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  • 1.
    Akner, Gunnar
    Örebro universitet, Hälsoakademin.
    Visualization of evaluation and management of the 'nutrition process' in individual elderly, multimorbid patients2010Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 14, nr 6, s. 502-502Artikkel i tidsskrift (Fagfellevurdert)
  • 2.
    Akner, Gunnar
    et al.
    Örebro universitet, Hälsoakademin.
    Flöistrup, H.
    Individual assessment of intake of energy, nutrients and water in 54 elderly multidiseased nursing-home residents2003Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 7, nr 1, s. 1-12Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: Examination of the individual intake of energy, nutrients and water in clinically stable multidiseased nursing-home residents.

    METHODS: Comprehensive clinical assessment of 54 elderly nursing-home residents (80 +/- 10 years, mean +/- SD). The intake of food and beverages was measured by the weighed food intake method during five consecutive week days followed by computerized transformation to energy, 21 different nutrients, dietary fiber, alcohol and water. The resting energy expenditure was determined by indirect calorimetry.

    RESULTS: There was at least 2-3-fold, variation in intake of energy, nutrients and water, present also when expressed per kg body weight. For some micronutrients the relative intake variation was more than 8-fold. The results are compared with the present swedish recommended dietary allowances as well as with seven other studies of dietary intake in elderly using the weighed food intake method. The residents had on average 14.1 (range 6-31) different current clinical problems and were treated with a mean of 9.5 different drugs. The nursing staff spent 40 % of the total daytime working hours (7 am to 7 pm) on nutrition related issues.

    CONCLUSIONS: The nursing-home residents exhibited a large interindividual heterogeneity regarding intake of energy, nutrients and water. More emphasis should be given to individualized nutrition assessment in clinical geriatric care as a more solid base for nutrition treatment programmes integrated with the regular medical management and evaluation.

  • 3. Dullemeijer, C.
    et al.
    Verhoef, P.
    Brouwer, I. A.
    Kok, F. J.
    Brummer, Robert
    Örebro universitet, Hälsoakademin.
    Durga, J.
    Plasma very long-chain n-3 polyunsaturated fatty acids and age-related hearing loss in older adults2010Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 14, nr 5, s. 347-351Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: Age-related hearing loss is a common social and health problem in the older adult population. Up until now, very little scientific attention has been given to the potential role of fatty acids in age-related hearing loss. In this study we investigated whether plasma very long-chain n-3 polyunsaturated fatty acids (PUFAs) are associated with age-related hearing loss over three years.

    DESIGN: Cross-sectional and 3-year longitudinal analyses.

    SETTING: Wageningen, the Netherlands.

    PARTICIPANTS: 720 men and postmenopausal women (50-70 years of age) without middle ear dysfunction or unilateral hearing loss.

    MEASUREMENTS: Fatty acid proportions were measured in plasma cholesteryl esters. Hearing thresholds (in decibels, dB) at baseline and after three years were measured with pure-tone audiometry. Hearing loss was calculated as the increase in mean hearing thresholds in the low (0.5-kHz, 1-kHz, and 2-kHz) and high (4-kHz, 6-kHz, and 8-kHz) frequencies over three years.

    RESULTS: Subjects in the highest quartile of plasma very long-chain n-3 PUFA had less hearing loss in the low frequencies over three years than subjects in the lowest quartile (p < 0.01, ANCOVA, difference in mean adjusted hearing thresholds= -1.2 dB). There were no significant differences between the quartiles of plasma very long-chain n-3 PUFA in hearing loss in the high frequencies (p=0.49, ANCOVA). These associations are adjusted for baseline mean hearing thresholds, age, sex, level of education and alcohol consumption.

    CONCLUSION: This study is the first to show an inverse association between plasma very long-chain n-3 PUFAs and age-related hearing loss. These results are encouraging, but require confirmation from future studies.

