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Background: The aim of the study was to identify and compare components of the COM-B (capability, opportunity, motivation and behaviour) model, that influences behaviour to modify dietary patterns in 40-55-year olds living in Northern Ireland (NI) and Italy, in order to reduce the risk of cognitive decline in later life.Methods: This was a qualitative study examining factors influencing Mediterranean-DASH (Dietary Approaches to Stop Hypertension) Intervention for Neurodegenerative Delay (MIND) diet behaviour. This study further elaborated the COM-B components into the 14 domains of the Theoretical Domains Framework to further understand behaviour. Twenty-five Northern Irish and Italian participants were recruited onto the study, to take part in either a focus group or an interview. Participants were both male and female aged between 40 and 55 years.Results: Thematic analysis revealed that the main barriers to the uptake of the MIND diet were; time, work environment (opportunity), taste preference and convenience (motivation). Culture (motivation), seasonal foods and lack of family support (opportunity) to be a barrier to the Italian sample only. The main facilitators reported were; improved health, memory, planning and organisation (motivation) and access to good quality food (opportunity). Cooking skills, knowledge (capability) and heathy work lunch (opportunity) reported as a facilitator to the Italian sample only.Conclusions: Cross-cultural differences in relation to psychosocial barriers and facilitators were found in both samples. More barriers than facilitators towards uptake of the MIND diet were found. There is a need for interventions that increase capability, opportunity, and motivation to aid behaviour change. The findings from this study will be used to design a behaviour change intervention using the subsequent steps from the Behaviour Change Wheel. [ABSTRACT FROM AUTHOR]

Background: Short-term and mid-term comparison of the efficacy of a multimodal program that incorporates a therapeutic workout program, medication review, diet adjustment and health education, in comparison to the standard medical practice in the improvement of the neuromuscular and physiological condition. Furthermore, it is intended to analyse the maintenance of these effects in a long-term follow-up (12 months) from the onset of the intervention.Methods: A randomized clinical trial of elderly frail patients drawn from the Clinical Management Unit "Tiro de Pichón", Health District of Malaga, will be included in the study (after meeting the inclusion / exclusion criteria) will be randomized in two groups: a control group that will undergo an intervention consistent of medication review + diet adjustment + health education (regular workout recommendations within a complete advice on healthy lifestyles) and an experimental group whose intervention will consist of a multimodal treatment: therapeutic workout program+ medication review+ diet adjustment + health education. The sociodemographic, clinical and tracing variables will be reflected at the beginning of the study. In addition, the follow-up variables will be gathered at the second and sixth months after the beginning of the treatment and at the third and sixth months after the treatment (follow-up). The follow-up variables that will be measured are: body mass index, general health condition, fatigue, frailty, motor control, attention- concentration- memory, motor memory, spatial orientation, grip strength, balance (static, semi-dynamic), gait speed and metabolomics. A descriptive analysis of the sociodemographic variables of the participants will be conducted. One-Factor ANOVA will be used for the Within-Subject analysis and as for the Between-Subject analysis, the outcome variables between both the groups in each moment of the data collection will be compared.Discussion: A multimodal program that incorporates a therapeutic workout program, medication review, diet adjustment and health education may be effective treatment to reduce the functional decline in elderly. The results of the study will provide information on the possible strengths and benefits in multimodal program in elderly.Trial Registration: ClinicalTrials.gov NCT02772952 registered May 2017. [ABSTRACT FROM AUTHOR]

