Adult Nutrition Research Articles

General Practitioners’ Perspective towards Healthy Ageing in Indonesia

Background: The rapid ageing population among older adults from 2020 to 2040 has led to an emerging focus as this group begins to experience ageing and has a higher risk of having chronic illness of non-communicable diseases. Therefore, it is important to provide General Practitioners (GPs) with adequate knowledge and attitude of healthy ageing to ensure the quality of health service among older adults.Objectives: To identify the perspective of general practitioners including the knowledge, attitude and practice towards adult health and nutrition to support healthy ageing in Indonesia.Methods: An online survey was conducted among 100 general practitioners registered at the Indonesian Medical Council (KKI) and domiciled in the Greater Jakarta area and outside the Jabodetabek area. The sample recruitment process was carried out using the Alomedika online application. All data were analyzed using SPSS software.Results: Almost all (92%) of respondents who took this survey had a supportive attitude in providing additional nutrition to adults to support healthy ageing. About 76% of the respondents did so by recommending milk. However, in terms of knowledge, around 67% of the respondents showed inadequate results, especially about physiological changes that occurred in adults. There is no statistically significant difference between respondents’ demographic characteristics and all perspectives measured in this study (i.e., knowledge, attitude and practice)Conclusions: The study indicates that it is important to educate general practitioners about the healthy aging process in order to maintain general practitioners' attitudes and behavior in health services to support the success of achieving healthy aging in Indonesia.

The Influence of Dysphagia on Nutritional and Frailty Status among Community-Dwelling Older Adults.

Malnutrition is a core symptom of the frailty cycle in older adults. The purpose of this study was to investigate whether dysphagia influences nutrition or frailty status in community-dwelling older adults. The study participants were 320 Japanese community-dwelling older adults aged ≥65 years. All participants completed a questionnaire survey that included items on age, sex, family structure, self-rated health, nutritional and frailty status, and swallowing function. Nutritional status was categorized as malnourished, at risk of malnutrition, and well-nourished based on the Mini Nutrition Assessment-Short Form. The participants were then classified into a malnutrition (malnourished/at risk) or a well-nourished group (well-nourished). Frailty was assessed using the Cardiovascular Health Study criteria. The participants were then divided into a frailty (frail/pre-frail) or a non-frailty group (robust). Dysphagia was screened using the 10-item Eating Assessment Tool. Multiple logistic regression analysis was conducted to determine whether dysphagia was associated with nutritional or frailty status. The results revealed that dysphagia influenced both nutrition (odds ratio [OR]: 4.0; 95% confidence interval [CI]: 1.9–8.2) and frailty status (OR: 2.3; 95% CI: 1.0–5.2); therefore, the swallowing function would be an important factor for community-dwelling older adults on frailty prevention programs.

Enteral Nutrition With High-Dose Vasopressors.

Enteral Nutrition With High-Dose Vasopressors.

Personalised nutrition for older adults: design challenges, SME barriers, and options and competencies for innovation

Personalised nutrition (PN) products and services have the potential to enhance the health and quality of life of older adults. However, PN innovation is challenging and requires specific competencies and supportive collaborations. This paper reports findings from a Collective Intelligence Scenario-Based Design session conducted with PN experts as part of the Horizon 2020 project INCluSilver, which aims to support the development of products, services, and systems that improve the health and quality of life of older adults through innovation in PN. Experts identified challenges to the design of PN products and services and barriers that small and medium enterprises (SMEs) face when innovating PN products and services for older adults. Options to address these barriers were generated and specific SME competencies supporting PN innovation were identified. This study provides a useful framework for understanding the challenges, opportunities, and key competencies needed to innovate PN products and services for older adults.

The Potential of Multi-Biomarker Panels in Nutrition Research: Total Fruit Intake as an Example.

