloricintake between meals from supplements or snack items, refusal ratesand the amount of staff time required to provide each intervention.

Results:Both interventions increased between meal caloric intakesignificantly relative to the control group and required more stafftime than usual NH care. The snack intervention was slightly lessexpensive and more effective than the supplement intervention.

Conclusions:Offering residents a choice among a variety of foods andfluids twice per day may be a more effective nutrition interventionthan oral liquid nutrition supplementation.

Key words: Nursing homes, Weight loss, Intervention, Nutrition supplementation.



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Maintaining Nutrition In Aged Care Residents With A Train-The-Trainer Intervention And Nutrition Coordinator

D. Gaskill, E.A. Isenring, L.J. Black, S. Hassall, J.D. Bauer

ABSTRACT

Objective: To investigate the impact of a train-the-trainer program onthe nutritional status of older people in residential care.

Design: Prospective, randomized controlled study. Setting: Eight nursing homes in Southeast Queensland, Australia. Participants: A total of 352 residents participated - 245 were female (69.6%). The mean age was 84.2 years and the majority (79.4%) were classified as high dependency. Intervention: Residents from four nursing homes were randomly selected for a nutrition education program coordinated by Nutrition Coordinators. Residents from the other four nursing homes (control) received usual care. Measurements: The Subjective Global Assessment was used to determine prevalence of malnutrition at baseline and six months post intervention. The Resident ClassificationScale measured functional dependency. Prescribed diet, fluids, oral hygiene status and allied health referrals were obtained by chart audit.

Results: Approximately half the residents were well nourished with 49.4% moderately or severely malnourished. Residents in the intervention group were more likely to maintain or improve their nutritional status compared with the control group who were more likely to experience a deterioration (P=0.027). The odds of the control group being malnourished post test was 1.6 times more likely compared with the intervention group but this did not reach statistical significance (P=0.1).

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Conclusion: The results of the study encourage the implementation of a Nutrition Coordinator program to maintain nutritional status of agedcare residents. Nevertheless, malnutrition rates continue to be unacceptably high. In a rapidly aging society, the aged care sector needs to confront malnutrition and provide better resources for staff to take measures against this problem.

Key words:Train-the-trainer, Nutrition intervention, Nursing home, Frail elderly.The Journal of Nutrition, Health & Aging Volume , Number , 2009www.springer.com › Home › Medicine › Family & Geriatric Medicine

NUTRITIONAL ASSESMENT

Clinical Study Of Mini-Nutritional Assesment For Older Chinese Inpatients

Z. Lei, D. Qingyi, G. Feng, W. Chen, R. Shoshana Hock, W. Changli

ABSTRACT

Background: Malnutrition is a common problem in older patients. Earlydetection of malnutrition is an important task in clinical practice.The MNA has become an extensively used tool to evaluate nutritionalstatus in European countries and the United States. Objective: Weevaluated the Mini-Nutritional Assessment (MNA) test and the short-form MNA (MNA-SF) test as screening tools for malnutrition in olderChinese inpatients and focused on finding an optimal cutoff point forMNA total score and MNA-SF score.

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Design: One hundred eighty-four older Chinese inpatients were enrolledin this study from July to August 2006. Nutritional assessmentincluded MNA, anthropometric measurements, and biochemical markers.

Results: According to the original cutoff point of the full MNA, 19.6%of those assessed were malnourished, 53.2% were at risk ofmalnutrition and 27.2% were well nourished. Correlations were foundbetween MNA, MNA-SF and body mass index, triceps skinfold thickness,serum albumin, lymphocyte count, hemoglobin, lymphocyte ratio. Withthe most proper cut off point lower than 19 indicating malnutrition,when using serum albumin (<35.0 g/L) as the indicator, the sensitivityand specificity of the MNA total score were 0.6286 and 0.7466; whenusing BMI (<18.5 kg/m2) as the

indicator, the sensitivity and specificity were 0.8636 and 0.7469. Theincidence rate of malnutrition was 32.6%. The most proper cutoff pointof MNA-SF was lower than 12. Conclusion: The MNA and MNA-SF wereuseful tools to identify older Chinese inpatients with malnutrition.However, the cutoff point of the MNA should be modulated for thispopulation.

Key words:Nutritional assesment, Gerontology, Screening.