Aim: Amyotrophic lateral sclerosis (ALS) is a chronic, neurodegenerative disease, which leads to development of malnutrition. The main purpose of this research was to analyze the impact of malnutrition on the course of the disease and long-term survival. Material and methods: A retrospective analysis has been performed on 48 patients (22 F [45,83%] and 26 M [54,17%], the average age of patients: 66,2 [43-83]) in 2008-2014. The analysis of the initial state of nutrition was measured by body mass index (BMI), nutritional status according to NRS 2002, SGA and concentration of albumin in blood serum. Patients were divided into two groups, depending on the state of nutrition: well-nourished and malnourished. The groups were created separately for each of these, which allowed an additional comparative analysis of techniques used for the assessment of nutritional status. Results: Proper state of nutrition was interrelated with longer survival (SGA: 456 vs. 679 days, NRS: 312 vs. 659 vs. 835 days, BMI: respectively, 411, 541, 631 days, results were statistically significant for NRS and BMI). Concentration of albumin was not a prognostic factor, but longer survival was observed when level of albumin was increased during nutritional therapy. Conclusions: The initial nutrition state and positive response to enteral feeding is associated with better survival among patients with ALS. For this reason, nutritional therapy should be introduced as soon as possible. [ABSTRACT FROM AUTHOR]

Background: Dietary supplements have been extensively studied for their beneficial effects on cognition and AD neuropathology. The current study examines the effect of a medical food cocktail consisting of the dietary supplements curcumin, piperine, epigallocatechin gallate, α-lipoic acid, N-acetylcysteine, B vitaminsvitamin C, and folate on cognitive functioning and the AD hallmark features and amyloid-beta (Aβ) in the Tg2576 mouse model of the disease. Principal Findings: The study found that administering the medical food cocktail for 6 months improved cortical- and hippocampal- dependent learning in the transgenic mice, rendering their performance indistinguishable from non-transgenic controls. Coinciding with this improvement in learning and memory, we found that treatment resulted in decreased soluble Aβ, including Aβ oligomers, previously found to be linked to cognitive functioning. Conclusion: In conclusion, the current study demonstrates that combination diet consisting of natural dietary supplements improves cognitive functioning while decreasing AD neuropathology and may thus represent a safe, natural treatment for AD. [ABSTRACT FROM AUTHOR]

Aging is associated with increasing inflammation and oxidative stress in the body, both of which can have negative health effects. Successful attenuation of such processes with dietary countermeasures has major public health implications. Soy foods, as a source of high-quality protein and isoflavones, may improve such indices, although the effects in healthy postmenopausal women are not well delineated. A single-blind, randomized controlled trial was conducted in 31 postmenopausal women who were assigned to consume 3 servings of soy (n = 16) or dairy (n = 15) milk per day for 4 weeks. Parameters of systemic inflammation (tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6)) and the oxidative defense system (superoxide dismutase (SOD), glutathione peroxidase, cyclooxygenase-2) were measured post supplementation, before and after an eccentric exercise bout performed to elicit an inflammatory response. A significant group-by-time effect for plasma TNF-α was observed (p = 0.02), with values in the dairy group increased post supplementation and then decreasing into the postexercise period. Additionally, significant time effects were observed for plasma SOD (p < 0.0001) and IL-6 (p < 0.0001) in the postexercise period. Overall results from our study do not support the notion that 4 weeks of daily soy milk ingestion can attenuate systemic elevations in markers of inflammation or oxidative defense. However, data do suggest that the downhill-running protocol utilized in this study can be effective in altering systemic markers of inflammation and oxidative defense enzyme activity, and that the ingestion of soy may help prevent fluctuations in plasma TNF-α. Le vieillissement est associé à plus d’inflammation et de stress oxydatif dans l’organisme, ce qui entraine des effets négatifs sur la santé. L’atténuation de ces effets au moyen de mesures alimentaires s’avère de la plus haute importance en matière de santé publique. Les produits de soja, sources de protéines de grande qualité et d’isoflavones, recèlent un potentiel d’amélioration de ces processus; cependant on ne connait pas bien les effets chez les femmes postménopausées en bonne santé. Dans un essai clinique comparatif à simple insu et d’une durée de quatre semaines, on répartit au hasard 31 femmes postménopausées; 16 acceptent de consommer tous les jours trois portions de produits de soja et 15, des produits laitiers. Les paramètres de l’inflammation systémique (TNF-α, IL-1β, IL-6) et du système de défense contre l’oxydation (SOD, GPx, COX-2) sont évalués après la supplémentation, et ce, avant et après une séance d’exercices pliométriques suscitant une réponse inflammatoire. On observe un effet significatif du traitement en fonction du temps : les valeurs de TNF-α plasmatique (p = 0,02) du groupe consommant des produits laitiers augmentent après la supplémentation puis diminuent après la séance d’exercices. De plus, on observe un effet significatif en fonction du temps au sujet du SOD (p < 0,0001) et des IL-6 (p < 0,0001) plasmatiques après la séance d’exercices. D’après ces observations, la consommation quotidienne de boisson de soja durant quatre semaines n’atténue pas les augmentations des marqueurs de l’inflammation et du système de défense antioxydative. En contrepartie, ces observations suggèrent que la course sur pente négative utilisée dans cette étude est efficace dans la modification des marqueurs systémiques de l’inflammation et de l’activité enzymatique suscitée pour la défense antioxydative et que la consommation de soja peut contribuer à la prévention des fluctuations plasmatiques de TNF-α. [ABSTRACT FROM AUTHOR]