  • 4. Engelheart, S.
    et al.
    Lammes, E.
    Akner, Gunnar
    Örebro universitet, Hälsoakademin.
    Elderly peoples' meals: a comparative study between elderly living in a nursing home and frail, self-managing elderly2006Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 10, nr 2, s. 96-102Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Sweden is one of few countries that have specific recommendations regarding mealtime habits. The importance of mealtime habits for health outcome is inadequately studied in elderly subjects.

    OBJECTIVE: The aim of this study was to investigate the distribution of the daily meals/energy intake; the number of eating episodes per day and subjectively estimated meal-dependent variables (appetite, motivation to eat, sense of taste and sense of smell) and compare the results of elderly living in a nursing home with frail, self-managing elderly living at home.

    DESIGN: Explorative study. All analyses of energy intake were based on food records; weighed in the nursing home and estimated in the frail, self-managing elderly. Participants or contact persons estimated the subjective variables using a 10-point VAS scale.

    RESULTS: On average there were 4-5 daily eating episodes in both groups. The eating episodes were much more widespread over the day in the self-managing elderly, and their length of fasting at night was significantly shorter. The subjects estimated appetite and sense of smell was reduced in about 30-40% in both groups. Sense of taste was reduced in 40 % of the males and 10-20 % of the females. Energy intake was similar in both groups, 25 kcal/kg body weight/day, with more than a threefold variation among individual subjects. Energy intake/kg body weight correlated with a shorter length of fasting at night in the nursing home residents, however, did not correlate with ADL, number of eating episodes per day, appetite, motivation to eat, or senses of taste or smell.

    CONCLUSION: The self-managing elderly had more widespread eating episodes than the elderly in the nursing home, indicating that self-managing elderly exhibit larger variations in food intake preferences, however, without affecting mean energy intake. The lack of correlation between energy intake and estimated appetite, taste and smell is in line with previous findings in elderly.

  • 5.
    Engelheart, Stina
    et al.
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Akner, Gunnar
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Dietary intake of energy, nutrients and water in elderly people living at home or in nursing home2015Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 19, nr 3, s. 265-272Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

    Design: Observational study, analysing prospective data.

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

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

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

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

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

  • 6. Lammes, E.
    et al.
    Akner, Gunnar
    Örebro universitet, Hälsoakademin.
    Repeated assessment of energy and nutrient intake in 52 nursing home residents2006Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 10, nr 3, s. 222-230Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    UNLABELLED: Studies in Swedish nursing-home patients have shown a high prevalence of protein-energy malnutrition. One potential cause for this may be low food intake.

    OBJECTIVE: To examine the intake of energy and nutrients in the residents of a nursing home; to investigate changes in dietary intake and body-weight over time and to analyze two-year-mortality.

    DESIGN: Explorative study. Five-day weighed assessment of food intake repeated three times during 1.5 years. Analysis of body composition at baseline and recording of body weight every third month. Analysis of two-year mortality.

    RESULTS: Fifty-two residents had three complete dietary assessments. Mean age 84 +/- 7 years, 79% were female. Mean body weight was stable at 61 kg. Mean energy intake at baseline was 1501 kcal/d (25 kcal/kg/d) and mean protein intake was 53 g/d (0.9 g/kg/d). Mean intake of vitamin D, vitamin E, folic acid, selenium and dietary fibre was less than 60% of recommended. At the second assessment intake of energy and many nutrients was higher than at baseline, but at the third assessment intake had decreased. There was no correlation between energy intake and body weight over time. Two-year mortality was 52%. Male gender and low body-weight constituted an increased risk of mortality. Comparing survivors and non-survivors showed that the mean body weight was 9 kg higher in the survivors throughout the study (p=0.02). This group had a relatively lower fat free mass and higher fat mass than the non-survivors. The difference in body composition was only seen in females, possibly due to the low number of males. The survivors had higher intakes of most nutrients but this reached significance only for a few of them. The non-survivors had significantly higher intakes of sucrose.

    CONCLUSION: Intake of energy and many nutrients was low in these nursing-home patients, and decreased further after one year, without any change in body weight. The significant positive relation between energy intake and body weight at group level disappeared when analyzing data at an individual level. Male gender and low body weight were associated with increased risk of mortality.

