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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (5 October 2024) | Viewed by 11595

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Prof. Dr. Yung Liao

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Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, Taipei 10610, Taiwan
Interests: behavioral epidemiology; obesity prevention; environment and physical activity; sedentary behavior and health; health-related quality of life in the elderly; diet
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Special Issue Information

Dear Colleagues,

Evidence shows the importance of diet and physical activity for older adults. However, there are still many gaps in our knowledge regarding physical activity, sedentary behavior, and diet in improving the health-related quality of life among older adults, especially older adults with sarcopenia, frailty, and chronic diseases. Thus, the effects of the interaction between diet and physical activity on older adults need to be researched deeply.

Therefore, this Special Issue of Nutrients “The Effects of Nutrition and Physical Activity on the Health of Older Adults” welcomes submissions of original research and reviews focusing on nutrition and physical activity in older adults.

Dr. Yung Liao
Guest Editor

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Keywords

nutrition
dietary
physical activity
sedentary behavior
older adults
sarcopenia
frailty
muscle
chronic diseases

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Published Papers (9 papers)

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Research

12 pages, 427 KiB

Open AccessArticle

An Investigation of the Risk Factors Related to Frailty in Older Adults Receiving Home Care Services

by Eirini Stratidaki, Enkeleint A. Mechili, Christina Ouzouni, Athina E. Patelarou, Ioannis Savvakis, Konstantinos Giakoumidakis, Aggelos Laliotis and Evridiki Patelarou

Nutrients 2024, 16(23), 3982; https://doi.org/10.3390/nu16233982 - 21 Nov 2024

Viewed by 365

Abstract

(1) Background: Frailty in older adults is a condition that involves an interaction of psychological, biological, and social factors. This study aimed to assess the frailty status of older adults (65 years old and above) who receive home care services. Additionally, this work aimed to explore the key factors that have a statistically significant impact on the frailty of this vulnerable population. (2) Methods: This study represents the first phase of an intervention trial involving individuals aged 65 and over who received primary healthcare services and resided in the municipality of Archanes-Asterousia in Crete, Greece. Frailty was assessed using the SHARE-Frailty Instrument, while nutritional status was evaluated with the Mini Nutritional Assessment. Diet-related factors were analyzed, including health factors (oral hygiene, depression, cognitive decline, impaired functioning, quality of life), social factors (educational attainment, marital status, type of work before the age of 60), and lifestyle factors (smoking, alcohol consumption, diet). (3) Results: A total of 730 older adults were evaluated (31.5% male), with an average age (±SD) of 76.83 (±6.68) years. The frailty status analysis revealed 108 (14.8%) to be frail, 249 (34.1%) to be pre-frail, and 373 (51.1%) to be non-frail. Statistically significant associations were found between the MNA and Barthel scores (rs = 0.822, p < 0.001). Higher nutritional evaluations (MNA) were revealed in non-frail adults (mean (±SD); 26.97 ± 1.96) compared to pre-fail (mean (±SD); 19.37 ± 3.36) and frail adults (mean (±SD); 13.08 ± 3.16), as well as in pre-fail compared to frail adults (F = 1338.08, p < 0.001). Functional independence (Barthel) significantly differed with the frailty status of older adults (H = 521.98, p < 0.001; median for non-frail: 20.00, pre-fail: 19.00, frail adults: 15.00). (4) Conclusions: This study demonstrated that good nutritional status, good oral health, functional independence, and good quality of life are strongly correlated with lower frailty. Additionally, having chronic conditions is positively associated with one’s frailty status. Educational programs for both healthcare personnel and older adults are recommended. Full article

(This article belongs to the Special Issue The Effects of Nutrition and Physical Activity on the Health of Older Adults)

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13 pages, 587 KiB

Open AccessArticle

Evaluating the Diagnosis of Malnutrition Based on Global Leadership Initiative on Malnutrition (GLIM) Criteria in Community-Dwelling Older Adults (Singapore Longitudinal Aging Study)

by Phoo Pyae Sone Win, Denise Qian Ling Chua, Xinyi Gwee, Shiou Liang Wee and Tze Pin Ng

