İki aylık proteinden zengin beslenme önerileri malnütrisyon riski altındaki yaşlı hastalarda nütrisyonel durumu düzeltir ve vücut yağ oranını azaltır
Öz
Amaç: Bu çalışmada; proteinden zengin beslenme (PZB) programının malnütrisyon riski (MR) altındaki yaşlı hastalarda vücut kompozisyonuna etkisinin araştırılması amaçlanmıştır.
Gereç ve Yöntem: İç Hastalıkları Diyet polikliniğine başvuran, kognitif sorunları, diyabeti ve renal hastalığı olmayan ≥65 yaş bireyler taranarak, çalışmaya normal nütrisyonel durum (ND)’da 30 yaşlı, MR altında 30 yaşlı alınması planlandı. Vücut kompozisyonu, ND, antropometrik değerlendirmeler yapıldı. Malnütrisyon riski altındaki bireylere PZB programı eğitimi verildi. İki aylık program sonrasında tüm değerlendirmeler her iki grupta tekrarlandı.
Bulgular: Çalışmaya 60 yaşlı dahil edildi (yaş ortalaması 72,5 ± 6,2; Kadın / Erkek: %63,3 / %36,7). İkinci ay sonunda MR altındaki grupta (n = 30): ortalama vücut yağ oranı azalmış (P = 0,036), total vücut suyu ve Mini Nütrisyonel Değerlendirme Kısa Form (MND – KF) skoru artmış bulundu (P =0,020 ve P < 0,001). Ortalama vücut ağırlığı (VA), vücut kitle indeksi (VKİ), bel - kalça çevresi, yağ kütlesi, yağsız vücut kitlesi (FFM) ve baldır çevresi ölçümleri ise benzer bulundu. Normal ND’daki
grupta (n = 30) ölçülen ortalama VA, bel - kalça çevresi, yağ kütlesi, FFM, ve baldır çevresi ölçümlerinde anlamlı düşüş gözlenirken (sırasıyla; P = 0,001, P = 0,021, P = 0,016, P = 0,025, P =0,002, P = 0,017), VKİ, yağ yüzdesi, toplam vücut suyu ve MND-KF skorları iki ölçümde benzerdi.
Sonuç: PZB önerilen MR altındaki yaşlılarda ND düzelirken, yağ oranı azalmıştır. Normal ND’daki genel öneriler verilen yaşlılarda ise VA, bel - kalça çevresi, yağ kütlesi, FFM, ve baldır çevresi ölçümlerinde anlamlı düşüş gözlenmiştir. İleri yaştaki hastaların bakımında uygun hastalarda PZB önerileri yapılmalıdır.
Anahtar Kelimeler
Yaşlı malnütrisyon vücut kompozisyonu program beslenme tedavisi protein
Kaynakça
- Savas S. Geriatrik olgularda sarkopeni immobilite ilişkisi. Turkiye Klinikleri J Geriatr-Special Topics 2017; 3 (3): 201-5.
- Savaş S. Prevention of sarcopenia. Ege Journal of Medicine 2015; 54: 46-50.
- Cramer JT, Cruz-Jentoft AJ, Landi F, et al. Impacts of High-Protein Oral Nutritional Supplements Among Malnourished Men and Women with Sarcopenia: A Multicenter, Randomized, Double-Blinded, Controlled Trial. JAMDA 2016; 17 (11): 1044-55.
- Vellas B, Villars H, Abellan G, et al. Overview of the MNA® - Its History and Challenges. J Nutr Health Aging 2006; 10: 456-65.
- Guigoz Y. The Mini-Nutritional Assessment (MNA®) Review of the Literature - What does it tell us? J Nutr Health Aging 2006; 10: 466-87.
- Khaw KT, Wareham N, Bingham S, Welch A, Luben R, Day N. Combined impact of health behaviours and mortality in men and women: the EPIC-Norfolk prospective population study. Plos Med 2008; 5 (1): e12.
- Feldblum I, German L, Castel H, et al. Characteristics of undernourished older medical patiens and the identification of predictors for undernutrition status. Nutritional Journal 2007; 6 (37): 1-9.
- El Zoghbi M, Boulos C, Awada S, et al. Prevalence of Malnutrition and Its Correlates in Older Adults Living in Long Stay Institutions Situated in Beirut, Lebanon. J Res Health Sci 2014; 14 (1): 11-7.
- Damião R, Santos ASS, Matijasevich A, Menezes PR. Factors associated with risk of malnutrition in the elderly in south-eastern Brazil. Rev Bras Epidemiol 2017; 20 (4): 598-610.
- Kshatriya GK, Acharya SK. Gender Disparities in the Prevalence of Undernutrition and the Higher Risk among the Young Women of Indian Tribes. PloS one 2016; 11 (7): e0158308.