The Journal of Nutrition, Health & Aging Volume , Number , 2009


NUTRITIONAL SCIENCES

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Macronutrient Intake In Collegiate Powerlifters Participating In Off Season TrainingJonathan M Oliver, Michelle A Mardock, Adam J Biehl, Steven E Riechman

ABSTRACT

Background: Currently, the ISSN recommends 50-80 kcal/kg/day forstrength athletes participating in intense training. In addition tocaloric recommendations, other macronutri-ent recommendations includeprotein, carbohydrate and fat, 1.5-2.0 g/kg bodyweight, 5-8 g/kgbodyweight, and 30% of total calories respectively. Athletesparticipating in collegiate club sports may not have the benefit ofobtaining nutrition information from a designated coach ornutritionist; therefore, the purpose of this study was to determinethe macronutrient intake of collegiate club sport power liftersparticipating in intense off season training.

Methods : Six men (22±4 yrs, 177±7 cm, 91±16kgs, 15± 4% bf) and threewomen (25± 4 yrs, 159± 9 cm, 74± 17 kgs, 31± 12% bf), all members ofthe Texas A & M University Powerlifting Team, completed 3 day dietrecords while participating in team training designed to elicit hyper-trophy 4 days/week for 9 weeks. Diets were analyzed for macro nutrientcontent using Nutribase software by a registered dietitian.

Results: Powerlifters participating in off season training failed tomeet the current ISSN recommendations for calories (25± 8 kcal/kg),protein (1.18± .36 g/kg) or carbohydrate (3.06± .91 g/kg), butobtained the recommended percen-tage fat intake (32± .3% kcal). Whenusing lean bodymass instead of body weight, powerlifters still failedto meet caloric and carbohydrate recommendations, 34.0±\ 7.0 kcal/kgand 4± 1 g/k respectively. Protein require-ments were met (1.6± .3g/kg) as well as percentage fat intake when lean body mass was usedinstead of total body weight.

Conclusion : Powerlifters participating in off season training shouldstrive to increase caloric intake in an effort to better meet currentISSN guidelines for macronutrient intake in an effort to optimizetraining goals through nutrition.

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Oliveret al. Journal of the International Society of Sports Nutrition2010,7(Suppl 1):P8

http://www.jissn.com/content/7/S1/P

Nutritional Behavior Of Cyclists During A 24-Hour Team Relay Race: A Field Study Report

Raúl Bescós, Ferran A Rodríguez, Xavier Iglesias, Beat Knechtle, Adolfo Benítez, Míchel Marina,Josep M Padullés, Priscila Torrado, Jairo Vazquez ,Thomas Rosemann

ABSTRACT

Background: Information about behavior of energy intake in ultra-endurance cyclists during a 24-hour team relay race is scarce. Thenutritional strategy during such an event is an important factor whichathletes should plan carefully before the race. The purpose of thisstudy was to examine and compare the nutritional intake of ultra-endurance cyclists during a 24-hour team relay race with the currentnutritional guidelines for endurance events. Additionally, we analyzedthe relationship among the nutritional and performance variables.

Methods: Using a observational design, nutritional intake of eightmales (mean ± SD: 36.7 ± 4.7 years; 71.6 ± 4.9 kg; 174.6 ± 7.3 cm; BMI23.5 ± 0.5 kg/m2) participating in a 24-hour team relay cycling racewas assessed. All food and fluid intake by athletes were weighed andrecorded. Additionally, distance and speed performed by each riderwere also recorded. Furthermore, before to the race, all subjectscarried out an incremental exercise test to determine two heart rate-

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VO2 regression equations which were used to estimate the energyexpenditure.

Results: The mean ingestion of macronutrients during the event was 943± 245 g (13.1 ± 4.0 g/kg) of carbohydrates, 174 ± 146 g (2.4 ± 1.9g/kg) of proteins and 107 ± 56 g (1.5 ± 0.7 g/kg) of lipids,respectively. This amount of nutrients reported an average nutrientintake of 22.8 ± 8.9 MJ which were significantly lower compared withenergy expenditure 42.9 ± 6.8 MJ (P= 0.012). Average fluid consumptioncorresponded to 10497 ± 2654 mL. Mean caffeine ingestion was 142 ± 76mg. Additionally, there was no relationship between the mainnutritional variables (i.e. energy intake, carbohydrates, proteins,fluids and caffeine ingestion) and the main performance variables(i.e. distance and speed).

Conclusions: A 24-hour hours cycling competition in a team relayformat elicited high energy demands which were not compensated byenergy intake of the athletes despite that dietary consumption ofmacronutrients did not differ to the nutritional guidelines for longerevents.