Nutrients 2024, 16(22), 3823; https://doi.org/10.3390/nu16223823 - 7 Nov 2024

Viewed by 547

Abstract

Background: A minority of studies using the GLIM criteria for malnutrition diagnosis have performed formal empirical validation. Objectives: To evaluate the concurrent and predictive validity of GLIM criteria with and without prior screening among community-dwelling older adults in Singapore. Method: In the Singapore Longitudinal Aging Study (SLAS-2, n = 2477), malnutrition was diagnosed using single-step and two-step GLIM procedures using the Mini Nutritional Assessment Short Form (MNA-SF) and Elderly Nutritional Index for Geriatric Malnutrition Assessment (ENIGMA) for initial screening. Criterion validity was evaluated using MNA-Full Form (MNA-FF) as reference malnutrition diagnosis. Prognostic validity was evaluated using logistic and Cox regression analyses with respect to impaired quality of life (QoL) and 10-year mortality. Results: GLIM malnutrition with and without MNA-SF or ENIGMA screening showed significant associations with known clinical correlates; single-step GLIM malnutrition: sensitivity = 80%, specificity = 83%; two-step MNA-SF-GLIM malnutrition: sensitivity = 80%, specificity = 85%; two-step ENIGMA-GLIM malnutrition: sensitivity = 74%, specificity = 88%; positive predictive values of around 20% and negative predictive values above 98%. Cohen’s kappa values of agreement were uniformly low (0.26 to 0.32). All showed significant associations with about 50% increased odds of impaired QoL and 10-year mortality, adjusted for age, sex, ethnicity, education levels, and housing type, with the ENIGMA-GLIM malnutrition showing the highest risk estimates. Compared to MNA-FF malnutrition prevalence of 4.1%, GLIM-based malnutrition increased prevalence (14.6% to 19.7%) estimates. Conclusions: The GLIM criteria showed good construct and criterion validity. It increased the number of individuals diagnosed with malnutrition. The agreement between diagnoses of malnutrition was low. Diagnostic and prognostic accuracy vary with the screening instrument used. Early identification of malnutrition using appropriate tools can provide opportunities to delay or prevent the risk of important adverse outcomes such as impaired QoL and mortality. Full article

(This article belongs to the Special Issue The Effects of Nutrition and Physical Activity on the Health of Older Adults)

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10 pages, 484 KiB

Open AccessArticle

Relationship Between Mediterranean Diet Adherence and Body Composition Parameters in Older Adults from the Mediterranean Region

by Kaja Teraž, Katarina Pus, Saša Pišot, Ana Cikač and Boštjan Šimunič

Nutrients 2024, 16(21), 3598; https://doi.org/10.3390/nu16213598 - 23 Oct 2024

Viewed by 860

Abstract

In recent decades, the rapid spread of various communication media has led to changes in traditional eating habits. In the Mediterranean region, the classic (Mediterranean) dietary pattern has been lost as a result. This has led to a shift in eating habits towards unhealthy eating patterns, which in turn has resulted in an inadequate distribution of body composition. It is known that, among other things, the number of non-communicable diseases increases with the inadequate distribution of body composition. The aim of our study was to examine the level of adherence to the Mediterranean diet (MD) of older adults in the Mediterranean region in relation to specific body composition parameters. This study included 521 older adults with a mean age of 69.6 ± 6.3 years. Body composition was measured using the BIA 101 Anniversary device (Akern s.r.l., Florence, Italy) and adherence to the MD was assessed using the MEDLIFE index questionnaire. This study found significant differences in body composition between males and females. The mean adherence to the MD was 17.0 ± 3.3 points among the participants and there was higher adherence in females (p = 0.002, η_p² = 0.019). A multiple linear regression was performed to assess the relationship between the body composition parameters and MD. Multiple linear regression models were significant for reactance, fat mass (%), fat-free mass (%), skeletal muscle index, and total body water (%), with specific individual MEDLIFE items such as the consumption of processed meat, meat, white meat, fruit, vegetables, olive oil and limiting snacks between meals. Moreover, promising correlations were found between certain MD characteristics and BIA parameters, but the overall health effects of the MD remain unclear. Full article