  • 7. Lammes, E.
    et al.
    Akner, Gunnar
    Örebro universitet, Hälsoakademin.
    Resting metabolic rate in elderly nursing home patients with multiple diagnoses2006Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 10, nr 4, s. 263-270Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: In the diseased elderly weight loss and malnutrition are common. It is unclear to what degree this is caused by an elevated resting metabolic rate (RMR), a decreased energy intake or a combination of the two.

    OBJECTIVE: To measure RMR and nutrient induced thermogenesis (NIT) in chronically diseased elderly living in a nursing home and test for a correlation with fat free mass (FFM), age, energy intake and activities of daily living (ADL).

    DESIGN: Explorative study performed in the residents' own apartments. RMR was measured by indirect calorimetry, and NIT was tested by giving the subjects an oral fluid test meal, then measuring metabolic rate again one hour later. Body composition was measured anthropometrically and FFM was calculated. Energy intake was calculated from a five-day record of weighed food. BMR was calculated using four different prediction equations and compared with measured RMR. Results: RMR was 1,174 kcal/d (29.3 kcal/kg FFM/d). The variation in RMR was significantly related to FFM (p < 0.0001). Energy intake was 1,474 kcal/d, (36.5 kcal/kg FFM/d). The energy intake/RMR ratio, was 1.27, and NIT was 15% (0-33%). NIT was not correlated to any of the parameters tested. The equation of Harris and Benedict underestimated BMR by 4%; the WHO/FAO overestimated BMR by 7%; Schofield and an estimate of 20 kcal/kg/d did not significantly differ from the measured mean.

    CONCLUSION: RMR was closely correlated to FFM. Variations in NIT could not be explained by any tested parameters. Predicted BMR differed from measured RMR by less than 8% in all methods, but individual variations were large.

  • 8.
    Lammes, Eva
    et al.
    Department of Laboratory Medicine, Division of Clinical Physiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
    Rydwik, Elisabeth
    Research Unit for the Elderly, North, Jakobsbergs Hospital, Karolinska Institutet, Järfälla, Sweden.
    Akner, Gunnar
    Department of Geriatric medicine, Örebro University Hospital, Örebro, Sweden.
    Effects of nutritional intervention and physical training on energy intake, resting metabolic rate and body composition in frail elderly: a randomised controlled pilot study2012Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 16, nr 2, s. 162-167Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: To analyse the effect of nutritional intervention and physical training on energy intake, resting metabolic rate (RmR) and body composition in the frail elderly. Design: Open, randomised, controlled pilot treatment study.

    Setting: Community-based research centre. Participants: ninety-six community-dwelling frail elderly people aged 75 and older, 40% men.

    Intervention: Four treatment arms: i) individual nutritional advice and group sessions on nutrition for the elderly, ii) physical training 2 x 45 minutes per week for 3 months, 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 body composition (anthropometry) performed at baseline, after 3 months’ intervention (completed by 79 individuals), and as a follow-up at 9 months (completed by 64 individuals).

    Results: The training group showed a significantly increased RmR at 3 months. Otherwise, there were no observed differences within or between the four groups.There was no correlation over time between energy intake, RmR and fat free mass. The participants with a low energy intake who managed to increase their energy intake during the study (‘responders’) had a statistically significantly lower Bmi (21 vs. 24) and a lower fat percentage (23 vs. 30) at baseline than the ‘non-responders.’The ‘non-responders’ showed a small but statistically significant decrease in body fat percentage at F1, and inbody weight, Bmi and FFm at 9 months (F3).

    Conclusion: individual nutrition counselling and physical exercise had no effect on energy intake, RmR or fat free mass in community-dwelling frail elderly people aged 75 and older. interventions in frail elderly people should be targeted according to the needs of the individual patients. The issues of randomisation, targeting and responders in are problematised and discussed.

