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"Bad Enough to Cook for Two, Worse for One" - Mixed Method Evaluation of Eating Behavior among Community Dwelling Older Adults. “两个人吃够了,一个人更糟”——社区居住老年人饮食行为的混合方法评价。
Q3 Medicine Pub Date : 2020-07-01 Epub Date: 2020-04-30 DOI: 10.1080/21551197.2020.1759478
Kerri Lynn Knippen, HeeSoon Lee, Tasha Ford, Philip Welch

Food insecurity, life events, and emotional eating can influence dietary patterns. However, their interaction among older adults requires further investigation. This mixed-method, interdisciplinary project included 7 focus groups and a cross-sectional survey (n = 55) to evaluate these factors among older adults (60-102 years of age) living in rural Ohio communities. Qualitative data highlighted critical life events, emotions and personal relationships, food insecurity, and learning how to do more with less, and resilience in dietary patterns. The majority of the participants were overweight or obese. Food insecurity, frequency of congregate meals, and age were associated with emotional eating. Attributes of diet quality correlated with emotional eating and food insecurity. Future work should address the unique needs of older adults by expanding food assistance programs, while including the older adult's perspectives with regard to life experiences, the value of social support, personal relationships, and honoring food preferences, particularly nutrient-dense foods.

粮食不安全、生活事件和情绪化饮食都会影响饮食模式。然而,它们在老年人中的相互作用需要进一步研究。这个混合方法的跨学科项目包括7个焦点小组和一个横断面调查(n = 55),以评估生活在俄亥俄州农村社区的老年人(60-102岁)的这些因素。定性数据强调了重要的生活事件、情感和个人关系、粮食不安全、学习如何少花钱多做事以及饮食模式的弹性。大多数参与者都超重或肥胖。食物不安全、聚餐频率和年龄与情绪化饮食有关。饮食质量属性与情绪性饮食和食物不安全相关。未来的工作应该通过扩大食品援助计划来解决老年人的独特需求,同时包括老年人在生活经历、社会支持的价值、人际关系和尊重食物偏好方面的观点,特别是营养丰富的食物。
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引用次数: 1
A Community-Based Feasibility Study of Weight-Loss in Rural, Older Adults with Obesity. 以社区为基础的农村老年肥胖患者减肥可行性研究
Q3 Medicine Pub Date : 2020-07-01 Epub Date: 2020-09-09 DOI: 10.1080/21551197.2020.1817226
John A Batsis, Curtis L Petersen, Summer B Cook, Rima I Al-Nimr, Dawna Pidgeon, Todd A Mackenzie, Stephen J Bartels

This study was a 12-week feasibility weight-loss intervention consisting of caloric restriction and aerobic/resistance exercise in older adults with obesity (body mass index ≥ 30 kg/m2) in a geographically isolated area. Primary outcomes assessed weight and physical function. Mean age was 71.0 ± 5.1 years (67% female). Individuals completed 100% of all assessments, attended 88% of the physical therapy classes and 89% of the nutrition sessions. Level of satisfaction (5-point Likert) was high (5.0, 1 - low; 5 - high). Weight decreased from 93.7 ± 9.7 to 89.4 ± 4.0 kg (p < 0.001). Mean BMI and waist circumference decreased, respectively, from 35.4 ± 3.4 to 33.6 ± 3.7 (p < 0.001), and 116.3 ± 7.5 to 108.7 ± 9.2 cm (p = 0.002). Grip strength, gait speed, and 5-times sit-to-stand time all improved from 29.2 ± 7.5 to 35.2 ± 6.7 kg (p = 0.006), 1.16 ± 0.21 to 1.35 ± 0.23 m/s (p = 0.004), and 12.5 ± 4.0 to 9.6 ± 1.7s (p = 0.02). The intervention was feasible and acceptable, and holds promise in promoting weight loss with a concomitant improvement in physical function in older adults.