(This article belongs to the Special Issue The Effects of Nutrition and Physical Activity on the Health of Older Adults)

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14 pages, 310 KiB

Open AccessArticle

Risk Factors for a Higher Dietary Acid Load (Potential Renal Acid Load) in Free-Living Elderly in Poland

by Katarzyna Rolf and Olga Januszko

Nutrients 2024, 16(19), 3409; https://doi.org/10.3390/nu16193409 - 8 Oct 2024

Viewed by 733

Abstract

Background: Dietary composition is one of the factors influencing the acid–base balance of the body by providing acid or base precursors. One of the methods for assessing the acid-forming potential of a diet is to calculate its potential renal acid load (PRAL). The aim of this study was to identify the sociodemographic, lifestyle, and health factors related to the PRAL. Methods: Dietary intake was assessed among 133 individuals aged 70+ years using the three-day record method. Results: The average PRAL value was 15.7 mEq/day (range from −42.4 to +101.7). The diets of a majority of the participants (71.4%) had acid-forming potential (PRAL > 0). From a univariate analysis, the acid-forming potential of the diets was linked mainly to women (65.3% in PRAL > 0 group vs. 10.5% in PRAL < 0 group), people using dietary supplements, those who consumed alcohol, those who assessed their health as being at least good, people with osteoporosis, those hospitalized during the previous year, and those with rather lower physical activity. Conclusions: From a multivariate analysis, gender was the strongest predictor of an acid-forming diet, but the following also contributed: an average self-rated health status (compared to good), a good health status (compared to poor), alcohol drinking, hospitalization, lack of nutritional knowledge, and, to a lesser extent, non-frail status (compared to pre-frail). Therefore, more extensive nutritional education in the identified groups is required. Full article

(This article belongs to the Special Issue The Effects of Nutrition and Physical Activity on the Health of Older Adults)

13 pages, 278 KiB

Open AccessArticle

A Study of Factors Contributing to the Nutritional Status of Elderly People Receiving Home Care

by Eirini Stratidaki, Enkeleint A. Mechili, Christina Ouzouni, Athina E. Patelarou, Konstantinos Giakoumidakis, Aggelos Laliotis and Evridiki Patelarou

Nutrients 2024, 16(18), 3135; https://doi.org/10.3390/nu16183135 - 17 Sep 2024

Viewed by 1495

Abstract

(1) Background: Nutrition is a critical aspect of health and well-being in the elderly population, as physiological changes associated with aging can impact nutrient utilization and dietary needs. The aim of this study was the assessment of nutritional screening and associated factors among community-dwelling elderly people. (2) Methods: This study is the first phase of an intervention trial of people aged 65 years and over who received primary health services and resided in the municipality of Archanes Asterousia in Crete, Greece. Nutritional risk was assessed using the Mini Nutritional Assessment. Diet-related factors were analyzed, including health status (oral hygiene, depression, cognitive decline, impaired functioning, quality of life), social factors (educational attainment, marital status, type of work before 60 years), and lifestyle factors (smoking, drinking, diet). (3) Results: A total of 730 elderly people were evaluated (males, 31.5%), with an average age (±SD) of 76.83 (±6.68) years. MNA was found to have a statistically significant connection with assessment of oral hygiene, mental state, Charlson comorbidity, functional independence (assessed with the Barthel scale), and quality of life. The exception was geriatric depression (GDS), with which no statistically significant association was found (p > 0.05). Nutritional risk analysis revealed 379 participants (51.9%) to be adequately nourished, 205 (28.1%) to be at risk of malnutrition, and 146 (20.0%) to be malnourished. (4) Conclusions: These results clearly demonstrated the key factors that contribute to the nutritional screening of elderly people and need to be addressed by health authorities and social services. Full article