- Nykanen I, Lonnroos E, Kautiainen H, Sulkava R, Hartikainen S. Nutritional screening in a population-based cohort of community-dwelling older people. Eur J Public Health 2013; 23 (3): 405-9.
- Rasheed S, Woods RT. An investigation into the association between nutritional status and quality of life in older people admitted to hospital. J Hum Nutr Diet 2014; 27 (2): 142-51.
- Malara A, Sgro G, Caruso C, et al. Relationship between cognitif impairment and nutritional assessment on functional status in Calabrian longterm-care. Clin Interv Aging 2014; 2014 (9): 105-10.
- Schneider SM, Correia MITD. Epidemiology of weight loss, malnutrition and sarcopenia: A transatlantic view. Nutrition 2020; 69: 110581.
- Symons TB, Schutzler SE, Cocke TL, Chinkes DL, Wolfe RR, Paddon-Jones D.Aging does not impair the anabolic response to a protein-rich meal. Am J ClinNutr 2007; 86: 451e6.
- Katsanos CS, Kobayashi H, Sheffield-Moore M, Aarsland A, Wolfe RR. A highproportion of leucine is required for optimal stimulation of the rate of muscle protein synthesis by essential amino acids in the elderly. Am J Physiol Endocrinol Metab 2006; 291: E381e7.
- Nieuwenhuizen WF, Weenen H, Rigby P, Hetherington MM. Older adults and patients in need of nutritional support: review of current treatment optionsand factors influencing nutritional intake. Clin Nutr 2010; 29 (2): 160e9.
- Bouillanne O, Curis E, Hamon-Vilcot B, et al. Impact of protein pulse feeding on lean mass in malnourished and at risk hospitalized elderly patients: A randomized controlled trial. Clin Nutr 2013; 32 (2): 186-92.
- Arnal M, Mosoni L, Boirie Y, et al. Protein pulse feeding improves protein retention in elderly women. Am J Clin Nutr 1999; 69: 1202e8.52.
- Stelten S, Dekker IM, Ronday EM, et al. Protein-enriched regular products and their effect on protein "..intake in.." acute hospitalized older adults; a randomized controlled trial. Clin Nutr 2015; 34 (3): 409-14.
- Alemán-Mateo H, Carreón VR, Macías L, Astiazaran-García H, Gallegos-Aguilar AC, Enríquez JR. Nutrientrich dairy proteins improve appendicular skeletal muscle mass and physical performance, and attenuate the loss of muscle strength in older men and women subjects: a single-blind randomized clinical trial. Clin Interv Aging 2014; 9: 1517-25.
- Lo JH, U KP, Yiu T, Ong MT, Lee WY. Sarcopenia: Current treatments and new regenerative therapeutic approaches. J Orthop Translat 2020; 30; 23: 38-52.
Two months of protein–rich dietary recommendations for older patients at risk of malnutrition improves nutritional status, and decreases body fat percentage
Öz
Aim: It is aimed to evaluate the impact of protein – rich dietary (PRD) recommendations on the body composition of older patients at malnutrition risk (MR) in this study.
Materials and Methods: Patients ≥65 years of age, without cognitive problems, diabetes, renal diseases, admitted to Internal Medicine Nutrition Outpatient Clinic consecutively were screened, and 30 patients in normal nutritional status (NS), 30 patients at MR were planned to be enrolled. Body compositions, NS, and anthropometric measurements were performed. Patients at MR were trained for PRD recommendations. Evaluations were repeated in both groups after two months.
Results: Sixty older patients were enrolled (mean age 72.5 ± 6.2; Female / Male: %63.3 / %36.7). After two months; in the group at MR (n = 30); there was a significant decrease in mean body fat ratio (P = 0.036), increase in body water ratio and Mini Nutritional Assessmnet – Short Form (MNA-SF)
score (P = 0.020 and P < 0.001). Mean body weight (BW) , body mass index (BMI), waist – hip circumference, fat mass, fat free mass (FFM) and calf circumference were similar. In the normal NS group (n = 30) mean BW, waist – hip circumference, fat mass, FFM, calf circumference values
significantly decreased (P = 0.001, P = 0.021, P = 0.016, P = 0.025, P = 0.002, P = 0.017, respectively), and BMI, fat ratio, body water and MNA – SF scores were similar.
Conclusion: In the group at MR, PRD recommendations improved NS, and fat ratio decreased. In patients given general nutritional recommendations with normal NS; BW, waist – hip circumference, fat mass, FFM, and calf circumference decreased. PRD recommendations should be given for the care of appropriate older patients.
Anahtar Kelimeler
Aged, malnutrition body composition program nutrition therapy proteins
Kaynakça
- Savas S. Geriatrik olgularda sarkopeni immobilite ilişkisi. Turkiye Klinikleri J Geriatr-Special Topics 2017; 3 (3): 201-5.