  • 9.
    Mamhidir, A. G.
    et al.
    Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden and Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden .
    Wimo, A.
    KI Alzheimer’s Disease Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden .
    Kihlgren, Annica
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Fewer referrals to Swedish emergency departments among nursing home patients with dementia, comprehensive cognitive decline and multicomorbidity2012Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 16, nr 10, s. 891-7Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: The objective was to describe the extent to which nursing home patients had cognitive impairments and were diagnosed with dementia. Furthermore, to describe and compare multicomorbidity, health status and drug use in the three subgroups; dementia diagnosis/not referred, dementia diagnosis/referred and no dementia diagnosis/not referred to an emergency department (ED) over a one-year period.

    Methods: A cross-sectional follow-up study was carried out in Sweden. RAI/MDS assessments were conducted on 719 patients in 24 nursing homes, of whom 209 were referred to EDs during a one-year period, accounting for 314 visits. This study involved an extensive examination of the population.

    Results: The 719 patients were reported to suffer from comprehensive cognitive impairments, which not accorded with the dementia diagnoses, they were significantly fewer. Cognitive decline or dementia diagnosis contributed to a significant decrease of referrals to EDs. Patients with dementia diagnosis/not referred had difficulties understanding others, as well as impaired vision and hearing. Patients with dementia diagnosis/referred usually understood messages. Low BMI, daily pain, multicomorbidity and high drug consumption occurred in all groups. Patients with no dementia diagnosis/not referred had significantly less multicomorbidity. Neuroleptica was significantly more prevalent among those with dementia diagnosis.

    Conclusion: Dementia remains undetected. Patients with cognitive decline and dementia are probably as sick as or even worse than others but may, due to low priority be undertreated or referrals avoided with the objective to provide good care in the setting. Observational studies are needed to identify what is done and could be done in referral situations.

  • 10.
    Mamhidir, Anna-Greta
    et al.
    Högskolan i Gävle, Gävle, Sweden.
    Ljunggren, G
    Karolinska Institutet, Stockholm, Sweden.
    Kihlgren, Mona
    Örebro universitet, Institutionen för vårdvetenskap och omsorg.
    Kihlgren, Annica
    Örebro universitet, Institutionen för hälsovetenskap och medicin.
    Wimo, A
    Karolinska Institutet, Stockholm, Sweden.
    Underweight, weight loss and related risk factors among older adults in sheltered housing: a Swedish follow-up study2006Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 10, nr 4, s. 255-262Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Underweight and weight loss are important factors in detecting malnutrition.

    OBJECTIVE: To describe underweight, weight loss and related nutritional factors after 12 months among individuals 75 years or older and living in sheltered housing. A further aim was to identify possible risk factors associated with underweight and weight loss.

    DESIGN: This is a part of a cross-sectional follow-up study from a county in Sweden, examining the disabilities, resources and needs of 719 older adults in sheltered housing units. Data were collected twice, with a 12-month interval using the Resident Assessment Instrument.

    RESULTS: Among the 503 remaining chronically ill individuals with cognitive and functional disabilities, 35% were classified as underweight at the initial assessment and 38% at the second, a non-significant difference. A further analysis showed 39% had decreased weight, 27% remained stable and 28% gained weight. A weight loss of 5% occurred in 27% of the older adults and a loss of 10% occurred in 14%. Risk factors associated with being underweight and weight loss, using scales derived from the instrument were cognitive and functional decline. Dementia and Parkinson's disease, eating dependencies and constipation were the strongest risk factors when analyzed as single items.

    CONCLUSION: A high percentage was underweight or exhibited weight loss and several risk factors were identified. Ensuring adequate nutritional status in individuals with a variety of diseases and declining health status is challenging. Increased combined efforts using a wide range of measures, nutritional programs and routines need to be regularly implemented.

