impact of aging on nutritional risk and nutritional status

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THURSDAY, OCTOBER 28 POSTER SESSION: CLINICAL NUTRITION THE EFFECTS OF KREB CYCLE INTERMEDIATES ON CYCLING PERFORMANCE AND RECOVERY. AC Brown, PhD, RD, HPER, Northern Arizona University, Flagstaff, AZ, HSH MacRae, PhD, and NS Turner, BS, Sports Medicine, Pepperdine University, Malibu, CA. The use of kreb cycle intermediates by athletes is relatively new and their affect on performance has not been previously documented. The purpose of this study was to determine 1) if the consumption of a kreb cycle intermediate supplement (Naturade) for 3 weeks would improve the time to exhaustion (10% below V0 2 ,,,) during a submaximal cycling (70-75% VO2,,,) test, and 2) if the kreb cycle intermediate supplement (KI) would improve performance on the second ride to exhaustion 30 minutes following the first test. Eight well-trained male cyclists (X + SE V02m,,,, = 67.4 2.1 ml/kg/min; age 28.6+2.4) were randomly placed into a treatment or placebo (P) group for three weeks. The double- blind cross-over study required that each subject took either the treatment or placebo 30 min before ther normal workout and immediately after the workout, and 30 min before and immediately after the submaximal exercise test. After one: week separating the trials, the subjects were placed in the alternate group for another three weeks of supplementation. The results of this study showed no significant differences in 1) time to exhaustion during cycling (KI = 105+18, P = 113+11min), 2) respiratory exchange ratio at 20 minute intervals, 3) plasma glucose and lactate before, after, and at 30 min intervals during exercise, 4) perceived exertion at 20 min intervals during exercise, and 5) time to fatigue following the 30 min recovery (KI = 16.1 + 3.2, P = 15+2 min). We conclude that the kreb cycle intermediates do not improve cycling performance at 70-75% VO 2 ,,,,, nor do they speed recovery from previously fatiguing exercise. EFFECT OF DIETARY RESTRICTION ON AMOUNT OF PLATE WASTE IN AN ACUTE CARE HOSPITAL SETTING. E.Chan, MS, S. Gbanja-Trye, MS, C. Mueller, MS, RD, CNSD, S. Bradford, MS, RD, CNSD, Long Island College Hospital, Brooklyn, N.Y. This study was designed to measure the amount of waste associated with commonly ordered dietary restrictions. Previous explanations for plate waste in a hospital setting have included decreased appetite, inclusion of unwanted tray items, and missed meals caused by hospital procedures. Data was collected for 120 patient lunch trays. Forty trays of each; regular, low sodium, and modified consistency (puree or mechanical soft) diets were analyzed. The 6-point visual estimation method developed by Comstock was used, (scale: 1-6, less to more waste). Soup, entree, vegetable, starch, bread, and dessert items were evaluated. Three-way ANOVA's were performed with the following independent variables: tester, menu day, and type of diet. There was no significant difference in plate waste for entree, soup, bread, and dessert. There was a significant difference in plate waste for starch (p< .0004) and vegetable (p< .026) tray items. Vegetable and starch waste was higher for modified consistency diets than for regular and low sodium diets: Regular Low Na Modified Mean Vegetable Waste 1.58 1.40 3.35 Mean Starch Waste 1.90 1.23 2.38 This study demonstrates that modified consistency diets are associated with a significantly greater degree of plate waste than regular or low sodium diets. The study provides data for practice application and menu design. EVALUATION OF INTAKE USING PUREED FOOD APPEAL IN RESIDENTS WITH ALZHEIMER'S DEMENTIA. K. Carlson, RD, and J. D. Deleon, roduction Manager, Service Master Food Service, Las Vegas Medical Center, Las Vegas, NM Appearance of food is believed to have influence on intake, i.e. "people eat with their eyes." A question is raised as to whether residents with a diagnosis of Alzheimer's dementia have the cognitive ability to be influenced by the appearance of food. A study was developed to determine if intake improved when pureed foods were thickened and re-formed. Eight residents on pureed diets with a diagnosis of Alzheimer's dementia were included in the study group. Objective data was collected by weighing food before and after eating. Subjective data relating to appearance of food, ease of feeding and resident's acceptance of food was collected on questionnaires provided to nurse aides assisting the residents. Baseline data was collected for two weeks with usual pureed foods and compared to data collected when pureed foods were re-formed, using the same two week period on the menu cycle. The results showed a decrease in intake with the sculptured food, indicating that appearance of food was not an important factor for this group of residents. Information from nurse aides suggested that the consistency required to sculpture foods may have had an adverse effect on intake. Further study on the effects of sculptured foods is indicated. IMPACT OF AGING ON NUTRITIONAL RISK AND NUTRITIONAL STATUS. K.M. Chapman, RD, PhD and R.A. Pearlman, MD, MPH, School of Human Resources and Family Studies, University of Illinois, Urbana, IL and Geriatric Research, Education, and Clinical center, VA Medical Center, Seattle, WA The nutritional status of older male veterans was assessed during a three year prospective cohort study. One objective of the study was to compare older old (age Ž 75) and younger old (65-74 years) to assess the impact of age differences relative to nutritional status risk factors, nutritional status indicators, and health status reports during year one of the study. Sampling was randomized and analysis of nonresponders vs. responders indicated subject representativeness. Exclusion criteria included being born later than 1920, hospitalization within the past 3 months, and living in a nursing home as a permanent residence. The total sample consisted of 300 medical outpatients partitioned as n=219 in the younger old group and n=81 in the older old group. Data collection instruments were either standardized or pilot tested. Quality assurance procedures to assure reliability and validity of the data were conducted through the study's duration. Results of the study include finding that the older old veterans had more risk factors for poor nutrition when compared to the younger old. The older group more often lived alone, had incomes below the poverty level, and had less than a completed high school education. Sickness impact profile, abnormal gait, reduced hand strength, and reduced near vision indicated diminished physical functioning in the older old. However, intakes of 17 nutrients were not significantly different between age groups. Protein intake for younger old (76.8 30.9 gm) was significantly (p 0.05) different from that of older old (68.6 + 23.5 gm). Nevertheless, significant (p c 0.001) differences in fat skinfolds, arm muscle circumference, and arm muscle areas were found. Biochemical asessment revealed no statistically or clinically significant indices except for total and LDL cholesterol which was significantly (p c 0.001) higher in the younger old. Although findings may represent cohort differences, results suggest that age has little impact on the nutritional status of older old veterans as compared to younger old veterans. A-94 / SIEI'TEIMBER 1993 SUI'IEMIENT VOILUME 93 NUMBER 9