- Savaş S. Prevention of sarcopenia. Ege Journal of Medicine 2015; 54: 46-50.
- Cramer JT, Cruz-Jentoft AJ, Landi F, et al. Impacts of High-Protein Oral Nutritional Supplements Among Malnourished Men and Women with Sarcopenia: A Multicenter, Randomized, Double-Blinded, Controlled Trial. JAMDA 2016; 17 (11): 1044-55.
- Vellas B, Villars H, Abellan G, et al. Overview of the MNA® - Its History and Challenges. J Nutr Health Aging 2006; 10: 456-65.
- Guigoz Y. The Mini-Nutritional Assessment (MNA®) Review of the Literature - What does it tell us? J Nutr Health Aging 2006; 10: 466-87.
- Khaw KT, Wareham N, Bingham S, Welch A, Luben R, Day N. Combined impact of health behaviours and mortality in men and women: the EPIC-Norfolk prospective population study. Plos Med 2008; 5 (1): e12.
- Feldblum I, German L, Castel H, et al. Characteristics of undernourished older medical patiens and the identification of predictors for undernutrition status. Nutritional Journal 2007; 6 (37): 1-9.
- El Zoghbi M, Boulos C, Awada S, et al. Prevalence of Malnutrition and Its Correlates in Older Adults Living in Long Stay Institutions Situated in Beirut, Lebanon. J Res Health Sci 2014; 14 (1): 11-7.
- Damião R, Santos ASS, Matijasevich A, Menezes PR. Factors associated with risk of malnutrition in the elderly in south-eastern Brazil. Rev Bras Epidemiol 2017; 20 (4): 598-610.
- Kshatriya GK, Acharya SK. Gender Disparities in the Prevalence of Undernutrition and the Higher Risk among the Young Women of Indian Tribes. PloS one 2016; 11 (7): e0158308.
- Nykanen I, Lonnroos E, Kautiainen H, Sulkava R, Hartikainen S. Nutritional screening in a population-based cohort of community-dwelling older people. Eur J Public Health 2013; 23 (3): 405-9.
- Rasheed S, Woods RT. An investigation into the association between nutritional status and quality of life in older people admitted to hospital. J Hum Nutr Diet 2014; 27 (2): 142-51.
- Malara A, Sgro G, Caruso C, et al. Relationship between cognitif impairment and nutritional assessment on functional status in Calabrian longterm-care. Clin Interv Aging 2014; 2014 (9): 105-10.
- Schneider SM, Correia MITD. Epidemiology of weight loss, malnutrition and sarcopenia: A transatlantic view. Nutrition 2020; 69: 110581.
- Symons TB, Schutzler SE, Cocke TL, Chinkes DL, Wolfe RR, Paddon-Jones D.Aging does not impair the anabolic response to a protein-rich meal. Am J ClinNutr 2007; 86: 451e6.
- Katsanos CS, Kobayashi H, Sheffield-Moore M, Aarsland A, Wolfe RR. A highproportion of leucine is required for optimal stimulation of the rate of muscle protein synthesis by essential amino acids in the elderly. Am J Physiol Endocrinol Metab 2006; 291: E381e7.
- Nieuwenhuizen WF, Weenen H, Rigby P, Hetherington MM. Older adults and patients in need of nutritional support: review of current treatment optionsand factors influencing nutritional intake. Clin Nutr 2010; 29 (2): 160e9.
- Bouillanne O, Curis E, Hamon-Vilcot B, et al. Impact of protein pulse feeding on lean mass in malnourished and at risk hospitalized elderly patients: A randomized controlled trial. Clin Nutr 2013; 32 (2): 186-92.
- Arnal M, Mosoni L, Boirie Y, et al. Protein pulse feeding improves protein retention in elderly women. Am J Clin Nutr 1999; 69: 1202e8.52.
- Stelten S, Dekker IM, Ronday EM, et al. Protein-enriched regular products and their effect on protein "..intake in.." acute hospitalized older adults; a randomized controlled trial. Clin Nutr 2015; 34 (3): 409-14.
- Alemán-Mateo H, Carreón VR, Macías L, Astiazaran-García H, Gallegos-Aguilar AC, Enríquez JR. Nutrientrich dairy proteins improve appendicular skeletal muscle mass and physical performance, and attenuate the loss of muscle strength in older men and women subjects: a single-blind randomized clinical trial. Clin Interv Aging 2014; 9: 1517-25.
- Lo JH, U KP, Yiu T, Ong MT, Lee WY. Sarcopenia: Current treatments and new regenerative therapeutic approaches. J Orthop Translat 2020; 30; 23: 38-52.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 19 Nisan 2021 |
| Gönderilme Tarihi | 18 Ocak 2021 |
| Yayımlandığı Sayı | Yıl 2021Cilt: 60 Özel Sayı: 1 (Geriatri) |