Abstract: Age-related macular degeneration (AMD) is a leading cause of vision loss in people over the age of 60 with a prevalence that continues to rise, particularly in industrialized nations. Although treatments for AMD were once limited, with disappointing clinical results, new treatments have emerged for both the nonexudative and exudative forms of the disease, which have improved prognostic outcomes. These treatments include nutritional supplementation, antioxidant prophylaxis, and intravitreal injection of medications that inhibit aberrant vascular proliferation. This review serves as a summary of the current and experimental therapies for both exudative and nonexudative AMD. Although a number of challenges and clinical questions remain, the future of treating AMD appears promising particularly as we gain further insights into the genetic and biochemical pathways of the disease. [Copyright &y& Elsevier]

Dysphagia is a difficulty in eating and swallowing of solid and/or liquid foods in elderly patients. Texture characterization of therapeutic diets for dysphagia patients has not been studied extensively. In this study, five different pureed therapeutic cakes (apple, orange, vanilla, carrot, and chocolate), previously proved efficient in the treatment of dysphagic patients, were evaluated for firmness, cohesiveness, adhesiveness, and springiness using textural profile analysis. The therapeutic cakes were tested at two serving temperatures: 12°C and 23°C. Results of sensorial tests confirmed that clinical efficiency and texture firmness of the therapeutic cakes ranged from 0.741 to 2.52 N for cakes at 12°C and from 0.608 to 2.58 N for cakes at 23°C. Similarly, cohesiveness ranged from 0.391 to 0.561 at 12°C and 0.479 to 0.568 at 23°C, adhesiveness from -0.219 to -0.436 N at 12°C and - 0.201 to -0.424 N at 23°C and finally springiness ranged from 46 to 70% at 12°C and 24 to 61% at 23°C. Non-therapeutic cakes averaged 2.77 N for firmness, 0.553 for cohesiveness, -0.385 N for adhesiveness, and 55% for springiness. [ABSTRACT FROM AUTHOR]

Background Observational studies have shown associations between nutritional status and cognition in later life but evidence from intervention studies is unclear. The present study systematically reviewed the evidence on the effect of nutrient supplementation on cognitive function in people aged ≥65 years. Methods Databases including MEDLINE and EMBASE were searched up to 1 September 2006. Randomized controlled trials using at least one kind of vitamin, mineral or omega-3 fatty acid, evaluating standardized neuropsychological test(s), were included. There were no restrictions on participants’ baseline nutritional status or cognitive function. Quality assessment and data abstraction were conducted by one author and checked by another. Results Of 4229 articles retrieved, 22 trials (3442 participants) were identified. Many were small, short duration and of poor methodology. Only 16 out of 122 cognitive tests were significantly different between groups. A meta-analysis showed no significant effect of taking B vitamins or antioxidant vitamins on global cognitive function. There was insufficient evidence to evaluate the effect of omega-3 fatty acids on any cognitive domains. Conclusion There was little evidence of a beneficial effect from taking B vitamins or antioxidant supplements on global cognitive function in later life. Larger-scale randomized controlled trials of longer duration in selected age groups are needed. [ABSTRACT FROM AUTHOR]

