Search

In clinical practice, geriatric nutritional assessment usually includes nutritional screening, a simple anthropometric assessment, measurement of various biochemical parameters, such as serum albumin, and sometimes (not always) body composition analysis (BCA). However, there is a high prevalence of undiagnosed malnutrition in patients with dementia. Several factors contribute to this situation; probably, the most notable is the methodology used to assess body composition (BC). In this regard, for BCA, techniques are needed that are noninvasive, affordable, safe, simple and that require the minimum possible collaboration by the elderly patient. Consequently, body mass index (BMI) and waist circumference (WC) are widely used as indicators of overall and central adiposity, respectively; however, there is no consensus on the cutoffs for the elderly, and changes in BC (especially muscle-mass depletion) are masked by normal values of BMI and WC. Bioimpedance analysis is a simple, cost-effective and precise method for BCA, provided that cross-validated equations are used. Its main disadvantage is that it is highly sensitive to changes in body water (overhydration or dehydration), leading to substantial errors in BC estimates. However, using Bioelectrical Impedance Vector Analysis errors are minimized, as there is no need for the subject to be normally hydrated and it does not require the use of predictive models. European Journal of Clinical Nutrition (2014) 68, 1228-1233; doi: 10.1038/ejcn.2014.168; published online 13 August 2014, MALNUTRITION AND DEMENTIA: WHY MUST BODY COMPOSITION (BC) ANALYSIS BE PERFORMED IN OLDER ADULTS WITH DEMENTIA? Malnutrition is a prevalent syndrome among elderly individuals. Although aging per se implies a [...]

Copyright of International Journal of Medicine & Science of Physical Activity & Sport / Revista Internacional de Medicina y Ciencias de la Actividad Física y del Deporte is the property of Revista Internacional de Medicina y Ciencias de la Actividad Fisica y del Deporte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Social media- and internet-based interventions are nowadays widely used tools in health interventions. Although evidence of their effectiveness is still low, their applications could be very promising due to their affordability and wide reach. The current paper aims to evaluate the effectiveness of an intervention program, "The University of Valladolid Community Eats Healthy" (UVEH), to increase fruit and vegetable (FV) intake in adults from the University of Valladolid (U. Valladolid) employing three online methodologies. A sample of 211 volunteers was randomly assigned into four groups: virtual campus (VC), Facebook (FB), Instagram (IG), and control. An intervention based on the Theory of Planned Behavior was implemented for seven weeks. Data were collected at the beginning (T0) and the end of the program (T1). The Predimed questionnaire was employed to assess FV intake. Vegetable intake was statistically significantly higher in the VC group (17.4% pre vs. 72.7% post). In the rest of the groups, there was also an increase in intake. Fruit consumption increased slightly only in the VC group (23.9% pre vs. 45.5% post). Participation decreased through the weeks: FB (week 2), IG (week 3), and VC (week 4). Retention was higher in the VC (48%) and control (60%) groups. Internet-based interventions employing interactive platforms such as virtual campus can be effective in enhancing participants' dietary habits in a clinically relevant manner.

Malnutrition (MN) is a highly prevalent condition in the elderly. It is associated with functional impairment, disability, frailty, and sarcopenia. The aim was to analyze the capacity of GLIM and ESPEN criteria to diagnose MN in a sample of institutionalized psychogeriatric patients. Clinical and anthropometric data were collected in a cross-sectional study. Patients' frailty, dependence, functional capacity, MNA, hand-grip strength (HS), and sarcopenia were evaluated. Body composition (BC) was estimated by conventional bioimpedance analysis. MN diagnosis was established using the ESPEN and the GLIM criteria based on fat-free mass index (GLIM-FFMI), appendicular skeletal muscle mass index (GLIM-ASMMI), skeletal muscle mass index (GLIM-SMMI), and HS (mGLIM). Ninety-two patients (57.6% men; mean age: 79.4 years) were studied. Depending on the diagnosis criteria, MN prevalence was between 25% (ESPEN) and 41.3% (GLIM-SMMI). Agreement between ESPEN and all GLIM criteria was poor, but it was excellent between all GLIM criteria (kappa > 0.8). Phenotypic criteria carried more weight in the diagnosis of MN than etiological ones. Depending on the parameter used, the prevalence of reduced muscle mass was notably different. Differences in BMI, BC, inflammation, and albumin are detected by the GLIM-FFMI criteria in the MN and non-MN subjects. Also, this criterion is the only one that identified differences in phase angle (PhA) between these groups. In the elderly, PhA can be very useful to monitor nutritional status.