Bescóset al. Journal of the International Society of Sports Nutrition2012,9:3


NUTRITIONAL STATUS

Different Components Of Nutritional Status In Older Inpatients With Cognitive Impairment

G. Orsitto

58

ABSTRACT

Objectives: to evaluate different components of nutritional status inolder patients with cognitive deficit, particularly in those with mildcognitive impairment (MCi).

Design: Cross-sectional study. Setting and participants: 560 elderlysubjects aged ≥ 65 years consecutively admitted to an acute GeriatricUnit of Apulia region of southern italy. Measurements: A standardizedcomprehensive geriatric assessment was used to evaluate medical,cognitive, affective and social aspects. Nutritional status wasassessed using the mini nutritional assessment (MNA). the cognitivefunction was categorized into three levels – MCi, dementia or normalcognition (NoCi) – according to the neuropsychological test score.

Results: subjects with cognitive decline had significantly lowerfrequency of well-nourished (MCi=10%, dementia=8%, NoCi=22%, p<0.05)and higher frequency of malnourished (MCi=47%, dementia=62%, NoCi=19%,p<0.001) than patients with normal cognition. similarly, MNA totalscore, MNA-3 and MNA-4 subscores were significantly lower in patientswith MCi and dementia than patients with normal cognition (p<0.001).

Conclusions: these results suggest that cognitive decline may beassociated with malnutrition in this sample of hospitalized olderpatients. Dietary habits (MNA-3) and subjective assessment of self-perceived quality of health and nutrition (MNA-4) are particularlypoor also in patients with MCi and could be very important variablesto be considered in the multidimensional evaluation of subjects withcognitive impairment.

Key words: Malnutrition, Elderly, Mild cognitive impairment, Dementia.



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Country Of Origin Predicts Nutrition Risk Among Community Living OlderPeople

C.Wham, R. Carr, F. Heller

ABSTRACT

Objectives: To assess the nutrition risk status of community livingolder people and to identify associated risk factors. Design:A cross-sectional study using convenience sampling.Setting:North Shore City,Auckland, NewZealand.Datacollectionwas carriedoutby aresearchnutritionist using computer assisted personal interviewing in theparticipant’s own home.Participants:Fifty-one independently livingpeople aged between 80 and 85 years.

Measurement:A survey using three validated questionnaires:Practitioner Assessment of Network Type (PANT) to evaluate socialnetworks;Elderly Assessment System(EASY-Care) to evaluate physical andmental wellbeing and Seniors in the Community: Risk Evaluation forEating and Nutrition Version II (SCREENII) to assess nutrition risk.

Results:Athird of the participants (31%) were at high risk ofmalnutrition (SCREENII score <50; range 29-58 outof maximum score of64). The majority ofparticipants (82%) lived alone and nearly half(47%) had supportive social networks including close relationshipswith local family, friends and neighbours. Low self-rated health,disability and social factors (being born outside of NewZealand,losing aspouse and loneliness) were key underlying factorsassociated with being at nutrition risk.

Conclusion:Nutrition risk is common among aged individuals living inthe community. Health and social factors thatshapeeatingbehavioursplace older people at increased nutrition risk. Strategiesare neededfor the early identification of risk factors to prevent

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nutrition problems. Engaging older people at risk to share mealpreparation and dining experiences may foster better outcomes.

Key words:Older people, nutrition risk, SCREENII, New Zealand.



NUTRITIONAL SUPPORT

Nutritional Supplement Use By Elite Young UK Athletes: Fallacies Of Advice Regarding Efficacy

Andrea Petróczi, Declan P Naughton, Gemma Pearce, Richard Bailey, Andrew Bloodworth,Michael McNamee

ABSTRACT

Background: The objective was to study nutritional supplement useamong young elite UK athletes to establish whether a rationale versuspractice incongruence exists, and to investigate the sources ofinformation. Survey data were analysed for association betweensupplements used and motives for using such substancesamong youngathletes along with the sources of advice and literature precedents onsupplement effects.

Methods: Participants were elite UK male and femaleathletes, withinthe age range between 12 and 21 (n = 403), mean age 17.66 ± 1.99.Associations between type of supplements and reasons for usingsupplements were tested by calculating Pearson's χ2 and the strength

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of these symmetric associations shown by phi (ϕ) associationcoefficients.

