4th May 2018

Healthcare and communications professionals will bring PROMISS-results to the older adults

The world is facing a situation without precedent: we will soon have more older people than children, and more people at very
old age than ever before. When looking at nutrition in old age, it strikes that more than 90 % of older people in Europe are living at home, and a very poor appetite is reported by 10–15 % of them, which, consequentially, causes malnutrition, and a ‘cascade’ of deteriorated body functions and illnesses; muscle loss, cognitive decline, weak immune systems and slowed wound healing.

The PROMISS project intends to tackle malnutrition, and Professor Marjolein Visser from Vrije Universiteit Amsterdam explains that, in order to design concrete and tailored solutions, optimal protein intake combined with physical activity at certain time points release extra positive effects on ageing. We should however not be left alone in improving our nutrition: the support by healthcare professionals is key.

Discover more in the extensive article, appeared in the BIOECONOMY INNOVATION – COMMBEBIZ MAGAZINE 2017-2018

13th March 2018

Kristina S. Fluitman, Madelief Wijdeveld, Max Nieuwdorp, Richard G IJzerman Gut.

2018 Jan 30. pii: gutjnl-2017-315543. doi: 10.1136/gutjnl-2017-315543. [Epub ahead of print]

Various issues influence our appetite and metabolism, and gut bacteria have a role to play in there. A previous research project focused on one of the substances made by gut bacteria, namely butyrate, which is thought to improve body weight, appetite, and glucose- and fat-metabolism.

The project demonstrated in mice that most effects of butyrate on body weight and metabolism were actually not caused by butyrate directly.  Rather, butyrate caused a decrease in appetite and food intake, which in turn caused the improvements in body weight and metabolism. Because of its effects on appetite, the researchers concluded that butyrate might potentially be used as weight-losing drug.

PROMISS would like more research to be carried out. The fact that that project was performed in mice, not in human beings, cannot make us jump to the conclusions that their results would be similar in human beings.  The PROMISS experience is that effects in mice (promising as they might be) are often not as remarkable in humans. Furthermore, even if butyrate would work as effective in humans as it does in mice, we think that it might only work in specific individuals.

Read the whole scientific paper here: “Potential of butyrate to influence food intake in mice and men”.

14th December 2017

Antoneta Granic, Nuno Mendonca, Avan Aihie Sayer, Tom R Hill, Karen Davies, Ashley Adamson, Mario Siervo, John C Mathers, Carol Jagger

Clinical Nutrition 2017 Nov 9 (Article in Press).

As they age adults experience a progressive decline in muscle mass and strength which puts them at increased risk of falls, frailty, disability and death. Physical inactivity and a poor diet can accelerate this loss of muscle mass and strength. We aimed to investigate the relationship between an important part of the diet for muscle, protein intake, and muscle strength and physical performance in very old adults (aged 85 years) as they aged further. Our study, the Newcastle 85+ Study, was based in North East England, and involved 722 people aged 85 years old, with diet assessed by 24h recalls on two non-consecutive days. Low protein intake was defined as less than 1 g per kg of adjusted body weight per day (or around 65 g per day for an average weight individual). Muscle strength was measured by grip strength (squeezing a dynamometer for 5s) and physical performance was measured by the Timed Up-and-Go test (getting up, walking 3 m, walking back, and sitting again). Both grip strength and Timed-Up-and-Go were measured at age 85, 87.5, 88 and 90 years of age.

We found that very old women who had low protein intake had lower grip strength and Timed-Up-and-Go at baseline, but grip strength and Timed-Up-and-Go declined at the same rate as in women with adequate protein intake (1 g per kg of adjusted body weight or more). For men, there was no difference in the baseline measures or decline in grip strength and Timed-Up-and-Go between those with low or adequate protein intake. We found an added benefit of combining adequate protein intake (above 1 g per kg of adjusted body weight per day) with medium/high physical activity on muscle strength. This positive effect was not observed if medium/high physical activity was combined with low protein intake. We conclude that (a) low protein intake may negatively affect muscle strength and physical performance in late life, especially in older women and before age 85, independently of other important factors; and (b) a combination of adequate protein intake and physical activity may be necessary to reduce the loss of muscle strength in the very old.

Read the whole scientific paper here.