Phase angle (PhA) has been evidenced to be a useful survival indicator and predictor of morbi-mortality in different pathologies, but not in psychogeriatric patients. The aim of this study was to evaluate the clinical utility of PhA as a prognostic indicator of survival in a group of institutionalized psychogeriatric patients. A survival study was conducted on 157 patients (46.5% dementia, 43.9% schizophrenia). Functional impairment stage, frailty, dependence, malnutrition (MNA), comorbidity, polypharmacy, BMI, and waist circumference were registered. Body composition was analyzed using a 50-kHz whole-body BIA; PhA was recorded. The association between mortality and standardized-PhA was evaluated through univariate and multivariate Cox regression models and ROC-curve. The risk of death decreased when Z-PhA, BMI, and MNA were higher. Mortality increases with age, frailty, and dependence. The risk of death was statistically significantly lower (56.5%) in patients with schizophrenia vs. dementia (89%). The Z-PhA cut-off point was -0.81 (Sensitivity:0.75; Specificity:0.60). Mortality risk was multiplied by 1.09 in subjects with a Z-PhA < -0.81, regardless of age, presence of dementia, and BMI. PhA presented a remarkable clinical utility as an independent indicator of survival in psychogeriatric patients. Moreover, it could be useful to detect disease-related malnutrition and to identify subjects eligible for an early clinical approach.

Microbial pathogens are the cause of many foodborne diseases after the ingestion of contaminated food. Several preservation methods have been developed to assure microbial food safety, as well as nutritional values and sensory characteristics of food. However, the demand for natural antimicrobial agents is increasing due to consumers' concern on health issues. Moreover, the use of antibiotics is leading to multidrug resistant microorganisms reinforcing the focus of researchers and the food industry on natural antimicrobials. Natural antimicrobial compounds from plants, animals, bacteria, viruses, algae and mushrooms are covered. Finally, new perspectives from researchers in the field and the interest of the food industry in innovations are reviewed. These new approaches should be useful for controlling foodborne bacterial pathogens; furthermore, the shelf-life of food would be extended.

Introduction: Vector bioimpedance analysis (BIVA) can be very useful for the evaluation of body composition, hydration, and nutritional status in infants and newborns. The objective of this study was to determine the impedance vector distribution for a group of healthy newborn Spanish children., Methods: This was a cross-sectional, descriptive study conducted with 154 healthy, Spanish newborns (gestational age: 37-41 weeks) aged 24 to 72 hours (79 males, 75 females). Weight, height, and cephalic-circumference were determined. Resistance and reactance were measured with a single-frequency impedance analyzer at 50 kHz (tetrapolar analysis). The newborns' specific 95% confidence intervals of the mean vectors and the 95%, 75%, and 50% tolerance intervals for the individual vector measurements were plotted using R and Xc components standardized by the subjects' lengths. The mean impedance vectors were compared with Hotelling's-T 2 test for vector analysis (significance level: P < .05)., Results: The newborns exhibited gender-related differences in the mean impedance vector (mean [SD] R/H: 833.6 [97.5] Ohm/m in males vs 918.2 [107.7] Ohm/m in females; mean [SD] Xc/H: 91.3 [34.7] Ohm/m in males vs 95.6 [23.2] Ohm/m in females). No statistically significant differences in the mean impedance vectors were observed according to days of life. Lower values of resistance and slightly higher reactance values were observed in the healthy Spanish newborns compared to Italian newborns., Conclusions: New tolerance ellipses were constructed for healthy Spanish newborns. These data allow detecting alterations in the hydration status and cell mass in term newborns in the first 3 days of life., (© 2019 Wiley Periodicals, Inc.)

University students are characterized by having inadequate eating habits, along with an unhealthy lifestyle, which, among other factors, can affect the perception they have of their state of health. The aim of the study was to evaluate the health perception of a group of university students according to lifestyle. A cross-sectional observational study was carried out on 214 university students from different universities and branches of knowledge. Anthropometric data were collected. Three questionnaires were administered: PREDIMED (Mediterranean Diet (MD) adherence), SF-36 (perception of health state) and GPAQ (physical activity (PA)). The differences between variables were analyzed using Student-t or Mann-Whitney U, Kruskal-Wallis and Pearson Chi-Square tests. Statistical significance was reached at p < 0.05. Most students were found to be normal weighted. The subjects presented an moderate MD adherence, this being better in Health Sciences students. 75.7% practiced light PA. The health perception is worse for most of the subscales analyzed than that of the reference population (except physical-function, physical-role, and emotional-role). There is an association between PA and health perception: students with intense PA have less body pain and better physical function; the less active, the less vitality. The more physically active subjects the greater MD adherence. Lifestyle and eating habits of health sciences students are healthier than that of students from other branches of knowledge. The physically active subjects have a better perception of quality of life-related to health and greater MD adherence.