Results: Single supplement use was reported by 48.1%, with energydrinks being the most popular, consumed by 41.7% of all athletes and86.6% ofthe supplement users in the sample. No agreement was observedbetween athletes' rationale and behaviour in relation to nutritionalsupplements except for creatine. Among healthprofessionals,nutritionists and physiotherapists, followed by coaches, were mostfrequentlyconsulted. Answers regarding reasons and supplements usedshowed incongruence and suggest widespread misinformation regardingsupplements and their effects is an issue for the young athlete.

Conclusion: Widespread supplement taking behaviour was evidenced inthe young elite athlete population with the most notable congruencebetween rationale and practice among young athletes being performance-related.Young athletes in the present sample appear to be less 'healthconscious' and more 'performancefocused' than their adultcounterparts. Further research, using a full list of supplements, iswarranted to test the hypothesisthat health consciousness is lessdominant in supplement choice by young athletes.

Journal of the International Society of Sports Nutrition2008, 5:22doi:10.1186/1550-2783-5-22


OBESITY

Maternal Feeding Practices Predict Weight Gain And Obesogenic Eating Behaviors In Young

Children: A Prospective Study

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Rachel F Rodgers, Susan J Paxton, Robin Massey, Karen J Campbell, Eleanor H Wertheim,Helen Skouteris,Kay Gibbons

ABSTRACT

Background:Maternal feeding practices have been proposed to play animportant role in early child weight gain and obesogenic eatingbehaviors. However, to date longitudinal investigations in youngchildren exploring these relationships have been lacking. The aim ofthe present study was to explore prospective relationships betweenmaternal feeding practices, child weight gain and obesogenic eatingbehaviors in 2-year-old children. The competing hypothesis that childeating behaviors predict changes in maternal feeding practices wasalso examined.

Methods:A sample of 323 mother (mean age = 35 years, ± 0.37) and childdyads (mean age = 2.03 years, ± 0.37 at recruitment) wereparticipants. Mothers completed a questionnaire assessing parentalfeeding practices and child eating behaviors at baseline and again oneyear later. Child BMI (predominantly objectively measured) wasobtained at both time points.

Results:Increases in child BMI z-scores over the follow-up period werepredicted by maternal instrumental feeding practices. Furthermore,restriction, emotional feeding, encouragement to eat, weight-basedrestriction and fat restriction were associated prospectively with thedevelopment of obesogenic eating behaviors in children includingemotional eating, tendency to overeat and food approach behaviors(such as enjoyment of food and good appetite). Maternal monitoring,however, predicted decreases in food approach eating behaviors.Partial support was also observed for child eating behaviorspredicting maternal feeding practices.

Conclusions:Maternal feeding practices play an important role in thedevelopment of weight gain and obesogenic eating behaviors in youngchildren and are potential targets for effective preventioninterventions aiming to decrease child obesity.

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Keywords: Obesity, Child, Feeding practices, Eating behaviors, Bodymass index

Rodgerset al. International Journal of Behavioral NutritionandPhysical Activity2013,10:24


PHYSICAL FITNESS

Physical Activity And Nutrition Behavioural Outcomes Of A Home-Based Intervention Program

For Seniors: A Randomized Controlled Trial

Linda Burke, Andy H Lee, Jonine Jancey, Liming Xiang, Deborah A Kerr, Peter A Howat,Andrew P Hillsand,Annie S Anderson

ABSTRACT

Background:This intervention aimed to ascertain whether a low-cost, accessible, physical activity and nutrition program could improve physical activity and nutrition behaviours of insufficiently active 60–70 year olds residing in Perth, Australia.

Methods:A 6-month home-based randomised controlled trial was conductedon 478 older adults (intervention,n = 248; control, n = 230) of low tomedium socioeconomic status. Both intervention and control groups completed postal questionnaires at baseline and post-program, but onlythe intervention participants received project materials. A modified fat and fibre questionnaire measured nutritional behaviours, whereas physical activity was measured using the International Physical Activity Questionnaire. Generalised estimating equation models were used to assess the repeated outcomes over both time points.

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Results:The final sample consisted of 176 intervention participants and 199 controls (response rate 78.5%) with complete data. After controlling for demographic and other confounding factors, the intervention group demonstrated increased participation in strength exercise (p < 0.001), walking (p = 0.029) and vigorous activity (p =0.015), together with significant reduction in mean sitting time (p <0.001) relative to controls. Improvements in nutritional behaviours for the intervention group were also evident in terms of fat avoidance(p < 0.001), fat intake(p = 0.021) and prevalence of frequent fruit intake (p = 0.008).

Conclusions:A minimal contact, low-cost and home-based physical activity program can positively influence seniors’ physical activity and nutrition behaviours.