22nd November 2017

Nuno Mendonça, Antoneta Granic, John C. Mathers, Tom R. Hill, Mario Siervo, Ashley J. Adamson, Carol Jagger

European Journal of Nutrition 2017 Sep 25. doi: 10.1007/s00394-017-1537-5. [Epub ahead of print]

The very old, those aged 85 years and older, are the fastest growing age group in most western societies and are at especially high risk of malnutrition, as well as loss of muscle mass and strength. The amount of protein that the very old get from their diet, which foods provide the best source of protein and the time of day that such foods are eaten, are all factors that may play important roles in delaying or even preventing malnutrition and such information is essential to develop new food products and public health policies to better tackle the problem of malnutrition. Our study, the Newcastle 85+ Study, was based in North East England, and involved 722 people aged 85 years old, whose diet was estimated by a 24 hour multiple pass recall (people are asked what foods and drinks were consumed in the past 24 hours) on two non-consecutive days. We found that 28% of our population were below the commonly used protein intake target (0.8g of protein per kg of adjusted bodyweight per day) and that this group ate less meat, more cereals and had more non-alcoholic beverages than those who had adequate protein intake. After accounting for other factors, people in the low protein group were more likely to be men, had lower energy intake and fewer teeth. People with low protein also took more of their protein during the morning than those in the adequate protein intake group. This study provides new evidence of the magnitude of low protein intake in the very old, the sources of protein and the diurnal patterning of protein intake.

Read the whole scientific paper here.

19th September 2017

S. van der Meij , H. A.H. Wijnhoven , J. S. Lee, D. K. Houston, T. Hue, T. B. Harris, S. B. Kritchevsky , B. Newman , M. Visser

Journal of the American Geriatrics Society, accepted for publication on 31-5-2017

Poor appetite is a problem in many older adults and is associated with unintentional weight loss and lower quality of life. Insight in food preferences of these older adults could be used to improve dietary intake and develop meals, drinks and snacks that are specifically adapted to these preferences. It can also be used to identify the risk of nutrient deficiencies.

In this study we investigated differences in food intake by appetite level among 2.597 older adults (70-79 years) who are living in the United States and who participated in the second year of the Health, Aging and Body Composition Study. The dietary intake of the older adults was measured with a “food frequency questionnaire” that consisted of 108 items on frequency and amount of different foods.

In total, 22% of the older adults reported that they had a poor appetite, 38% reported a good appetite and 40% a very good appetite. The older adults with a poor appetite were more often female, black, lower educated, and reported a poorer general health status, more biting/chewing problems, unintentional weight loss, and a lower Healthy Eating Index score.

The older adults with a poor appetite consumed less protein and dietary fiber, less solid foods, smaller portion sizes, less wholegrains, and less fruits and vegetables than older adults with a very good appetite. They consumed more dairy foods, fats, oils, sweets and soda’s.

This study shows that older adults with a poor appetite report a different dietary intake pattern compared to those with very good appetite. The study results can be used for nutrition interventions to enhance food intake, diet variety and diet quality in older adults with a poor appetite.

Read the whole scientific paper here.

19th June 2017

Houston DK, Tooze JA, Garcia K, Visser M, Rubin S, Harris TB, Newman AB, Kritchevsky SB; Health ABC Study.

J Am Geriatr Soc. 2017 Mar 17. doi: 10.1111/jgs.14856

In this study we investigated the protein intake of 1.998 older adults (70-79 years) who are living in the United States and who participate in the Health, Aging and Body Composition Study. On average, the older adults consumed 66.2 gram of protein per day. Of the men, 27.3% consumed less protein than the current Recommended Dietary Allowance, which indicates a consumption of at least 0.8 gram protein per kilogram of body weight. For women this was 26.5%.

All adults were well-functioning at baseline. The older adults were followed over 6 years, during which 45.5% developed a new mobility limitation, indicating they reported to experience difficulties walking one-quarter of a mile or climbing 10 steps without resting.

Older adults who consumed less than 0.70 grams of protein per kilogram of body weight at baseline, and those who consumed between 0.70 and 1.0 grams of protein per kilogram of body weight at baseline, were more likely to developed mobility limitation during the 6 years compared to older adults who consumed 1.0 or more grams of protein per kilogram body weight. These findings were similar when the animal protein consumption or the vegetable protein consumption were investigated separately.

The results of this research suggest that older adults with a lower protein intake are at greater risk of developing mobility limitations. They also suggest that consuming 1.0 or more grams of protein per kilogram body weight might be optimal for older persons to maintain physical function.

Read the whole scientific paper here.

18th June 2017

Fluitman, K. S., De Clercq, N. C., Keijser, B. J. F., Visser, M., Nieuwdorp, M., & Ijzerman, R. G. (2017). The intestinal microbiota, energy balance, and malnutrition: emphasis on the role of short-chain fatty acids. Expert Review of Endocrinology & Metabolism, 12(3), 215-226. doi: 10.1080/17446651.2017.1318060

 

Over the last decades, increasing attention is being directed toward the vast amount of bacteria inhabiting the human gut: the intestinal microbiota.

These microbiota have been demonstrated to actively influence human energy balance.

Thus, a disruption of the normal microbiota can contribute to the development of malnutrition.

Accordingly, it was demonstrated that microbial composition differs between subjects with and without malnutrition.

This review of the literature summarizes the pathways through which the intestinal microbiota might contribute to malnutrition, how the microbiota differs in over- and undernutrion, and how the microbiota could be manipulated in a way to promote a healthy nutritional state.

Read the whole scientific paper here.