(This article belongs to the Special Issue The Effects of Nutrition and Physical Activity on the Health of Older Adults)

18 pages, 334 KiB

Open AccessArticle

Association of Dietary Patterns, Suspected Sarcopenia, and Frailty Syndrome among Older Adults in Poland—A Cross-Sectional Study

by Robert Gajda, Marzena Jeżewska-Zychowicz, Ewa Raczkowska, Karolina Rak, Małgorzata Szymala-Pędzik, Łukasz Noculak and Małgorzata Sobieszczańska

Nutrients 2024, 16(18), 3090; https://doi.org/10.3390/nu16183090 - 13 Sep 2024

Viewed by 1082

Abstract

Background: The association of sarcopenia and frailty syndrome with dietary patterns is not yet well recognized. The aim: The aim of the study was to evaluate the association among dietary patterns, suspected sarcopenia, and frailty syndrome among older people in Poland. Methods: The study was conducted in 2022 and 2023 among people aged 55 and older. The sample was chosen arbitrarily. The following questionnaires were used in the study: the KomPAN (assessment of frequency of food intake and sociodemographic characteristics), the SARC-F (assessment of risk of sarcopenia), and the EFS (diagnosis of frailty syndrome). To confirm the suspicion of sarcopenia, muscle strength was assessed using the HGS and FTSST, and physical fitness was assessed using the GST. Based on the frequency of food consumption, 11 DPs (factors) were selected using PCA analysis. SARC-F, HGS, FTSST, and GST results were used to identify homogeneous groups (clusters) using cluster analysis, a k-means method. Results: Two clusters were identified: cluster 1 (the non-sarcopenic cluster, or nSC) and cluster 2 (the sarcopenic cluster, or SC). Associations between variables were assessed using logistic regression. Suspected sarcopenia was found in 32.0% of respondents, more in men than women, and more among those either over 75 or 65 and under. EFS results showed that the risk (22.1%) or presence of frailty syndrome (23.8%) was more common in men than women and more common in those aged 75 and older than in other age groups. Male gender; older age; and unfavorable dietary patterns, i.e., consumption of white bread and bakery products, white rice and pasta, butter, and potatoes (factor 1) and cheese, cured meat, smoked sausages, and hot dogs (factor 9), increased the likelihood of sarcopenia and frailty syndrome, while the pattern associated with fruit and water consumption (factor 7) had the opposite effect. Conclusions: Confirmation of the importance of dietary patterns in the etiology and pathogenesis of sarcopenia and frailty syndrome should be documented in prospective cohort studies. Full article

(This article belongs to the Special Issue The Effects of Nutrition and Physical Activity on the Health of Older Adults)

13 pages, 771 KiB

Open AccessArticle

Lost in Transition: Insights from a Retrospective Chart Audit on Nutrition Care Practices for Older Australians with Malnutrition Transitioning from Hospital to Home

by Kristin Gomes, Jack Bell, Ben Desbrow and Shelley Roberts

Nutrients 2024, 16(16), 2796; https://doi.org/10.3390/nu16162796 - 22 Aug 2024

Viewed by 1104

Abstract

Care transitions from hospital to home for older adults with malnutrition present a period of elevated risk; however, minimal data exist describing the existing practice. This study aimed to describe the transition of nutrition care processes provided to older adults in a public tertiary hospital in Australia. A retrospective chart audit conducted between July and October 2022 included older (≥65 years), malnourished adults discharged to independent living. Dietetic care practices (from inpatient to six-months post-discharge) were reported descriptively. Of 3466 consecutive admissions, 345 (10%) had a diagnosis of malnutrition documented by the dietitian and were included in the analysis. The median number of dietetic visits per admission was 2.0 (IQR 1.0–4.0). Nutrition-focused discharge plans were inconsistently developed and documented. Only 10% of patients had nutrition care recommendations documented in the electronic discharge summary. Post-discharge oral nutrition supplementation was offered to 46% and accepted by 34% of the patients, while only 23% attended a follow-up appointment with dietetics within six months of hospital discharge. Most patients who are seen by dietitians and diagnosed with malnutrition appear lost in transition from hospital to home. Ongoing work is required to explore determinants of post-discharge nutrition care in this vulnerable population. Full article