本研究是一项为期12周的可行性减肥干预,包括热量限制和有氧/阻力运动,研究对象为地理隔离地区的老年肥胖(体重指数≥30 kg/m2)。主要结局评估体重和身体功能。平均年龄71.0±5.1岁(67%为女性)。个体完成了100%的评估,参加了88%的物理治疗课程和89%的营养课程。满意度(5分Likert)高(5.0,1 -低;5 -高)。体重由93.7±9.7 kg降至89.4±4.0 kg (p p p = 0.002)。握力、步态速度和5次坐立时间均从29.2±7.5 kg提高到35.2±6.7 kg (p = 0.006),从1.16±0.21提高到1.35±0.23 m/s (p = 0.004),从12.5±4.0提高到9.6±1.7s (p = 0.02)。该干预措施是可行和可接受的,并有望促进体重减轻,同时改善老年人的身体功能。
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引用次数: 3
Dietetic Students' Perceived Facilitators, Barriers and Perceptions of Working with Older Adults: Implications for Curriculum Development. 饮食学生感知到的促进因素、障碍和与老年人一起工作的感知:对课程开发的启示。
Q3 Medicine Pub Date : 2020-04-01 Epub Date: 2020-02-21 DOI: 10.1080/21551197.2020.1729289
Seung Eun Jung, Hyunjin Noh, Kristi M Crowe-White, Amy C Ellis

Objective: The purpose of this study was to explore dietetic students' facilitators, barriers, and perceptions of working with older adults.Method: A purposive sampling method was used to conduct individual, face-to-face-interviews with students majoring in human nutrition (n = 17). All interviews were audio recorded, transcribed verbatim, and coded using NVivo 11 software. A directed content analysis revealed the following themes under categories of (1) perception, (2) barriers, (3) facilitators, and (4) impact of experience.Results: For perception, students discussed older adults' positive and negative personality traits and their physical and cognitive deterioration. Such perception contributed to their view of barriers in interactions with older adults, which were both external and internal in nature. Students mentioned previous experience and knowledge about older adults as well as their own personalities served as major facilitators in interacting with older adults. Gaining experience working with older adults deepened students' understanding of and empathy for this population.Discussion: Findings offer insight into how to develop dietetic curricula to address students' perceptions and resulting barriers for training well-prepared registered dietitians motivated to serve the rapidly growing older adult population.

目的:本研究的目的是探讨饮食学生与老年人一起工作的促进因素、障碍和看法。方法:采用目的抽样法,对17名人体营养学专业学生进行个别面对面访谈。所有访谈录音,逐字转录,并使用NVivo 11软件编码。直接内容分析揭示了以下主题类别:(1)感知,(2)障碍,(3)促进因素,(4)经验影响。结果:在感知方面,学生讨论了老年人的积极和消极人格特征以及他们的身体和认知退化。这种看法促成了他们对与老年人互动障碍的看法,这些障碍既有外部的,也有内部的。学生们提到以往的经验和对老年人的了解以及他们自己的个性是与老年人互动的主要促进因素。与老年人一起工作的经验加深了学生对这一群体的理解和同情。讨论:研究结果为如何开发饮食课程提供了见解,以解决学生的看法和由此产生的障碍,培训有充分准备的注册营养师,为快速增长的老年人口服务。
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引用次数: 0
Effect of New Zealand Blackcurrant on Blood Pressure, Cognitive Function and Functional Performance in Older Adults. 新西兰黑加仑对老年人血压、认知功能和功能表现的影响。
Q3 Medicine Pub Date : 2020-04-01 Epub Date: 2020-01-06 DOI: 10.1080/21551197.2019.1707740
Matthew David Cook, Amber Kaur Sandu BSc Hons, Jennifer Patricia Joyce PhD

New Zealand blackcurrant (NZBC) can increase exercise performance in young adults, potentially by anthocyanin-induced cardiovascular function alterations and increased blood flow, however, effects upon blood pressure, functional exercise performance and cognitive function in older adults is unknown. In a randomized, double-blind, placebo-controlled, cross-over design, 14 older adults (age: 69 ± 4 years, height: 172 ± 9 cm, body mass: 85 ± 12) ingested NZBC extract (600 mg·day-1 CurraNZ™) or placebo (PL, 600 mg microcrystalline cellulose) for 7-days (7-day washout between conditions). On day-7, 2-hours following consumption of the capsules, resting blood pressure, cognitive function (Cambridge neuropsychological test automated battery) and 6-minute walk test performance and were measured. Intake of NZBC caused a decrease (p < 0.05) in systolic (PL: 136 ± 14; NZBC: 130 ± 12 mmHg) and diastolic (PL: 84 ± 11; NZBC 78 ± 6 mmHg) blood pressure. There was no effect on 6-minute walk performance or cognitive function variables. Future research should address optimization of intake and examine cardiovascular responses during exercise.