Dietary and food intake biomarkers offer the potential of improving the accuracy of dietary assessment. An extensive range of putative intake biomarkers of commonly consumed foods have been identified to date. As the field of food intake biomarkers progresses toward solving the complexities of dietary habits, combining biomarkers associated with single foods or food groups may be required. The objective of this work was to examine the ability of a multi-biomarker panel to classify individuals into categories of fruit intake. Biomarker data was measured using 1H NMR spectroscopy in two studies: (1) An intervention study where varying amounts of fruit was consumed and (2) the National Adult Nutrition Survey (NANS). Using data from an intervention study a biomarker panel (Proline betaine, Hippurate, and Xylose) was constructed from three urinary biomarker concentrations. Biomarker cut-off values for three categories of fruit intake were developed. The biomarker sum cut-offs were ≤ 4.766, 4.766–5.976, >5.976 μM/mOsm/kg for <100, 101–160, and >160 g fruit intake. The ability of the biomarker sum to classify individuals into categories of fruit intake was examined in the cross-sectional study (NANS) (N = 565). Examination of results in the cross-sectional study revealed excellent agreement with self-reported intake: a similar number of participants were ranked into each category of fruit intake. The work illustrates the potential of multi-biomarker panels and paves the way forward for further development in the field. The use of such panels may be key to distinguishing foods and adding specificity to the predictions of food intake.

Ethanol-Enriched Substrate Facilitates Ambrosia Beetle Fungi, but Inhibits Their Pathogens and Fungal Symbionts of Bark Beetles.

Bark beetles (sensu lato) colonize woody tissues like phloem or xylem and are associated with a broad range of micro-organisms. Specific fungi in the ascomycete orders Hypocreales, Microascales and Ophistomatales as well as the basidiomycete Russulales have been found to be of high importance for successful tree colonization and reproduction in many species. While fungal mutualisms are facultative for most phloem-colonizing bark beetles (sensu stricto), xylem-colonizing ambrosia beetles are long known to obligatorily depend on mutualistic fungi for nutrition of adults and larvae. Recently, a defensive role of fungal mutualists for their ambrosia beetle hosts was revealed: Few tested mutualists outcompeted other beetle-antagonistic fungi by their ability to produce, detoxify and metabolize ethanol, which is naturally occurring in stressed and/or dying trees that many ambrosia beetle species preferentially colonize. Here, we aim to test (i) how widespread beneficial effects of ethanol are among the independently evolved lineages of ambrosia beetle fungal mutualists and (ii) whether it is also present in common fungal symbionts of two bark beetle species (Ips typographus, Dendroctonus ponderosae) and some general fungal antagonists of bark and ambrosia beetle species. The majority of mutualistic ambrosia beetle fungi tested benefited (or at least were not harmed) by the presence of ethanol in terms of growth parameters (e.g., biomass), whereas fungal antagonists were inhibited. This confirms the competitive advantage of nutritional mutualists in the beetle’s preferred, ethanol-containing host material. Even though most bark beetle fungi are found in the same phylogenetic lineages and ancestral to the ambrosia beetle (sensu stricto) fungi, most of them were highly negatively affected by ethanol and only a nutritional mutualist of Dendroctonus ponderosae benefited, however. This suggests that ethanol tolerance is a derived trait in nutritional fungal mutualists, particularly in ambrosia beetles that show cooperative farming of their fungi.

Nutrition and Physical Activity Clinical Practice Guidelines for Older Adults Living with Frailty

BackgroundWe developed clinical practice guidelines to provide health care providers with evidence-based recommendations for decisions related to the effective management of frailty and pre-frailty using nutrition and physical activity interventions.MethodsWe based the recommendations on two systematic reviews with meta-analyses. Nutrition, physical activity, and combined nutrition and physical activity interventions for adults ≥65y were considered if study populations were identified as frail using a frailty tool or assessment. Risk of bias and certainty of evidence were evaluated. We included physical outcomes, mobility, frailty, cognitive function, activities of daily living, falls, quality of life, diet quality, energy/fatigue levels, health services use, and caregiver outcomes.ResultsOverall, mobility improvements were moderate with nutritional strategies that optimize dietary intake, various types of physical activity interventions, and interventions that combine nutrition and physical activity. Physical outcomes, such as body mass and muscle strength, improved moderately with nutritional strategies and interventions that combined nutrition with physical activity. Frailty status improved with multi-component physical activity interventions. Strong recommendations include optimizing dietary intake, performing physical activity, and adopting interventions that combine nutrition and physical activity. We strongly recommend various types of physical activity including muscle strengthening activities, mobilization or rehabilitation exercises, and multi-component physical activity interventions.InterpretationTailored nutrition and physical activity interventions based on individual goals and health status are associated with improved clinical and physical outcomes. While the recommendations facilitate shared decision-making, we identified sparse application of validated frailty assessments and lack of standardized research outcomes as critical gaps in knowledge.