In 1999 we proposed a Modified Food Guide Pyramid for adults aged 70+ y. It has been extensively used in a variety of settings and formats to highlight the unique dietary challenges of older adults. We now propose a Modified MyPyramid for Older Adults in a format consistent with the MyPyramid graphic. It is not intended to substitute for MyPyramid, which is a multifunctional Internet-based program allowing for the calculation of individualized food-based dietary guidance and providing supplemental information on food choices and preparation. Pedagogic issues related to computer availability, Web access, and Internet literacy of older adults suggests a graphic version of MyPyramid is needed. Emphasized are whole grains and variety within the grains group; variety and nutrient density, with specific emphasis on different forms particularly suited to older adults' needs (e.g. frozen) in the vegetables and fruits groups; low-fat and non-fat forms of dairy products including reduced lactose alternatives in the milk group; low saturated fat and trans fat choices in the oils group; and low saturated fat and vegetable choices in the meat and beans group. Underlying themes stress nutrient- and fiber-rich foods within each group and food sources of nutrients rather than supplements. Fluid and physical activity icons serve as the foundation of MyPyramid for Older Adults. A flag to maintain an awareness of the potential need to consider supplemental forms of calcium, and vitamins D and B-12 is placed at the top of the pyramid. Discussed are newer concerns about potential overnutrition in the current food landscape available to older adults. [ABSTRACT FROM AUTHOR]

Aim To update dietetic guidelines based on systematic review evidence on dietary advice to prevent further events in people with existing cardiovascular disease (CVD) (secondary prevention). Methods The Cochrane Library, MEDLINE and EMBASE were comprehensively searched to January 2005 for systematic reviews on aspects of diet and heart health. Reviews were included if they searched systematically for randomized controlled trials relating to diet and secondary prevention of CVD. Each review was critically appraised by at least two members of the UK Heart Health and Thoracic Dietitians Group. The quality and results of each review were discussed and summarized at a group meeting. Results Evidence-based strategies that reduce cardiovascular events in those with CVD include reduction in saturated fat and substitution with unsaturated fats. Individuals who have suffered a myocardial infarction may also benefit from adopting a Mediterranean type diet and increasing intake of omega 3 fats, but it is not clear whether they are beneficial for all patients with CVD. There is no systematic review evidence to support the use of antioxidant vitamins supplements, low glycaemic index diets, or homocysteine lowering therapies in this group. Conclusion There remains good evidence that reducing saturated fat reduces morbidity in patients with CVD. This advice is consistent for most manifestations of CVD, with the addition of Mediterranean dietary advice and increased omega 3 fats for those who have had a myocardial infarction. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To evaluate the effect of a soy-rich diet on urogenital symptoms, vaginal health index, and vaginal cytology in perimenopausal and postmenopausal women. Materials and methods: Thirty-six perimenopausal and postmenopausal women (mean age 52.5±5.1 years) participated in a randomized, cross-over trial with two 12-week diet periods and two 4-week washout periods before and between treatments. The study diet consisted of a control diet (soy-free diet) and an isocaloric soy-rich diet (25g soy protein in various forms of soy food containing more than 50mg/day of isoflavones substituted for an equivalent amount of animal protein). Subjects were assessed for urogenital symptoms, vaginal health index, vaginal pH and vaginal cytology. The single physician and the single cytopathologist were blinded with regard to onset, period and randomization number. Statistical analyses were performed using paired t-test or Wilcoxon Signed Ranks Test, significance was set as P <0.05. Results: Good compliance to the diet was shown by the significant elevation of serum levels of daidzein and genistein during the soy-rich diet period. The symptoms of urge incontinence and vaginal dryness had significantly increased after 12-week of soy-free diet. All other urogenital symptoms did not change in both periods. The vaginal health index, the vaginal pH, the karyopyknotic index, and the maturation value were not significantly changed in both periods. Conclusion: A soy-rich diet did not relieve the urogenital symptoms or restore the vaginal epithelium or improve the vaginal health in perimenopausal and postmenopausal Thai women. [Copyright &y& Elsevier]