Keywords: Fat avoidance, Fibre intake, Fruit intake, Goal setting, Sitting, Strength exercise, Vegetable intake,Walking

Burke et al. International Journal of Behavioral Nutrition and Physical Activity 2013,10:14


REHABILITATION

Older Rehabilitation Patients Are A Thigh Risk Of Malnutrition: Evidencefroma Large Australian Database

K.E. Charlton,C. Nichols,S.Bowden,K.Lambert, L. Barone,M.Mason,M.Milosavljevic

ABSTRACT

Background/objectives:Routine nutrition screening is recommended forall older patients admitted to hospital however data on the prevalence

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of malnutrition in rehabilitation settings is sparse. This studyassessed the nutritional status of older patients admitted torehabilitation hospitals over a 5 year period and described theassociation betweennutritionalstatus and length of hospital stay (LOS)in this context. The usefulness of a recently revisedversionoftheshortened MNA (MNA-SF) was alsoinvestigated.

Methods:Aretrospective analysis was conducted of patients aged 65 + yadmitted to two rehabilitation hospitals in New South Wales, Australiabetween 1st March 2003 - 30th June 2004, and 11th January 2005 – 10thDecember 2008. Nutritional status was determined on admission bytrained dieitians usingthe fullMNA instrument andthe MNA-SF.Information on diagnosis-related grouping and length of stay (LOS) wasobtained.

Results: Data was available for 2076 patients with a mean age of 80.6(27.7) y. Thirty-three percent and 51.5 % of patients were classifiedas malnourished and at nutritionalrisk, respectively. Controlling fordate of admission and diagnosis related grouping, LOS was higher inmalnourished and at risk groups compared to their well nourished peers(P<0.001) by 18.5 and 12.4 days, respectively. MNA-SF demonstratedhigh sensitivity but relatively low specificity against the fullMNA.

Conclusion: The majority of older patients in therehabilitationsetting are nutritionally compromised which adverselyinfluences LOS. In order to encourage more widespread screening, theMNA-SF may be able to replace the full MNA.

Key words: Nutrition screening, Elderly, Rehabilitation, MNA,Malnutrition.



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SKIN

Evaluation Of Nutritional Status And Skin Condition Among Elderly Residents In A Long-Term Care Hospital

S. Lizaka, L. Jiao, J. Sugama, T. Minematsu, M. Oba, J. Matsuo,K. Tabata, T. Sugiyama, H. Sanada

ABSTRACT

Objective: The availability of nutritional screening tools for older adults is limited, depending on their physical characteristics or the setting. We investigated the relationships between various nutritionalindicators and skin conditions as possible screening indicators.

Design: Cross-sectional study.Setting: A long-term care hospital in Japan. Participants: 90 elderly residents who were aged ≥65 years old.Measurements: The nutritional status of the residents was assessed by body mass index (BMI), involuntary weight loss, arm muscle area, and serum albumin and prealbumin levels. Leg skin condition was evaluated by: 1) functional factors including pH, hydration and transepidermal water loss; 2) skin color including L*, a*, b*and individual typology angle (ITA°) using a tristimulus colorimetric instrument; and 3) skin morphology. Repeated measures analysis of variance was employed, adjusted for demographic characteristics and room temperature, with measurement site as the repeated variable.

Results: Among the skin indicators, b* was significantly correlated with BMI (p=0.018), and weight loss over the previous month (p=0.042) and 6 months (p=0.002). Additionally, ITA° was associated with weight loss over 1 month (p=0.013). Both b*and ITA° showed the area under thereceiver operating characteristic curve of 0.64 to 0.80 for weight loss >2% over 1 month.

Conclusions: Residents with poorer nutritional status had yellower anddarker skin color.

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key words: Malnutrition, Nutritional screening, Skin color, Aged, Barrier function.



SPORT MEDICINES

Evaluation Of The Nutrition Knowledge Of Sports Department Students OfUniversities

Yahya Ozdoğan, Ayse Ozfer Ozcelik

ABSTRACT

Background:Individuals who have knowledge on the importance ofadequate and balanced diet and reflect this knowledge to theirbehaviors are considered to be more successful in sports life. Thepresent study aims to evaluate the nutrition knowledge of studentsreceiving sports education in universities.