  • 11.
    Marisca-Arcas, M.
    et al.
    Department of Nutrition and Food Science, University of Granada, Granada, Spain.
    Caballero-Plasencia, M. L. A.
    Concejalia de Salud del Excmo, Ayuntamiento de Granada, Granada, Spain.
    Monteagudo, Celia
    Department of Nutrition and Food Science, University of Granada, Granada, Spain.
    Hamdan, M.
    Department of Nutrition and Food Science, University of Granada, Granada, Spain.
    Pardo-Vasquez, M. I.
    Department of Nutrition and Food Science, University of Granada, Granada, Spain.
    Olea-Serrano, F.
    Department of Nutrition and Food Science, University of Granada, Granada, Spain.
    Validation of questionnaires to estimate adherence to the Mediterranean diet and life habits in older individuals in Southern Spain2011Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 15, nr 9, s. 739-743Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: The aim of the present study was to determine the nutritional behaviour of an elderly urban population in Southern Spain, estimating their degree of adherence to the Mediterranean.

    DIET DESIGN: A population-based cross-sectional nutritional survey, recruiting a representative sample of elderly inhabitants. The study sample comprised 260 people. The mean age was 73.60 yrs for the men and 72.25 yrs for the women. Around 70% lived with their family.

    RESULTS: The questionnaires used were first validated by using the Bland-Altman plot and the Wilcoxon test for paired samples. The degree of adherence to the Mediterranean Diet was around 50%, similar to findings in other Mediterranean populations. We highlight the mean consumption of milk and milk products (300-317 g/day) and of fruit/vegetables (250 g/day), which are slightly below recommendations. Our study subjects were all autonomous in their movements and were physically independent: 80% reported that they performed some type of physical activity.

    CONCLUSION: In this study, both adherence to the Mediterranean Diet and physical activity were considered as components of a healthy life. In summary, a majority of this elderly population was slightly overweight, considered themselves to be in good health.

  • 12.
    Monteagudo, Celia
    et al.
    Örebro universitet, Restaurang- och hotellhögskolan. Department of Health Sciences, EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, Vrije University, Amsterdam, The Netherlands; Research Group “Nutrition, Diet and Risk Assessment” (AGR-255), Department Nutrition and Food Science, University of Granada, Granada, Spain.
    Dijkstra, S. C.
    Department of Health Sciences and the EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, Vrije University, Amsterdam, The Netherlands.
    Visser, M.
    Department of Health Sciences, EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, Vrije University, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, Vrije University Medical Center, Amsterdam, The Netherlands.
    Self-perception of body weight status in older Dutch adults2015Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 19, nr 6, s. 612-618Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    INTRODUCTION:

    OBJECTIVES: The prevalence of obesity is highest in older persons and a correct self-perception of body weight status is necessary for optimal weight control. The aim of this study was to determine self-perception of, and satisfaction with, body weight status, and to compare current versus ideal body image in a large, nationally representative sample of older people. Furthermore, determinants of misperception were explored.

    DESIGN: A cross-sectional study.

    SETTING: The Longitudinal Aging Study Amsterdam (LASA), conducted in a population-based sample in the Netherlands.

    PARTICIPANTS: 1295 men and women aged 60-96 years.

    MEASUREMENTS: Body weight status was assessed using measured weight and height. Self-perceived body weight status, satisfaction with body weight and current and ideal body image were also assessed. Multiple logistic regression analysis was used to investigate the association of age, educational level and objectively measured BMI with underestimation of body weight status.

    RESULTS: The prevalence of obesity was 19.9% in men and 29.3% in women. The agreement between objective and self-perceived body weight status was low (Kappa < 0.2). Among overweight and obese persons, 42.1% of men and 44.1% of women were (very) dissatisfied with their body weight status and >99% of obese participants desired to be thinner (ideal body image < current image). Only 4.4% of obese men and 12.3% of obese women perceived their body weight status correctly. Higher age (women), lower educational level (men) and higher BMI (all) were associated with greater underestimation of body weight status.

    CONCLUSION: Many older persons misperceive their body weight status. Future actions to improve body weight perception in older persons are necessary to increase the impact of public health campaigns focussing on a healthy body weight in old age.