Introduction: BMI is the most commonly used indicator to evaluate overweight and obesity, but it cannot distinguish changes in body composition. Over recent years, it has been demonstrated that bioelectrical impedance analysis (BIA) is a more accurate method for analyzing body composition. Bioelectrical impedance vector analysis (BIVA) has revealed its effectiveness as an indicator of nutritional status and hydration., Objective: To assess the usefulness of bioimpedance analysis on the study of body composition in a group of children with overweight and obesity., Materials and Methods: Cross-sectional observational study. The anthropometric parameters of 167 (79 were older than 12 years) overweight and obese children were recorded. Their body composition was analyzed using BIA and BIVA, and was classified based on different criteria. Concordance was analyzed (intraclass correlation coefficient, Bland-Altman analysis and weighted Kappa coefficient). The BIVA of the subgroups was compared using the Mahalanobis distance and Hotelling's T2. Statistical significance was considered for p<0.05., Results: The BMI revealed that the majority of the assessed subjects were obese, although 12% had a normal percentage of fat mass (%FM). The classification by Z-BMI and Z-%FM significantly discriminate between subjects with different levels of adiposity. In children over the age of 12, the classification of fat mass index also discriminates significantly between obesity and non-obesity. As anticipated, in the tolerance ellipses, most of the individual vectors were situated in the left lower quadrant., Conclusions: BIVA reflects differences in the bioelectric patterns of children who are classified as being overweight or obese (BMI) and who have different levels of %FM and FMI. BIVA permits a fast and easy monitoring of the evolution of the nutritional state and changes associated with body composition, and it identifies those children whose body compartments may be precisely estimated using traditional BIA methods., Competing Interests: The authors have declared that no competing interests exist.

Objective: To assess the association between whole-body and calf impedance vectors and muscle mass and strength in a group of elderly individuals., Material and Methods: We carried out a cross-sectional observational study on a sample of 113 elderly people. Anthropometric parameters (weight, height and body circumferences) were determined. Body composition was evaluated using conventional bioimpedance analysis (BIA) and vector bioimpedance analysis (BIVA) (whole-body and calf BIVAs), and muscle strength was determined (manual dynamometry). The results were analyzed using the Student t-test or the Mann-Whitney U, and the correlations using the Pearson or Spearman test. To compare BIVA results among the subgroups established, the Mahalanobis distance (dM) was calculated and the Hotelling T 2 statistic was used. Statistical significance was set to p < 0.05., Results: Nearly half the sample was overweight. Based on waist circumference, 66.7% of the males and 94.9% of the females showed risk of metabolic complications; calf circumference indicated no risk of disability or skeletal muscle mass depletion. However, BIA and dynamometry detected risk of sarcopenia in more than half the subjects. Whole-body BIVA results agreed with those of the BIA, given that most impedance vectors in both sexes were to the right of major axis of the tolerance ellipses. This shows cell mass depletion. While the whole-body BIVA distinguished the subjects having loss of muscle mass and strength, the specific BIVA (calf) only did so in individuals with muscle mass loss., Conclusions: Whole-body BIVA detects loss of muscle mass and strength, while calf BIVA only distinguishes subjects having muscle mass loss. The localized BIVA might be an alternative to conventional BIA or whole-body BIVA to assess body composition in the elderly., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Objectives: Reference values of the bioelectrical impedance vector for the Spanish child and adolescent population are needed for assessing body composition and hydration status in this population. The aim of this study is to provide reference values of the bioelectrical impedance vector in Spanish children and adolescents aged 4-18 years from Castilla y León., Methods: This was a cross-sectional descriptive study conducted in 4401 Spanish healthy children and adolescents aged 4-18 years (2265 boys and 2136 girls). Resistance and reactance were measured with a single-frequency impedance analyzer at 50 kHz (tetrapolar analysis). The values of resistance and reactance normalized by height were used to plot the bivariate 50th, 75th, and 95th percentiles of the population by age group. Mean impedance vectors were compared with Hotelling's T 2 test for vector analysis (differences being considered significant if p < .05)., Results: Tolerance ellipses were drawn for the Spanish child and adolescent population studied. The mean impedance vector showed displacement across all age groups except for (1) girls aged 12-13 years, (2) girls aged 15-18 years, and (3) boys aged 16-18 years. There were sex-related differences in the mean impedance vector in all age ranges, even in prepubertal children. Among adolescents, the patterns of the vector displacement were consistent with the timing of normal growth and development in all groups and are attributable to the maturation process., Conclusions: New tolerance ellipses have been constructed for Spanish children and adolescents by sex and age. These ellipses reflect the timing of normal childhood growth and development., (© 2017 Wiley Periodicals, Inc.)