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Page 1: Impact of aging on nutritional risk and nutritional status

THURSDAY, OCTOBER 28

POSTER SESSION: CLINICAL NUTRITION

THE EFFECTS OF KREB CYCLE INTERMEDIATES ONCYCLING PERFORMANCE AND RECOVERY.AC Brown, PhD, RD, HPER, Northern Arizona University,Flagstaff, AZ, HSH MacRae, PhD, and NS Turner, BS, SportsMedicine, Pepperdine University, Malibu, CA.

The use of kreb cycle intermediates by athletes isrelatively new and their affect on performance has not beenpreviously documented. The purpose of this study was todetermine 1) if the consumption of a kreb cycle intermediatesupplement (Naturade) for 3 weeks would improve the time toexhaustion (10% below V0 2,,,) during a submaximal cycling(70-75% VO2,,,) test, and 2) if the kreb cycle intermediatesupplement (KI) would improve performance on the secondride to exhaustion 30 minutes following the first test. Eightwell-trained male cyclists (X + SE V02m,,,, = 67.4 2.1ml/kg/min; age 28.6+2.4) were randomly placed into atreatment or placebo (P) group for three weeks. The double-blind cross-over study required that each subject took eitherthe treatment or placebo 30 min before ther normal workoutand immediately after the workout, and 30 min before andimmediately after the submaximal exercise test. After one:week separating the trials, the subjects were placed in thealternate group for another three weeks of supplementation.The results of this study showed no significant differences in1) time to exhaustion during cycling (KI = 105+18, P =113+11min), 2) respiratory exchange ratio at 20 minuteintervals, 3) plasma glucose and lactate before, after, and at30 min intervals during exercise, 4) perceived exertion at 20min intervals during exercise, and 5) time to fatigue followingthe 30 min recovery (KI = 16.1 + 3.2, P = 15+2 min). Weconclude that the kreb cycle intermediates do not improvecycling performance at 70-75% VO2,,,,, nor do they speedrecovery from previously fatiguing exercise.

EFFECT OF DIETARY RESTRICTION ON AMOUNT OFPLATE WASTE IN AN ACUTE CARE HOSPITAL SETTING.E.Chan, MS, S. Gbanja-Trye, MS, C. Mueller,MS, RD, CNSD, S. Bradford, MS, RD, CNSD, LongIsland College Hospital, Brooklyn, N.Y.