  • 13.
    Wengström, Yvonne
    et al.
    Department of Social and Welfare Studies, , Unit of Research and Development in Local Health Care, University of Linköping , Linköping, Sweden .
    Wahren, Lis Karin
    Department of Social and Welfare Studies, , Unit of Research and Development in Local Health Care, University of Linköping , Linköping, Sweden .
    Grodzinsky, Ewa
    Faculty of Health Sciences, University of Linköping and Norrköping, Unit of Research and Development in Local Health Care, Sweden .
    Importance of dietary advice, nutritional supplements and compliance for maintaining body weight and body fat after hip fracture2009Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 13, nr 7, s. 632-638Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Poor nutritional status amongst elderly individuals with hip fractures is well documented. Studies have suggested that 30-50 % of patients admitted to orthopaedic departments suffer from protein-energy malnutrition (PEM). An 6 month intervention study. The study was conducted in Sweden between February 2005 and October 2006. Elderly patients with hip fractures (n=32). Evaluation of compliance with individual nutritional support and whether body weight and body fat (BF) could be maintained after six months. Evaluation of possible effects of nutritional supplements and dietary advice after hip fracture on BMI, BF, and Mini Nutritional Assessment (MNA). Overall compliance with supplement intake was 73%. After six months, BMI was unchanged. Women's BF had decreased (P < 0.01), although the mean calorie intake with nutritional support was 34 calories per kg body weight/day. Three groups could be identified: one group with increased body weight and BF, one with loss of body weight and BF, and one with increased body weight together with increased TBW and loss of BF. Participants who consumed 0-1 supplements daily lost more weight than those who consumed 2 supplements daily. There was a positive difference (p=< 0.001) for women between MNA values at baseline and after six months. In the present study compliance was satisfactory at the group level, and the energy and protein intake increased significantly. BMI was unchanged during the 6 months period. However, the women lost BF during the study period of with some had increasing total body water (TBW). MNA values for women changed in a positive direction.

  • 14.
    Ödlund Olin, A
    et al.
    Department of Nursing Development, Karolinska University Hospital, Stockholm; Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm.
    Koochek, A
    Centre for Family and Community Medicine Karolinska Institutet, Stockholm.
    Cederholm, T
    Ljungqvist, Olle
    Department of Clinical Science Intervention and Technology, Karolinska Institutet, Stockholm; Centre of Gastrointestinal Disease, Ersta Hospital, Stockholm.
    Minimal effect on energy intake by additional evening meal for frail elderly service flat residents: a pilot study2008Inngår i: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 12, nr 5, s. 295-301Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Nutritional problems are common in frail elderly individuals receiving municipal care.

    Objective: To evaluate if an additional evening meal could improve total daily food intake, nutritional status, and health-related quality of life (HRQOL) in frail elderly service flat (SF) residents.

    Design: Out of 122 residents in two SF complexes, 60 subjects agreed to participate, of which 49 subjects (median 84 (79-90) years, (25th-75th percentile)) completed the study. For six months 23 residents in one SF complex were served 530 kcal in addition to their regular meals, i.e. intervention group (I-group). Twenty-six residents in the other SF building were controls (C-group). Nutritional status, energy and nutrient intake, length of night time fast, cognitive function and HRQOL was assessed before and after the intervention.

    Results: At the start, the Mini Nutritional Assessment classified 27% as malnourished and 63% as at risk for malnutrition, with no difference between the groups. After six months the median body weight was unchanged in the I-group, +0.6 (-1.7-+1.6) kg (p=0.72) and the C-group -0.6 (-2.0-+0.5) kg (p=0.15). Weight change ranged from -13% to +15%. The evening meal improved the protein and carbohydrate intake (p<0.01) but the energy intake increased by only 180 kcal/day (p=0.15). The night time fast decreased in the I-group from 15.0 (13.0-16.0) to 13.0 (12.0-14.0) hours (p<0.05). There was no significant difference in cognitive function or HRQOL between the groups.

    CONCLUSION: Nine out of ten frail elderly SF residents had nutritional problems. Serving an additional evening meal increased the protein and carbohydrate intake, but the meal had no significant effect on energy intake, body weight or HRQOL. The variation in outcome within each study group was large.

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