Posicionamento BRASPEN sobre o uso de micronutrientes via parenteral em adultos

Introduction: micronutrients (vitamins and oligoelements) are essential components in human nutrition. Usually, they are obtained through a varied and balanced diet. However, when patients are stricken with some diseases, it is often necessary to utilize alternative feeding methods, which can interfere in micronutrient availability and acquisition. The objective of this work is to promote the rational use of micronutrients in parenteral nutrition to doctors and other staff in the multidisciplinary nutritional therapy team (MNTT). Methods: the text reflects a compilation of the current guidelines and literature by experienced healthcare workers in adult parenteral nutrition therapy (PNT). Results: in cases of severe illness, the micronutrient concentration deficiency must be corrected in order to improve clinical results. The correction is necessary due to the negative effects micronutrient deficiency have on antioxidant defense mechanisms, metabolic and general immunologic pathways. Final considerations: the present document has the intention of contributing the rational use of micronutrients as a daily integrant of the safe and responsible supply of nutrients in parenteral nutrition.

What's the score? Adaptation of probability of adequate nutrient intake scores to the National Adult Nutrition Survey database using European reference values

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Preventing and Managing Chronic Conditions In Older Adults: Lessons Learned From the NHATS and NSOC 2017

According to the Centers for Disease Control, 85% of older adults have at least one chronic health condition, and 60% percent have at least two chronic conditions. This symposium explores strategies to prevent and manage chronic conditions (nutritional status, medication management, wound care, and physical function) using data from the 2017 National Health and Aging Trends Study (NHATS) and corresponding National Study on Caregiving (NSOC). The datasets include a nationally representative sample of US older adults (NHATS) and their caregivers (NSOC). In addition to survey questions, the 2017 NHATS cohort submitted dried blood samples which include inflammatory biomarkers (hs-C reactive protein [hsCRP] and interleukin-6 [IL-6]). All individual presentations report on weighted data from the analysis to more accurately reflect the US population. In the first paper, DiMaria-Ghalili explores the prevalence of and factors related to malnutrition in community-dwelling and residential living older adults. In the second paper Coates examines the extent to which source of purchased medications impacts the occurrence of self-reported medication mistakes and hospitalizations in community-dwelling participants who managed medications independently. In the third paper, Hathaway compares the socio-demographic, nutrition, and inflammatory profile of older adults with and without wounds. In the fourth paper, Sefcik examines the relationship between the frequency of community-dwelling older adults going outside and physical function. Collectively, findings provide insight into the experiences of vulnerable older adults with chronic conditions informed from the NHATS and NSOC datasets. The symposium will conclude with a discussion by Monturo on implications for research, policy and practice.

A Review of the Evidence Base for Nutrition and Nutritional Supplements in Older Adults with Bipolar Disorder: A report from the OABD task force.

To better understand the role of nutrition in older adults (aged 50 years or older) with bipolar disorders (OABD), we conducted a systematic review of the literature and appraise existing evidence. Following PRISMA guidelines, we searched databases including Medline/PubMed, PsychINFO, EMBASE, CINAHL, Scopus, Web of Science, Cochrane Register, FDA website, and clinical trial registries through 2019 for eligible reports. The search string combined MeSH terms for bipolar disorder, nutrition and older adults. This was supplemented by snowball searching of references in relevant studies and authors were contacted to request their work where necessary. All included studies were rated with the National Institutes of Health Study Quality Assessment Tools based on study designs. Of 2280 papers screened, ten studies including eight observational and two interventional studies. The topic foci of the papers examined several nutrients, (including vitamin B12, vitamin D, coenzyme Q10, homocysteine, and folate), nutritional deficiencies and biochemical correlates. The prevalence rates of deficiencies varied with specific nutrients (3.7% to 71.6% for Vitamin B12 and 34.6% for Vitamin D), and between inpatient versus outpatient populations. While nutritional interventions appeared to be associated with improvement in both affective and cognitive outcomes, the sample sizes of OABD varied and were generally small. While there is evidence for the benefits of nutritional interventions on affective, cognitive and overall outcome in OABD, the quality of the evidence is limited. Our findings underscore the need for high quality studies to inform evidence-based guidelines for nutritional assessment and supplemention in OABD.