This study was designed to measure theamount of waste associated with commonlyordered dietary restrictions. Previousexplanations for plate waste in a hospitalsetting have included decreased appetite,inclusion of unwanted tray items, and missedmeals caused by hospital procedures. Data wascollected for 120 patient lunch trays. Fortytrays of each; regular, low sodium, andmodified consistency (puree or mechanicalsoft) diets were analyzed. The 6-point visualestimation method developed by Comstock wasused, (scale: 1-6, less to more waste). Soup,entree, vegetable, starch, bread, and dessertitems were evaluated. Three-way ANOVA's wereperformed with the following independentvariables: tester, menu day, and type of diet.There was no significant difference in platewaste for entree, soup, bread, and dessert.There was a significant difference in platewaste for starch (p< .0004) and vegetable(p< .026) tray items. Vegetable and starchwaste was higher for modified consistencydiets than for regular and low sodium diets:

Regular Low Na ModifiedMean Vegetable Waste 1.58 1.40 3.35Mean Starch Waste 1.90 1.23 2.38

This study demonstrates that modifiedconsistency diets are associated with asignificantly greater degree of plate wastethan regular or low sodium diets. The studyprovides data for practice application andmenu design.

EVALUATION OF INTAKE USING PUREED FOOD APPEAL INRESIDENTS WITH ALZHEIMER'S DEMENTIA. K. Carlson,RD, and J. D. Deleon, roduction Manager, ServiceMaster Food Service, Las Vegas Medical Center,Las Vegas, NM

Appearance of food is believed to haveinfluence on intake, i.e. "people eat with theireyes." A question is raised as to whetherresidents with a diagnosis of Alzheimer'sdementia have the cognitive ability to beinfluenced by the appearance of food. A studywas developed to determine if intake improvedwhen pureed foods were thickened and re-formed.Eight residents on pureed diets with a diagnosisof Alzheimer's dementia were included in thestudy group. Objective data was collected byweighing food before and after eating.Subjective data relating to appearance of food,ease of feeding and resident's acceptance offood was collected on questionnaires provided tonurse aides assisting the residents. Baselinedata was collected for two weeks with usualpureed foods and compared to data collected whenpureed foods were re-formed, using the same twoweek period on the menu cycle. The resultsshowed a decrease in intake with the sculpturedfood, indicating that appearance of food was notan important factor for this group of residents.Information from nurse aides suggested that theconsistency required to sculpture foods may havehad an adverse effect on intake. Further studyon the effects of sculptured foods is indicated.

IMPACT OF AGING ON NUTRITIONAL RISK AND NUTRITIONALSTATUS. K.M. Chapman, RD, PhD and R.A. Pearlman, MD,MPH, School of Human Resources and Family Studies,University of Illinois, Urbana, IL and GeriatricResearch, Education, and Clinical center, VA MedicalCenter, Seattle, WA

The nutritional status of older male veterans wasassessed during a three year prospective cohort study.One objective of the study was to compare older old (ageŽ 75) and younger old (65-74 years) to assess the impactof age differences relative to nutritional status riskfactors, nutritional status indicators, and health statusreports during year one of the study. Sampling wasrandomized and analysis of nonresponders vs. respondersindicated subject representativeness. Exclusion criteriaincluded being born later than 1920, hospitalizationwithin the past 3 months, and living in a nursing home asa permanent residence. The total sample consisted of 300medical outpatients partitioned as n=219 in the youngerold group and n=81 in the older old group. Datacollection instruments were either standardized or pilottested. Quality assurance procedures to assurereliability and validity of the data were conductedthrough the study's duration. Results of the studyinclude finding that the older old veterans had more riskfactors for poor nutrition when compared to the youngerold. The older group more often lived alone, had incomesbelow the poverty level, and had less than a completedhigh school education. Sickness impact profile, abnormalgait, reduced hand strength, and reduced near visionindicated diminished physical functioning in the olderold. However, intakes of 17 nutrients were notsignificantly different between age groups. Proteinintake for younger old (76.8 30.9 gm) was significantly(p 0.05) different from that of older old (68.6 + 23.5gm). Nevertheless, significant (p c 0.001) differencesin fat skinfolds, arm muscle circumference, and armmuscle areas were found. Biochemical asessment revealedno statistically or clinically significant indices exceptfor total and LDL cholesterol which was significantly (pc 0.001) higher in the younger old. Although findingsmay represent cohort differences, results suggest thatage has little impact on the nutritional status of olderold veterans as compared to younger old veterans.

A-94 / SIEI'TEIMBER 1993 SUI'IEMIENT VOILUME 93 NUMBER 9