Abstract: It is the position of the American Dietetic Association (ADA) that the quality of life and nutritional status of older residents in long-term care facilities may be enhanced by liberalization of the diet prescription. The Association advocates the use of qualified dietetics professionals to assess and evaluate the need for medical nutrition therapy according to each person’s individual medical condition, needs, desires, and rights. In 2003, ADA designated aging as its second “emerging” area. Nutrition care in long-term settings must meet two goals: maintenance of health and promotion of quality of life. The Nutrition Care Process includes assessment of nutritional status through development of an individualized nutrition intervention plan. Medical nutrition therapy must balance medical needs and individual desires and maintain quality of life. The recent paradigm shift from restrictive institutions to vibrant communities for older adults requires dietetics professionals to be open-minded when assessing risks vs benefits of therapeutic diets, especially for frail older adults. Food is an essential component of quality of life; an unacceptable or unpalatable diet can lead to poor food and fluid intake, resulting in weight loss and undernutrition and a spiral of negative health effects. Facilities are adopting new attitudes toward providing care. “Person-centered” or “resident-centered care” involves residents in decisions about schedules, menus, and dining locations. Allowing residents to participate in diet-related decisions can provide nutrient needs, allow alterations contingent on medical conditions, and simultaneously increase the desire to eat and enjoyment of food, thus decreasing the risks of weight loss, undernutrition, and other potential negative effects of poor nutrition and hydration. [Copyright &y& Elsevier]

It is well known that postprandial glucose increases with aging in non-diabetic subjects. The question we addressed is whether elderly type 2 diabetic patients with definite fasting hyperglycemia (≥ 126 mg/dL) also display increased postprandial hyperglycemia relative to their younger counterparts. Diurnal plasma glucose profiles were measured in 162 overt type 2 diabetic patients treated by diet alone (diet group) or with sulfonylureas as monotherapy (SU group). Plasma glucose concentrations were measured at 08.00 hours (before breakfast), 10.00, 12.00 (before lunch), 14.00, 18.00 (before dinner), 20.00, 24.00, 03.00, 06.00 and 08.00 hours the next morning. The postprandial glucose area under the curve (AUC) from 08.00 to 24.00 hours was calculated above the baseline level equal to the 08.00-hours plasma glucose value, and the relationships with clinical variables, including age, were assessed. There were no differences in diurnal plasma glucose profiles between the middle-aged (< 65 years) and elderly (≥ 65 years) groups either the diet group or the SU group. Univariate analysis showed that the postprandial glucose area under the curve was related to the 08:00-hours plasma glucose value ( R = 0.583, P < 0.001) in the diet alone group and to the duration of diabetes ( R = 0.220, P < 0.05), SU dose ( R = 0.330, P = 0.001) and urine CPR ( R = −0.229, P < 0.05) in the SU group. In multivariate analysis, postprandial glucose area under the curve was only related to 08.00 hours plasma glucose value in the diet group (R2 of the model = 0.340, P < 0.001) and to the SU dose in SU group (R2 of the model = 0.145, P < 0.001). These results suggest that aging, per se, does not influence postprandial glucose levels in overt type 2 diabetic patients. [ABSTRACT FROM AUTHOR]