Highlights from the literature

This prospective observational study evaluated the role of teduglutide, a semisynthetic analogue of glucagon-like peptide-2 (sGLP-2), in reducing the need for parenteral nutrition in adults with short bowel syndrome. One...

Self-Reported Impact of the COVID-19 Pandemic on Nutrition and Physical Activity Behaviour in Dutch Older Adults Living Independently.

The aim was to explore the self-reported impact of the COVID-19 pandemic on nutrition and physical activity behaviour in Dutch older adults and to identify subgroups most susceptible to this impact. Participants (N = 1119, aged 62–98 y, 52.8% female) of the Longitudinal Aging Study Amsterdam living independently completed a COVID-19 questionnaire. Questions on diagnosis, quarantine and hospitalization were asked, as well as impact of the pandemic on ten nutrition and physical activity behaviours. Associations of pre-COVID-19 assessed characteristics (age, sex, region, household composition, self-rated health, BMI, physical activity, functional limitations) with reported impact were tested using logistic regression analyses. About half of the sample (48.3–54.3%) reported a decrease in physical activity and exercise due to the pandemic. An impact on nutritional behaviour predisposing to overnutrition (e.g., snacking more) was reported by 20.3–32.4%. In contrast, 6.9–15.1% reported an impact on behaviour predisposing to undernutrition (e.g., skipping warm meals). Those who had been in quarantine (n = 123) more often reported a negative impact. Subgroups with higher risk of impact could be identified. This study shows a negative impact of the COVID-19 pandemic on nutrition and physical activity behaviour of many older adults, which may increase their risk of malnutrition, frailty, sarcopenia and disability.

Relationship between chronic diseases and diet in older persons in nursing homes

This study aimed to determine the relationship between chronic diseases and nutrition in the older adults in a nursing home. In 2014 and 2019, we investigated older people aged 60 years and over living in a nursing home in Izmir and who agreed to participate and could perform self-care. A 26-item questionnaire that focuses on sociodemographic, socioeconomic and chronic disease characteristics, and the Turkish version of Mini Nutritional Assessment Test-Short Form were applied using the face-to-face method. In 2014, 68.9% of the older had no malnutrition risk, 23% had malnutrition risk, and 8.1% had malnutrition. The women had a higher malnutrition risk and actual malnutrition than men (P&lt;0.05). Malnutrition was most common in 75-84 years of age. In 2019, 41.6% of the older had malnutrition risk, whereas 7.8% had actual malnutrition. No difference was found between malnutrition and malnutrition risk, between women and men and between age and sex (P&gt;0.05). At both times, malnutrition risk increased in those with chronic disease (P&lt;0.05). At least one chronic disease (high blood pressure, heart disease, diabetes, etc.) was found in 67.6% of the older. Meanwhile, 70.1% had been previously hospitalized for some reason. Malnutrition risk increases with old age. An adequate and well-balanced diet is important for protecting health and increasing longevity and quality of life in old age. Older people and nursing home employees need to be trained on the relationship and risks of chronic disease and malnutrition.

Impact of the common MTHFR 677C\u2192T polymorphism on blood pressure in adulthood and role of riboflavin in modifying the genetic risk of hypertension: evidence from the JINGO project