Methods:The study sample consists of 343 voluntary students from theSports Departments of Hacettepe, Gazi and Ankara Universities inAnkara. The questionnaire used in the study included a demographicsection, and 30 questions on true-false nutrition knowledge. For thereliability of the questionnaire, the internal consistency coefficientwas calculated and the Kuder Richardson (KR-20) value was found to be0.71. For higher reliability, 9 dysfunctional questions were excludedfrom the questionnaire. The research data were collected through a

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questionnaire form and face-to-face interviews. For the statisticalanalyses of the data, tables were prepared to show mean, standarddeviation (¯ X±SD) and percentage (%) values. In order to determinethe nutrition knowledge of students, the“independent t test” was usedfor nutrition lesson and gender.

Results:University students receiving sports education and expected tocontinue their professional lives on sport-related fields weredetermined to have the lack of knowledge on nutrition. The mean valueabout the nutrition knowledge of the first year students was found11.150 ± 2.962, while the mean value of the fourth year students was13.460 ± 3.703, and the difference is statistically significant (p= .000).

Conclusion:Students, coaches and teachers in physical education werefound not to give the necessaryimportance to their diets, and theywere still not aware of the importance of nutrition on performance.

Ozdoğan and OzcelikJournal of the International Society of Sports Nutrition2011,8:11


URINARY TRACT

Poor Nutritional Status Is Associated With Urinary Tractinfection Among Older People Living In Residential Care Facilities

M. Carlsson, l. Haglin, E. Rosendahl, Y. Gustafson

ABSTRACT

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Aim:to investigate factors associated with poor nutritional status in older people living in residential care facilities.

Methods:188 residents (136 women, 52 men) with physical and cognitive impairments participated. Mean age was 84.7 y (range 65−100). the Mininutritional assessment (Mna), Barthel adl index, Mini Mental state Examination (MMsE), and geriatric depression scale were used to evaluate nutritional status, activities of daily living, cognitive status and depressive symptoms. Medical conditions, clinical characteristics and prescribed drugs were recorded. univariate and multivariate regressions were used to investigate associations with Mna scores.

Results:the mean Mna score was 20.5 ± 3.7 (range 5.5−27) and the median was 21 (interquartile range (iQr) 18.8−23.0). fifteen per cent of participants were classified as malnourished and 66% at risk of malnutrition. lower Mna scores were independently associated with urinary tract infection (uti) during the preceding year (ß = − 0.21, P= 0.006), lower MMsE scores (ß = 0.16, P = 0.030), and dependent in feeding (ß = − 0.14, P = 0.040).

Conclusion:the majority of participants were at risk of or suffering from malnutrition. urinary tract infection during the preceding year was independently associated with poor nutritional status. dependence in feeding was also associated with poor nutritional status as were low MMsE scores for women. Prospective observations and randomized controlled trials are necessary to gain an understanding of a causal association between malnutrition and uti.

Key words: Malnutrition, Mini nutritional assessment, Residential carefacilities, Urinary tract infection,

Cognitive impairment, Old people.



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VITAMINS

Vitamin Status In Elderly People In Relation To The Use Of NutritionalSupplements

E. Fabian, M. Bogner, A. Kickinger, K.H. Wagner, I. Elmadfa

ABSTRACT

Objective: This study aimed to evaluate the status of several vitaminsand to investigate the effect of regular individual supplementation ontheir status in this population.

Design: An observational study.Setting: State of Burgenland, Austria. Participants:A total of 102 non-institutionalized subjects (49% supplementing regularly, 51% without supplementation) aged between 70-90 years were recruited.Measurements: Plasma levels of vitamins A, D, E, K and C were determined by HPLC. The functional parameters of vitamins B1, B2 and B6, i.e. the activities of the erythrocyte enzymestransketolase, glutathione reductase and glutamic oxaloacetic transaminase, were analyzed photometrically; plasma folate and vitaminB12 were determined by RIA.

Results:The status of vitamins A, E and C was generally satisfactory.Eighty-eight percent and 42% of participants were deficient in vitamins D and K, respectively, as were 29% for B6; up to 10% of participants were deficient in vitamins B1, B2, B12 and folate. A considerable percentage of participants was, however, at risk for vitamin deficiencies (vitamins B1, B6, B12, folate: 20-30%, vitamin B2: 60%). Except for vitamins A and K, regular intake of supplements had a significant positive influence on vitamin levels.

Conclusion: These results indicate that use of supplements significantly improved the status of several vitamins in elderly

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people. Due to age-related problems concerning the intake and digestion of nutrients, a moderate, regular supplementation might be auseful option for older people who are otherwise unable to satisfy their micronutrient requirements.

Key words: Fat soluble vitamins, Water soluble vitamins, Nutritional supplements, Elderly.



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