Abstract: This survey of 84 case managers (CMs) (88% response rate) in 11 south Florida hospitals, in one for-profit health care system, sought to identify their discharge planning concerns regarding the food and nutrition needs of older patients, how they addressed these concerns, and the degree to which registered dietitians (RDs) were involved. Most CMs were female (82 of 84, 98%), older than age 40 (59 of 84, 70%), and were registered nurses (51 of 84, 61%). Almost all (82 of 84, 98%) reported job barriers, including excessive patient loads and responsibilities and limited community services. Almost all said that nutrition-related diseases and factors (eg, chewing/swallowing problems, poor appetite, modified diets, poor dentition) strongly influenced discharge planning. Many perceived community nutrition resources (eg, congregate meals, food stamps, shopping assistance, outpatient dietitians) as not readily available. While physicians, nurses, social workers, and physical therapists were identified as very important in discharge planning, RDs were not; almost half of CMs consulted them infrequently, if at all. Strategies for the six nutrition-related case scenarios were inconsistent. Home-health agencies were chosen most often and outpatient RDs least often. Comprehensive discharge planning must include more attention to nutrition with greater input from clinical, outpatient, home health, and community RDs through, for example, attendance at hospital discharge planning rounds, inservices for CMs, and better marketing of RD services. More RDs can and should become CMs to help serve the number of older adults with nutrition-related chronic conditions. [Copyright &y& Elsevier]

Objective To test the hypothesis that older men who consumed a vegetarian (lacto-ovo) diet would develop a lower iron status compared with older men who consumed a beef-containing diet during a period of resistive training (RT). Design Experimental, repeated measures study. Subjects Twenty-one healthy men aged 59 to 78 years, with a BMI range of 24 to 33 kg/m2, completed the study. Intervention All men consumed a vegetarian diet for 2 weeks (baseline). After this, the men were randomly assigned to one of two dietary groups. Eleven men consumed a beef-containing diet, and 10 men continued to consume a vegetarian diet for 12 weeks. During this time all subjects participated in RT three days per week, designated as RT1 to RT12. Main outcome measures Serum ferritin and serum iron concentrations, transferrin saturation, transferrin receptor, total iron binding capacity, and selected hematological variables, as well as selected nutrient intakes and estimated iron bioavailability from three-day diet records, were determined at baseline, RT5, and RT12. Statistical analyses A general linear model repeated-measures ANOVA was used to examine the effects of group, time, and group×time interactions for iron status and dietary data. Results Total iron intake was not different between the two groups; however, the beef group had a three to four times greater intake of bioavailable iron (P<.01) than the vegetarian group. Serum iron, total iron binding capacity, transferrin saturation, and transferrin receptor were not significantly different between the beef and vegetarian groups, or changed over time with RT. Serum ferritin decreased over time in both the beef and vegetarian groups during RT (P<.01). Re-introduction of beef into the diets of the beef group increased hemoglobin concentration and hematocrit compared with the vegetarian group during the 12 weeks of RT (group×time, P<.05). These changes were within clinically normal limits. Applications/Conclusions Older men who consume a beef-containing, higher-bioavailable-iron diet, compared with a vegetarian, lower-bioavailable-iron diet, have an increased hematological profile during a 12-week period of RT. Older men who consume either a beef-containing or a vegetarian diet maintain a hematological profile within clinically normal limits during 12 weeks of RT. J Am Diet Assoc. 2003;103:594-601. [Copyright &y& Elsevier]

Investigates whether long-term dietary treatment with L-arginine, the nitric oxide synthase substrate could prevent age-related renal injury. Effects of aging on the renal functions; Information on studies which were conducted.

The article presents an update on a case previously published in a Clinical Crossroads article by Doctor Jorge Arroyo in the journal concerning a 76-year-old man surgeon with age-related macular degeneration (AMD) who was unable to continue practicing because of a loss of depth perception in his right eye. Correspondence between the patient and Doctor Arroyo concerning the success of follow-up treatments, which included diet modification and efforts to protect the level of vision in his left eye, are presented. Trials testing the efficacy of tropical antioxidant eye drops for treating AMD and a study involving fetal cell transplantation in patients with dry AMD are discussed.

The article reports on the potential of higher intake of folate to reduce the risk of developing Alzheimer's disease according to a study published in the "Archives of Neurology" periodical. Between 1992 and 1994, the researchers examined, interviewed and reviewed the diets of study participants age 65 and older. Those individuals with higher levels of folate taken through diet and supplements were less likely to develop the disease. The vitamin is found in foods such as spinach, citrus fruits and beans.