(This article belongs to the Special Issue The Effects of Nutrition and Physical Activity on the Health of Older Adults)

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11 pages, 453 KiB

Open AccessArticle

Sedentary Behavior and Phase Angle: An Objective Assessment in Physically Active and Inactive Older Adults

by Liu-Yin Lin, Jiaren Chen, Ting-Fu Lai, Yen-Yu Chung, Jong-Hwan Park, Yih-Jin Hu and Yung Liao

Nutrients 2024, 16(1), 101; https://doi.org/10.3390/nu16010101 - 27 Dec 2023

Cited by 1 | Viewed by 1461

Abstract

The purpose of the present study was to investigate the associations of the objectively assessed total sedentary behavior (SB) amount and SB patterns with phase angle (PhA) in older populations and to conduct a comparison analysis for those who are physically active (meet 150 min/week) and inactive (less than 150 min/week). During May to August 2023, a convenience sampling was used to recruit older adults (aged ≥ 65 years) living in a community in Taiwan. The total SB amount (minutes/day), SB patterns (including SB bouts and breaks), and physical activity were assessed by a triaxial accelerometer. A multifrequency bioelectrical impedance analyzer (BIA) was used to measure PhA. Multiple linear regression analysis was employed to examine the associations between SB and PhA in the total number of participants and stratified in the physically active and inactive groups. For the whole sample (n = 166; mean age: 72.1 ± 5.5 years), the total SB amount and patterns of SB were not associated with PhA. For those physically active, the total SB amount and SB patterns were not associated with PhA. Among those physically inactive, the total SB amount was negatively related to PhA (B: −0.059, 95% CI: −0.118, 0.000). This study underscores the importance of minimizing the total SB amount in physically inactive older adults, providing evidence for future interventions targeting SB and PhA in this population. Full article

(This article belongs to the Special Issue The Effects of Nutrition and Physical Activity on the Health of Older Adults)

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14 pages, 410 KiB

Open AccessArticle

The Longitudinal Association of Egg Consumption with Cognitive Function in Older Men and Women: The Rancho Bernardo Study

by Donna Kritz-Silverstein and Ricki Bettencourt

Nutrients 2024, 16(1), 53; https://doi.org/10.3390/nu16010053 - 23 Dec 2023

Cited by 4 | Viewed by 2942

Abstract

This study examines the prospective association of egg consumption with multiple domains of cognitive function in older, community-dwelling men and women followed for 16.3 years. Participants were 617 men and 898 women from the Rancho Bernardo Cohort aged 60 and older, who were surveyed about egg intake/week in 1972–1974, and attended a 1988–1991 research visit, where cognitive function was assessed with 12 tests. Analyses showed that egg intake ranged from 0–24/week (means: men = 4.2 ± 3.2; women = 3.5 ± 2.7; p < 0.0001). In men, covariate-adjusted regressions showed that egg intake was associated with better performance on Buschke total (p = 0.04), long-term (p = 0.02), and short-term (p = 0.05) recall. No significant associations were observed in women (p’s > 0.05). Analyses showed that in those aged <60y in 1972–1974, egg intake was positively associated with scores on Heaton copying (p < 0.04) and the Mini-Mental Status Exam (MMSE; p < 0.02) in men and category fluency (p < 0.05) in women. Egg intake was not significantly associated with odds of poor performance on MMSE, Trails B, or category fluency in either sex. These reassuring findings suggest that there are no long-term detrimental effects of egg consumption on multiple cognitive function domains, and for men, there may be beneficial effects for verbal episodic memory. Egg consumption in middle age may also be related to better cognitive performance later in life. Full article

(This article belongs to the Special Issue The Effects of Nutrition and Physical Activity on the Health of Older Adults)

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