新西兰黑加仑(NZBC)可以提高年轻人的运动表现,可能是通过花青素诱导的心血管功能改变和血流量增加,然而,对老年人血压、功能性运动表现和认知功能的影响尚不清楚。在一项随机、双盲、安慰剂对照、交叉设计中,14名老年人(年龄:69±4岁,身高:172±9厘米,体重:85±12)服用NZBC提取物(600毫克·天-1 CurraNZ™)或安慰剂(PL, 600毫克微晶纤维素)7天(两种情况之间7天的洗脱期)。在第7天、服用胶囊后2小时,测量静息血压、认知功能(剑桥神经心理测试自动电池)和6分钟步行测试表现。摄入NZBC导致了下降(p
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引用次数: 15
Association of Nutritional Status with Physical Function and Disability in Community-Dwelling Older Adults: A Longitudinal Data Analysis. 社区老年人营养状况与身体功能和残疾的关系:一项纵向数据分析。
Q3 Medicine Pub Date : 2020-04-01 Epub Date: 2020-02-12 DOI: 10.1080/21551197.2020.1725711
Lixia Ge, Chun Wei Yap, Bee Hoon Heng

Objective: To investigate how change in nutritional status is associated with physical function and disability among community-dwelling older adults. Methods: Baseline and 1-year follow-up data of 593 community-dwelling older adults were obtained from the Population Health Index survey in Singapore. The Mini Nutritional Assessment was used to assess nutritional status; the Late-Life Function and Disability Instrument was used to measure physical function and disability. Multivariate linear regression was applied to examine the association of change in nutritional status with physical function and disability. Results: Compared to older adults with normal nutritional status at both baseline and 1-year follow-up, those who became undernourished or remained undernourished reported poorer physical function (B = -6.36 and -5.96, respectively; both P < 0.01), and had less frequent involvement (B = -3.95 and -2.84, respectively; both P < 0.01) and more limitation in performing life tasks (B = -13.24 and -16.02, respectively; both P < 0.01) at 1-year follow-up. However, older adults with improved nutritional status did not differ in physical function and frequency of involvement in life tasks compared to those with normal nutrition. Conclusion: Undernutrition is associated with poorer physical function and disability in community-dwelling older adults regardless of whether it developed or was persistent over one year. Improving nutritional status could be an effective strategy to improve physical function in older adults.

目的:探讨社区老年人营养状况变化与身体功能和残疾的关系。方法:从新加坡人口健康指数调查中获得593名社区居住老年人的基线和1年随访数据。采用迷你营养评估法评估营养状况;使用晚年功能和残疾量表测量身体功能和残疾。应用多元线性回归分析营养状况变化与身体功能和残疾的关系。结果:与基线和1年随访时营养状况正常的老年人相比,营养不良或营养不良的老年人报告的身体功能较差(B分别= -6.36和-5.96;P B分别= -3.95和-2.84;P B = -13.24, -16.02;结论:在社区居住的老年人中,营养不良与身体功能差和残疾有关,无论其是否发展或持续一年以上。改善营养状况可能是改善老年人身体机能的有效策略。
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引用次数: 9
Frailty and Nutrition Risk Screening in Home-Delivered Meal Clients. 家庭送餐客户的虚弱和营养风险筛查。
Q3 Medicine Pub Date : 2020-04-01 Epub Date: 2020-02-03 DOI: 10.1080/21551197.2020.1719258
Heather L Hutchins-Wiese, Sarah E Walsh