BackgroundGenome-wide and clinical studies have linked the 677C→T polymorphism in the gene encoding methylenetetrahydrofolate reductase (MTHFR) with hypertension, whilst limited evidence shows that intervention with riboflavin (i.e. the MTHFR co-factor) can lower blood pressure (BP) in hypertensive patients with the variant MTHFR 677TT genotype. We investigated the impact of this common polymorphism on BP throughout adulthood and hypothesised that riboflavin status would modulate the genetic risk of hypertension.MethodsObservational data on 6076 adults of 18–102 years were drawn from the Joint Irish Nutrigenomics Organisation project, comprising the Trinity-Ulster Department of Agriculture (TUDA; volunteer sample) and the National Adult Nutrition Survey (NANS; population-based sample) cohorts. Participants were recruited from the Republic of Ireland and Northern Ireland (UK) in 2008–2012 using standardised methods.ResultsThe variant MTHFR 677TT genotype was identified in 12% of adults. From 18 to 70 years, this genotype was associated with an increased risk of hypertension (i.e. systolic BP ≥ 140 and/or a diastolic BP ≥ 90 mmHg): odds ratio (OR) 1.42, 95% confidence interval (CI) 1.07 to 1.90; P = 0.016, after adjustment for antihypertensive drug use and other significant factors, namely, age, male sex, BMI, alcohol and total cholesterol. Low or deficient biomarker status of riboflavin (observed in 30.2% and 30.0% of participants, respectively) exacerbated the genetic risk of hypertension, with a 3-fold increased risk for the TT genotype in combination with deficient riboflavin status (OR 3.00, 95% CI, 1.34–6.68; P = 0.007) relative to the CC genotype combined with normal riboflavin status. Up to 65 years, we observed poorer BP control rates on antihypertensive treatment in participants with the TT genotype (30%) compared to those without this variant, CT (37%) and CC (45%) genotypes (P < 0.027).ConclusionsThe MTHFR 677TT genotype is associated with higher BP independently of homocysteine and predisposes adults to an increased risk of hypertension and poorer BP control with antihypertensive treatment, whilst better riboflavin status is associated with a reduced genetic risk. Riboflavin intervention may thus offer a personalised approach to prevent the onset of hypertension in adults with the TT genotype; however, this requires confirmation in a randomised trial in non-hypertensive adults.

In-House Production of Dialysis Solutions to Overcome Challenges During the Coronavirus Disease 2019 Pandemic

In-House Production of Dialysis Solutions to Overcome Challenges During the Coronavirus Disease 2019 Pandemic

Is it good for me? A content analysis of the healthiness of foods advertised in magazines

ABSTRACT This paper used Fooducate product ratings to evaluate the healthiness of food products being advertised in 15 U.S. magazines over a 1-year period (N = 623 food products), and compared those ratings across product categories, magazine genres, types of claims, and the presence of endorsement seals. Novel food rating apps like Fooducate offer scholars the ability to credibly assess food products in analyses of media content. In line with the academic grading scale where “A” is excellent and “D/F” is poor/failing, results indicate an average grade of approximately a “C+” (M = 2.57; SD = 0.80). Products in the ingredient, beverage and food pyramid categories received the highest scores, whereas foods high in fat/sugar, dietary supplements, and prepackaged meals scored significantly lower. Of the five magazine genres explored, health and food magazines featured the healthiest foods while fashion and women’s magazines featured the least healthy. In addition, products making health claims were significantly healthier than products without such claims, supporting their accuracy. Finally, advertisements with endorsement seals had the highest health ratings of any category assessed. Implications based on previous work in food advertising research are discussed, such as the benefit of including this topic in adult nutrition literacy initiatives.

Regional Differential in Diet Diversity Consumption and its Association with Adult Nutrition Status in Urban Areas

Background: The demographic and economic transition that many developing countries are undergoing isproducing important changes in diet and lifestyle that greatly impact on diet related disease risks. Therefore,evaluating the association between diet diversity and obesity would be interesting for the adult populationof urban areas.Objective: This study deals with the consumption of different food items in the region of Maharashtra andits association with adult nutritional status.Material & Method: This study used the National Family Health Survey (NFHS -4) data which wascollected during 2015-16. Multiple logistic regression analysis has been done to fulfill the objective of thestudy using software STATA version 14.Result: The present study found that the overweight and obesity situation among the adults of urbanMaharashtra is alarming. This study also shows that the consumption of the Non-veg food (Fish, Eggs,chicken or meat) higher in Konkan and Pune region.Conclusion: Based on the study findings, it is essential to address the present scenario of its increasingprevalence of overweight/obesity not only in the state but also at the national level.