Objective: To compare body composition as assessed by conventional and vector bioelectrical impedance analysis according to the nutritional cataloging using body mass index (BMI) in a group of institutionalized elderly., Methods: Cross-sectional study in 38 institutionalized elderly. Body composition was estimated by bioimpedance analysis. Differences in body composition were analyzed using t-test and ANOVA, or their corresponding nonparametric tests. Statistical significance was set at p<0.05., Results: Based on BMI, the sample showed overweight (average BMI: 26.4kg/m 2 ), and women had higher BMI values than men (28.9 vs. 25.5kg/m 2 ). Based on waist circumference, abdominal obesity was detected in 60.7% of men and 80% of women. Conventional bioimpedance analysis (BIA) yielded high fat mass values and slightly depleted skeletal muscle mass, compatible with sarcopenic obesity. All individual impedance vectors were located on the right of the major axis of the tolerance ellipses, reflecting body-cell-mass depletion in all subjects, regardless of BMI cataloging., Conclusions: Bioelectrical impedance vector analysis (BIVA) detects body compartment changes in institutionalized elderly that are not identified by the most widely used clinical practice nutritional indicators, such as BMI, waist circumference, and BIA-estimated body composition., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objective: to assess the utility of body mass index (BMI) and waist circumference (WC) as surrogate indicators of adiposity with respect to the total body fat estimated with bioimpedance analysis in psychogeriatric patients., Methods: Anthropometric and hand-to-foot bioimpedance measurements were performed according to standard procedures in a sample of 128 psychogeriatric patients (87 males, 41 females). WC cutoffs proposed by the International Diabetes Federation were used to define abdominal obesity. Z-scores of fat and fat-free mass indices (Z-FMI and Z-FFMI) were calculated., Results: Males with WC values below the cutoff were normal weight, and showed normal levels of FM and low FFM (Z-FFMI below 1.5 SD). Males with WC values above the cutoff were overweight, showed high levels of FM (Z-FMI: 1.34 SD) and a slight depletion of FFM (Z-FFMI: -0.59 SD). In females with WC values below the cutoff, BMI was close to 20 kg/m(2) and both FM and FFM were depleted (Z-FMI: -0.7 SD; Z-FFMI: -1.76 SD). In females with WC above the cutoff, the average BMI was 25.6 kg/m(2) , Z-FMI was 0.48 SD, and Z-FFMI was -0.56 SD., Conclusions: Our results indicate that it is necessary to establish age and sex-specific BMI and WC cutoffs, and also highlight the importance of focusing on body composition analysis to ensure an accurate nutritional diagnosis in older-adults and in psychogeriatric patients., (© 2015 Wiley Periodicals, Inc.)

Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, because elderly people are a vulnerable group due to their biological, psychological and social characteristics. Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología, SEGG) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner. The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories seeks to aid in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment associated to laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is to further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Objective: Although dementia and nutritional status have been shown to be strongly associated, differences in body composition (BC) among older people with dementia have not yet been firmly established. The aim of this study was to assess BC through conventional and vector bioimpedance analysis (BIA and BIVA, respectively) in a sample of institutionalized older men with and without dementia, in order to detect dementia-related BC changes., Methods: Forty-one institutionalized men ages ≥ 65 y (23 without dementia [CG] and 18 with dementia [DG]) were measured with BIA and interpreted with BIVA and predictive equations., Results: Age (74.4 and 75.7 y) and body mass index (22.5 and 23.6 kg/m(2)) were similar for DG and CG, respectively. Resistance and ratio of resistance to height did not differ significantly between the two groups. Reactance and ratio of reactance to height were 21.2% and 20.4% lower in DG than in CG. Phase angle was significantly lower in DG (mean = 4.0; 95% confidence interval [CI], 3.6°-4.3°) than in CG (mean = 4.7; 95% CI, 4.3°-5.1°). Mean fat mass index (6 and 7 kg/m(2)), and mean fat-free mass index (16.4 and 16.6 kg/m(2)) were similar in both groups. BIVA showed a significant downward migration of the ellipse in DG with respect to CG (T(2) = 15.1; P < 0.01)., Conclusion: Conventional BIA showed no significant differences in BC between DG and CG, although reactance and ratio of reactance to height were about 21% lower in DG. Nevertheless, a body cell mass depletion and an increase in the ratio of extracellular to intracellular water were identified in DG using BIVA. BIVA reflects dementia-related changes in BC better than BIA., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: A new analytical variation of bioelectrical impedance vector analysis (BIVA), called specific BIVA, has shown to be more accurate in detecting changes in fat mass than classic BIVA., Objective: To compare classic and specific BIVA in order to identify which is more strongly associated with psycho-functional and nutritional indicators in a group of institutionalised elderly patients with dementia., Subjects and Methods: Cross-sectional study. Fifty-four patients (34 women, 20 men) with dementia in moderately severe to very severe stages and aged 60-95years underwent geriatric nutritional assessment, including body mass index calculations, the Mini Nutritional Assessment, the Geriatric Nutritional Risk Index, and whole body composition analysis., Results: With specific BIVA (unlike with classic BIVA), significant differences were found between women with moderately severe and very severe dementia. In the BIVA conducted for body mass index, the confidence ellipses produced with the classic BIVA approach were highly overlapping; but with specific BIVA, significant differences were observed between the women in different nutritional categories (malnutrition, risk of malnutrition, normal weight and obesity). On the other hand, both approaches distinguished malnourished women from those who were at risk of malnutrition, according to the Mini Nutritional Assessment; and men with a moderate-high risk of malnutrition from men with no risk, on the basis of the Geriatric Nutritional Risk Index., Conclusion: Overall, the findings of the present study suggest that specific BIVA is more effective than classic BIVA in identifying bioelectrical changes associated with psycho-functional and nutritional indicators in institutionalised elderly with dementia., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Previous studies have shown a reduction in lymphocyte mitochondrial complex I activity (CIA) in malnourished patients, which is restored after refeeding. Our aim was to evaluate the usefulness of CIA as an indicator of nutritional status in anorexia nervosa patients. Twelve malnourished anorexia nervosa females (mean age, 24.5 years) were admitted to the Eating Disorders Unit. Basal and weekly anthropometrics, bioelectric impedance (BIA), body composition, and CIA were performed until discharge. Patients were matched to 25 healthy females and refeeding was adjusted according to the Unit's protocol. Statistics were used as appropriated and significance was reached at p < 0.05. Patients showed a significant reduction in body mass index, fat mass and fat free mass (FFM), triceps skinfold, and waist circumference on admission as compared with the control group. Parameters improved during hospitalization, but they failed to reach normal values at discharge. Compared with controls, CIA was significantly lower in patients on admission (2.16 vs. 5.68 nmol·min(-1)·mg protein(-1)). Refeeding and weight gain did not restore CIA. A positive association (r(2) = 0.69) was found between FFM and CIA in patients at discharge. Malnourished females with anorexia nervosa have lower CIA than controls that is not recovered after refeeding. This could be because of a low FFM exacerbated by physical inactivity while in hospital.

Patients with eating disorders (ED) show alterations in both their behaviour and their intake of food, frequently presenting nutritional and somatic affectations. Besides the classical forms such as anorexia or bulimia nervosa, there has recently been an increase in atypical or incomplete forms of ED, such as binge eating. Primary care (PC) services form the central and closest nucleus of health care for the individual and the family, where ED occur and leave their mark. This allows PC to provide an integral response at all levels of care for ED. Primary prevention at school, in the family and community is fundamental to avoiding its inception. Secondary prevention is based on early diagnosis and treatment of ED and favours a better prognosis of the illness. Tertiary prevention tries to reduce the serious consequences with rehabilitation measures to alleviate complications and avoid risk to life. Due to its complexity, these patients are afforded the attention of multidisciplinary teams of specialists with experience in treating this condition. In consultation with the team, the general practitioner should adopt a leading role at all levels of attention, as he/she is the link between the team, the family and the patient. This requires both regulated, specific training in the disease and the allocation of resources to carry it through. Putting into practice all these plans would allow us to give a positive answer to the question posed in the title of the present article.