Community service providers, such as Meals on Wheels (MOW) programs, help older adults remain in their homes despite advanced care needs. The purpose of this study was to determine if a frailty index (FI) could be calculated from self-reported health, function, and nutrition information already collected by MOW providers to provide additional information for care planning and risk stratification. Data from 258 MOW clients at one provider were used to calculate the FI from 40 possible health and age-related variables collected during routine health assessments. The average FI was 0.29 ± 0.13(SD), range 0.05-0.68. Frailty was categorized as non-frail, vulnerable, frail, and most frail; nutrition risk increased incrementally with these categories; however, they appear to assess risk from differing angles and etiologies. The addition of the FI can provide a more holistic picture of MOW client health than nutrition risk alone and the FI can be calculated from routinely-collected data.

社区服务提供者,如上门送餐(MOW)项目,帮助老年人在需要高级护理的情况下留在家中。本研究的目的是确定衰弱指数(FI)是否可以从MOW提供者已经收集的自我报告的健康、功能和营养信息中计算出来,为护理计划和风险分层提供额外的信息。在常规健康评估期间收集的40个可能的健康和年龄相关变量中,使用来自同一家医疗机构的258名MOW客户的数据来计算FI。平均FI为0.29±0.13(SD),范围为0.05 ~ 0.68。虚弱分为非虚弱、易受伤害、虚弱和最虚弱;营养风险随着这些类别逐渐增加;然而,他们似乎从不同的角度和病因来评估风险。与单独的营养风险相比,增加FI可以更全面地了解MOW客户的健康状况,FI可以从常规收集的数据中计算出来。
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引用次数: 4
Dietary Oily Fish Intake and Frailty. A Population-Based Study in Frequent Fish Consumers Living in Rural Coastal Ecuador (the Atahualpa Project) 食用油性鱼类与身体虚弱。厄瓜多尔沿海农村经常食用鱼类的人群研究(Atahualpa项目)
Q3 Medicine Pub Date : 2020-01-02 DOI: 10.1080/21551197.2019.1681343
O. D. Del Brutto, R. Mera, J. Ha, Jennifer Gillman, M. Zambrano, M. Sedler
Abstract Oily fish are recommended as part of a healthy diet due to their high content of long-chain omega-3 polyunsaturated fatty acids (ω-3 PUFAs), proteins, and other nutrients. There is preliminary evidence of beneficial effects of ω-3 PUFAs in the prevention of sarcopenia (a major component of frailty). In this study, we aimed to assess the relationship between dietary oily fish intake and a measure of frailty – the Edmonton Frail Scale (EFS) score – in community-dwelling older adults living in rural coastal Ecuador. A total of 363 Atahualpa residents were enrolled. The mean fish servings per week were 8.8 ± 5.2 and mean EFS score was 5 ± 2.8 points. A linear regression model showed no association between the amount of oily fish intake and EFS scores. However, an interaction model, with participants stratified according to their median age and fish intake in quintiles, showed a significant effect for both variables on the EFS score (ß coefficient = 0.104; 95% C.I.: 0.003–0.206; p = 0.044). At the lowest quintile of fish intake, younger individuals have lower EFS scores than their older counterparts. As the consumption of oily fish increases, mean EFS scores margins were found to be progressively reduced in subjects aged 60–69 years but were largely unaffected in persons aged ≥70 years. It appears that oily fish intake has a positive effect on the frailty status of younger subjects but is superseded by the effects of age in the older population.
