With the European population growing older, the challenge is to keep an increasing number of seniors across all European countries healthy and active. In Europe, between 13.5 % and 29.7 % of older adults living at home are malnourished or at risk of protein energy malnutrition. PROMISS aims to better understand and ultimately prevent protein energy malnutrition in seniors. Thereby, PROMISS will contribute to improve active and healthy ageing.

Project information

Nutrition for healthy ageing


12th November 2019

Protein intake and transitions between frailty states and to death in very old adults: The Newcastle 85+ Study

Nuno Mendonça, Andrew Kingston, Antoneta Granic, Carol Jagger.

Age and Ageing, afz142, https://doi.org/10.1093/ageing/afz142


Frailty is a clinical syndrome defined as an increased vulnerability to recover after a health shock. Pre-frailty and frailty are estimated to be present in 42% and 11% of community‐dwelling older adults respectively, and both increase with age. Frail older adults are at increased risk of disability, hospitalisation, care home admission and death. In this study we have used five criteria: muscle weakness, slow walking speed, low physical activity, exhaustion, and unintentional weight loss to define frailty. Malnutrition is central to all these criteria and it might be that a good intake of dietary protein is a viable strategy to change the progression of frailty in older adults by slowing down the progressive loss of muscle mass and physical function. We used data from a study on 700 very old adults that turned 85 years old in 2006/2007 living in North East England and we followed them until they were 90. Protein intake was estimated with a 24-hour multiple pass recall (people were asked what foods and drinks were consumed in the past 24 hours) on two different occasions in 2006/2007. We found that participants with higher protein intake were less likely to become frail if they were pre-frail to begin with. This was also true for those who had protein intake higher than 0.8 or 1.0 grams per kilogram of adjusted bodyweight. Energy intake seems to play an important role in this relationship between protein and frailty.


You can access the full scientific article here

16th September 2019

Oral health determinants of incident malnutrition in community-dwelling older adults

Eva Kiesswetter, Linda M. Hengeveld, Bart JF Keijser, Dorothee Volkert, Marjolein Visser.

Journal of Dentistry, Volume 85, June 2019, Pages 73-80  doi.org/10.1016/j.jdent.2019.05.017


Malnutrition is a state of energy or protein deficiency, which causes measurable changes in body functions. Among older people malnutrition is widespread and is associated with frailty, functional decline and poor quality of life. Malnutrition can be caused by multiple different factors such as disease-related, functional, psychological, and socio-economic aspects. Moreover, it is assumed that the oral health status plays a role in the development of malnutrition, as mastication and insalivation are important steps in eating and digesting. Therefore, the aim of our study was to investigate the association of different oral health characteristics and the development of malnutrition during 9-years in community-dwelling older adults.

The data used were from the Longitudinal Aging Study Amsterdam (LASA). We included participants aged 55-80 years without malnutrition at the beginning of the investigation. To describe oral health status, aspects relating to teeth, dentures, oral hygiene and oral problems (e.g. bleeding gums) as well as the self-rated oral health were assessed.

Of the 19 investigated oral health characteristics, toothache while chewing was identified to increase the risk of devolving malnutrition. In addition, for a poor self-rated oral health and the feeling of a dry mouth in combination with having no teeth we found indications that they might play a role in the long-term development of malnutrition. Regarding strategies to prevent malnutrition in older people these three aspects are of specific interest as they are modifiable and can be easily assessed by self-reports.


You can access the scientific article here

3rd September 2019

The association of olfactory function with BMI, appetite, and prospective weight change in dutch community-dwelling older adults

K.S. Fluitman, H.J. Nadar, D.S. Roos, H.W. Berendse, B.J.F. Keijser, M. Nieuwdorp, R.G.Ijzerman, M. Visser

J Nutr Health Aging (2019). https://doi.org/10.1007/s12603-019-1241-7


A common phenomenon amongst older adults is a decline in appetite, which is thought to contribute to the occurrence of undernutrition. This decline in appetite is called: “Anorexia of Aging”. Many factors are thought to contribute to anorexia of aging, including a decrease in smell function as we become older. A deteriorating sense of smell is believed to diminish eating pleasure and change people’s food-related choices. This would then lead to lower food intake and ultimately undernutrition.
In this study, we evaluated whether sense of smell was associated with appetite, weight change and BMI. In other words: do people with poorer sense of smell also report poorer appetite, suffer more weight loss and have a lower BMI? In 2012-2013, we used a commercially available smell test (the 40-item UPSIT test) to assess sense of smell in 824 Dutch older adults, aged 55-65 years old. All these older adults were also enrolled in the larger LASA-study which studies the consequences of aging in the Netherlands. In addition to the results of the smell test, we made use of the self-reported appetite, weight, and BMI, as well as many other variables measured by LASA.
Ultimately, 673 participant had correctly filled out the UPSIT-test and were included in this study. No association between sense of smell and appetite or weight change could be found. However, there was an association between poorer sense of smell and lower BMI in older adults who smoke, but not in older adults who do not smoke.
This means that poor sense of smell in older adults who also smoke might be a vulnerable group when it comes to undernutrition.


You can also read the scientific article here.

View all news


Want to learn more about #protein malnutrition in #older adults? Come visit the @PROMISS_VU booth at the #EFADConference2019 in Berlin on 01-02 November! You will find us next to the @efad_org booth, at the back of the hotel reception desk.

About 5 days ago from PROMISS Project's Twitter via TweetDeck

View all Tweets