Reproductive physiology corresponds to adult nutrition and task performance in a Neotropical paper wasp: a test of dominance-nutrition hypothesis predictions

The dominance-nutrition hypothesis predicts that nutritional intake and energetic costs in adulthood interact to drive behavioral and physiological differences between females in primitively eusocial insects, and thereby affect reproductive caste. We tested predictions of this hypothesis in independent-founding Mischocyttarus pallidipectus paper wasps. We measured stable isotope tissue composition to compare nutritional status before adult emergence and among adult females. Adult tissue δ15N content (an indicator of feeding at a higher trophic level because it is enriched in animal prey relative to plant-based foods) was significantly higher in adults than at the end of pupal development, suggesting adult nutrition affects δ15N content after the end of pupal development. We then asked if behavior and nutritional status predicted ovary development. We measured ovary development, nitrogen and carbon stable isotope ratios, dominance behavior, and task performance (foraging, as indicated by time spent on the nest) for adult female wasps. We used social network analysis to quantify differences in social status between females with developed and undeveloped (filamentous) ovaries. Dominant females spent more time on the nest and were significantly more enriched in δ15N than subordinate females. These data support the dominance-nutrition hypothesis: adult behavior and energy expenditure, and access to animal-based diets, correspond to female reproductive physiology, and may play a role in adult-stage caste determination. Within animal social groups, differential access to resources can affect differences in reproductive success. This may affect caste determination in eusocial colonies, where reproductive tasks are divided between female castes, with a queen (or multiple queens) capable of egg-laying and helped by sterile workers. Female sterile workers and reproductives of some social Hymenoptera are morphologically similar at adult emergence, suggesting that adult experience may impact caste status. We asked whether patterns of nutritional physiology in Mischocyttarus pallidipectus paper wasps matched adult-stage caste determination by testing predictions of the dominance-nutrition hypothesis, which states that adult nutrition and energetic costs of tasks shape reproductive female development through behavioral and physiological changes.

Association of Dietary Fiber on Asthma, Respiratory Symptoms, and Inflammation in the Adult National Health and Nutrition Examination Survey Population.

Rationale: High intake of dietary fiber may have antiinflammatory properties and be protective against respiratory morbidity.Objectives: We examined the relationship between dietary fiber intake and asthma, respiratory symptoms, and inflammation among adults who participated in the 2007 to 2012 NHANES (National Health and Nutrition Examination Survey).Methods: We analyzed data from adults 20 to 79 years of age (n = 13,147) with complete information on fiber intake, total calorie intake, body mass index, smoking status, and poverty level. Fiber intake was categorized into quartiles, with Q1 being lowest quartile of intake and Q4 being the highest quartile. Respiratory morbidities included asthma, wheeze, cough, and phlegm. Self-report questionnaires were used to define asthma, wheeze, cough, and phlegm production. Serum C-reactive protein (CRP) was used as a biomarker of inflammation. Exclusion criteria included current pregnancy and implausible intake of total calories.Results: A total of 69.5% of participants were non-Hispanic white; 54.5% were nonsmokers, and 7.8% had current asthma. After adjusting for covariates, fiber intake was associated with asthma (P = 0.01), with an increased odds of asthma with lower fiber intake (Q1 vs. Q4: odds ratio [OR], 1.4; 95% confidence interval [CI], 1.0-1.8; P = 0.027). There were significant interactions between fiber and sex and fiber and race/ethnicity; stronger associations were seen for women and for non-Hispanic white adults. Low fiber intake (Q1) was associated with increased odds of wheeze (OR, 1.3; 95% CI, 1.0-1.6; P = 0.018), cough (OR, 1.7; 95% CI, 1.2-2.3; P = 0.002), and phlegm (OR, 1.4; 95% CI, 1.1-2.0; P = 0.021) compared with high fiber intake. The odds of having high CRP versus nondetectable CRP were 1.6 times higher in the low-fiber group (Q1) compared with high-fiber group (Q4; OR, 1.6; 95% CI, 1.0-2.5).Conclusions: High-fiber diet may mediate an inflammatory response and decrease odds of having asthma, especially for women and specific racial groups, cough, wheeze, and phlegm production when compared with low-fiber diet.