油性鱼类被推荐作为健康饮食的一部分,因为它们富含长链ω-3多不饱和脂肪酸(ω-3 PUFAs)、蛋白质和其他营养素。有初步证据表明ω-3 pufa在预防肌肉减少症(虚弱的主要成分)方面具有有益作用。在这项研究中,我们旨在评估生活在厄瓜多尔沿海农村社区居住的老年人饮食中油性鱼类摄入量与脆弱性测量-埃德蒙顿虚弱量表(EFS)评分之间的关系。共有363名Atahualpa居民被纳入研究。平均每周吃鱼量为8.8±5.2次,平均EFS评分为5±2.8分。线性回归模型显示,油性鱼类摄入量与EFS评分之间没有关联。然而,根据参与者的年龄中位数和鱼摄入量(五分位数)分层的相互作用模型显示,这两个变量对EFS评分都有显著影响(ß系数= 0.104;95% ci: 0.003-0.206;p = 0.044)。在鱼类摄入量最低的五分之一,年轻人的EFS得分低于老年人。随着食用油性鱼类的增加,60-69岁受试者的平均EFS评分边缘逐渐降低,但在≥70岁的受试者中基本不受影响。似乎油性鱼的摄入对年轻人的虚弱状态有积极的影响,但在老年人中被年龄的影响所取代。
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引用次数: 11
Application of the Theory of Planned Behavior to Predict Nutrition Students’ Intention to Work with Older Adults 计划行为理论在预测营养学生与老年人合作意向中的应用
Q3 Medicine Pub Date : 2020-01-02 DOI: 10.1080/21551197.2019.1664967
S. Jung, J. Lawrence, J. Hermann, Amy McMahon
Abstract As Registered Dietitian Nutritionists play an important role in providing nutrition care plans for successful aging, it is important to identify factors influencing nutrition students’ intention to work with older adults. A cross-sectional study was conducted to identify significant predictors of nutrition students’ intention to work with older adults by utilizing the Theory of Planned Behavior (TPB). A total of 183 students, majoring in Nutrition at a large Southern University, completed a questionnaire examining validated TPB constructs. Structural Equation Modeling with maximum likelihood was used to analyze the data. The structural model provided a good fit to the data (x2 = 44.95, df = 38, p < 0.01; RMSEA = 0.03, CFI = 0.99; TLI = 0.99. Attitude (γ = 0.49, p < 0.001) and subjective norm (γ = 0.39, p < 0.001) emerged as significant predictors of nutrition students’ intention to work with older adults. Findings highlight the importance of providing dietetics curricula that provide opportunities for students to develop positive attitudes toward working with older adults. Dietetic educators should present themselves as positive role models in working with older adults, as the educators influence students’ intention to work with this population.
注册营养师营养师在为老年人成功提供营养护理计划方面发挥着重要作用,因此确定影响营养专业学生与老年人合作意愿的因素非常重要。利用计划行为理论(TPB)进行了一项横断面研究,以确定营养专业学生与老年人一起工作的意向的重要预测因素。对183名来自南方某大型大学营养专业的学生进行问卷调查。采用最大似然结构方程模型对数据进行分析。结构模型对数据拟合较好(x2 = 44.95, df = 38, p < 0.01;Rmsea = 0.03, cfi = 0.99;tli = 0.99。态度(γ = 0.49, p < 0.001)和主观规范(γ = 0.39, p < 0.001)是营养专业学生与老年人合作意向的显著预测因子。研究结果强调了提供营养学课程的重要性,为学生提供机会,培养与老年人一起工作的积极态度。饮食教育工作者应该在与老年人一起工作时表现出积极的榜样,因为教育者会影响学生与老年人一起工作的意愿。
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引用次数: 2
Validation of an Online Screener, the Mediterranean Eating Pattern for Americans-III in Older Patients with Parkinson’s Disease 美国老年帕金森患者地中海饮食模式在线筛查的验证
Q3 Medicine Pub Date : 2020-01-02 DOI: 10.1080/21551197.2019.1683116
Katherine E Weaver, J. Goldman, Neltje Ribbens, H. Rasmussen, K. Gustashaw, C. Tangney
Abstract Mediterranean diet accordance has been associated with slower rates of cognitive decline, a common feature in more advanced Parkinson’s disease (PD). Thus, a brief tool was needed to monitor Mediterranean diet accordance of older adults with PD. Relative validity, acceptability, and feasibility of the 21-item online screener, Mediterranean Eating Pattern for Americans (MEPA-III) was assessed. Maximum diet accordance is reflected by a MEPA III score of 21 points. Forty-four adults completed the online reference tool, the VioScreen™ Food Frequency Questionnaire (FFQ), and then the MEPA-III screener three to seven days later. MEPA-III scores averaged 10.7 ± 2.7. When FFQ responses were coded to match those of MEPA-III screener components, agreement for individual components averaged 71.5%, with 8 of 21 component scores with kappas ≥ 0.31 (p < 0.05). Total MEPA-III scores were concordant with those from the FFQ (r = 0.50, p < 0.001). Participants reported that the MEPA-III screener was acceptable (median score 8 out of a possible 10). The screener was feasible because the median completion time was 4.1 min (range 1.6–14.9). The online MEPA-III screener demonstrates good validity, acceptability and feasibility and can be used to characterize a Mediterranean-style diet pattern among participants with PD.
地中海饮食与认知能力下降的速度较慢有关,认知能力下降是晚期帕金森病(PD)的共同特征。因此,需要一种简单的工具来监测老年PD患者的地中海饮食。对21项在线筛选美国人地中海饮食模式(MEPA-III)的相对效度、可接受性和可行性进行评估。最高饮食符合程度反映在MEPA III评分为21分。44名成年人完成了在线参考工具VioScreen™食物频率问卷(FFQ),然后在3至7天后完成了MEPA-III筛选。MEPA-III评分平均10.7±2.7分。当对FFQ反应进行编码以匹配MEPA-III筛选组件时,单个组件的一致性平均为71.5%,21个组件评分中有8个评分kappas≥0.31 (p < 0.05)。MEPA-III总评分与FFQ评分一致(r = 0.50, p < 0.001)。参与者报告说,MEPA-III筛查是可以接受的(中位数得分为8分,满分为10分)。筛选器是可行的,因为中位完成时间为4.1分钟(范围1.6-14.9)。在线MEPA-III筛查显示出良好的有效性、可接受性和可行性,可用于表征PD参与者的地中海式饮食模式。
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引用次数: 3
Does a High-Energy High-Protein Diet Reduce Unintentional Weight Loss in Residential Aged Care Residents? 高能量高蛋白饮食是否能减少老年居民的意外体重下降?
Q3 Medicine Pub Date : 2019-11-26 DOI: 10.1080/21551197.2019.1691108
L. Sossen, M. Bonham, J. Porter
Abstract Malnutrition and unintentional weight loss are known to occur in residential aged care facilities (RACFs). The use of oral nutritional supplements (ONS) and high-energy high-protein (HEHP) diets are two foodservice strategies that may be implemented in efforts to reduce unintentional weight loss in RACFs. This observational study aimed to determine whether incorporation of a structured high-energy high-protein diet (sHEHP) into the standard menu could reduce unintentional weight loss in RACF residents. RACFs in this study were facilities that provide long-term care to older adult residents. Weight change, body mass index and subjective global assessment scores of participants were measured at baseline and at six months across five RACFs receiving usual care with ONS or a sHEHP diet. Groups were different at baseline, with a high prevalence of severe malnutrition observed in the ONS group. Over the six-month period, there was a small but statistically significant difference in weight change within the groups: −1.64 ± 3.62 kg, ONS group; 0.56 ± 2.76 kg, sHEHP group, P = 0.0004. Both approaches investigated are feasible, however, future research using high-quality methods is needed to determine the most effective approach to deliver best practice nutrition care for residents into the future.
营养不良和无意体重减轻是已知发生在住宅养老机构(racf)。口服营养补充剂(ONS)和高能量高蛋白(HEHP)饮食的使用是两种食品服务策略,可用于减少racf意外体重减轻的努力。本观察性研究旨在确定将结构化高能量高蛋白饮食(sHEHP)纳入标准菜单是否可以减少RACF居民的意外体重减轻。本研究中的racf是为老年居民提供长期护理的设施。在基线和六个月时,在五个接受ONS或sHEHP饮食常规护理的racf中,测量参与者的体重变化、体重指数和主观总体评估分数。各组在基线时不同,在ONS组中观察到严重营养不良的高发率。6个月期间,各组体重变化差异虽小但有统计学意义:ONS组为−1.64±3.62 kg;0.56±2.76 kg, sHEHP组,P = 0.0004。这两种方法都是可行的,然而,未来的研究需要使用高质量的方法来确定最有效的方法,为未来的居民提供最佳的营养护理实践。
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引用次数: 5
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Journal of Nutrition in Gerontology and Geriatrics
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