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Background. This study tested the hypothesis that a home-based exercise program would improve functional performance in elderly people. Methods. We conducted a 6-month, single-blinded, randomized controlled trial. 72 community dwelling men and women (aged [greater than equal] 70 years) with self-reported and laboratory based functional impairment were recruited for the study. Participants were randomly assigned to either a home-based progressive strength, balance, and general physical activity intervention or an attention-control group that received home-based nutrition education. Functional performance was measured in the laboratory using the Physical Performance Test (PPT) and the Established Populations for Epidemiologic Studies of the Elderly (EPESE) short physical performance battery. Physiologic capacity was measured by strength (one repetition maximum), dynamic balance (tandem walk), gait speed (2-meter walk), and cardiovascular endurance (6-minute walk). Results. 70 participants (97%) completed the 6-month trial. Compliance with study interventions within each group ranged from 75% in controls to 82% in exercisers. PPT increased by 6.1 [+ or -] 13.4% in exercisers and decreased by 2.8 [+ or -] 13.6% in controls (p = .02). EPESE improved by 26.2 [+ or -] 37.5% in exercisers and decreased by 1.2 [+ or -] 22.1% in controls (p = .001). Dynamic balance improved by 33.8 [+ or -] 14.4% in exercisers versus 11.5 [+ or -] 23.7% in controls (p = .0002). There were no differences between groups in the change in strength, gait speed, or cardiovascular endurance. Conclusions. Minimally supervised exercise is safe and can improve functional performance in elderly individuals. The improvements in functional perfomance occured along with improvements in balance but without a significant change in muscle strength or endurance.

Objective To increase fruit, vegetable, and calcium-rich food consumption in community-dwelling, functionally impaired elderly. Design Six-month, home-based nutrition intervention study. Subjects Seventy men and women older than age 69 years were randomized to either a nutrition education intervention (n=38) or a control group that received an exercise intervention (n=32). Intervention Nutrition education was designed to increase fruit, vegetable, and calcium-rich food consumption. Main Outcome Measures Food intake was assessed by a food frequency questionnaire. Fasting blood measures of nutrients and carotenoids were performed. Statistical Analysis Two-group randomized controlled trial with pre-test and post-test design and intention-to-treat analysis. Analysis of covariance to was used to assess differences between the two groups. Baseline and change partial correlation coefficients were performed between intake and blood nutrient levels. Paired tests were conducted to test within-group changes. Results Compared with the exercise group, subjects in nutrition group increased their self-reported intake of fruits by 1.1±0.2 (mean ±SEM) servings per day (2.8 to 3.9, P=.0l), vegetables 1.1±0.2 servings per day (2.3 to 3,4, P=.001), and milk/dairy 0.9±0.2 servings per day (3.0 to 3.9, P=.001). There was an increase in the dietary intake of αcarotene and βcarotene in the nutrition group and this correlated with the increase in blood concentrations of αcarotene and β-carotene (P≤ 02; γ=0.33 and γ=0.33, respectively). Conclusion The results of this study suggest that it is possible to improve the dietary intake of community dwelling elders to include more fruits, vegetables, and calcium-rich foods. Recommendations for increasing consumption of fruits, vegetables, and calcium-rich foods should be specific and individualized to meet the dietary pattern and lifestyle of the individual. Compliance should be encouraged with record keeping as well as through continuous monitoring and positive reinforcement., Research has shown that diets high in fruits and vegetables are linked to decreased risk of cancer, heart disease, hypertension, macular degeneration, stroke, diabetes, and constipation. In addition, osteoporosis is [...]

Background. Identification of the physiologic factors most relevant to functional independence in the elderly population is critical for the design of effective interventions. It has been suggested that muscle power may be more directly related to impaired physical performance than muscle strength in elderly persons. We tested the hypothesis that peak muscle power is closely associated with self-reported functional status in sedentary elderly community-dwelling women. Methods. We used baseline data that were collected as part of a 1-year randomized controlled clinical trial of a combined program of strength, power, and endurance training in 80 elderly women (mean age 74.8 +/- 5.0 years) with 3.2 +/- 1.9 chronic diseases, selected for baseline functional impairment and/or falls. Results. Functional status at baseline was related in univariate analyses to physiologic capacity, habitual physical activity level, neuropsychological status, and medical diagnoses. Leg power had the strongest univariate correlation to self-reported functional status (r = -.47, p < .0001) of any of the physiologic factors we tested. In a forward stepwise regression model, leg press power and habitual physical activity level were the only two factors that contributed independently to functional status (r = .64, p < .0001), accounting for 40% of the variance in functional status. Conclusions. Leg power is a strong predictor of self-reported functional status in elderly women.

The riboflavin requirements of two groups of riboflavin-deficient, but otherwise healthy, Guatemalan elderly persons over the age of 60 y were studied by varying the fat: carbohydrate ratio in two diets. The first group consumed a diet similar in macronutrient content to a Western-type diet with low carbohydrate and high fat; the second group consumed a typical Guatemalan diet with high carbohydrate and low fat. Energy and protein intakes of both groups were similar. Riboflavin status was monitored by weekly measurements of erythrocyte glutathione reductase activity coefficient (EGRAC) and urinary riboflavin excretion. Increasing increments of riboflavin were added to the subjects' diets until their status was normalized, as indicated by EGRAC of < 1.34 and a sharp increase in urinary riboflavin excretion. Using the EGRAC method, the mean value of riboflavin intake at which the subjects' EGRAC reached the limit of normality was 1.37 + or - 0.03 mg/d in the first phase and 1.29 + or - 0.03 mg/d in the second phase. The sharp increase in urinary excretion occurred at riboflavin intakes of 1.13 and 1.03 mg/d for Groups 1 and 2, respectively. Thus, the differences between the two groups suggest that diets with a lower fat: carbohydrate ratio can decrease the dietary need for riboflavin. The dietary requirement of riboflavin, as estimated by the more reliable urinary excretion method, was 1.1-1.3 mg/d for those consuming the Western-type diet, which is similar to values found over 40 y ago in young adults. We conclude that the dietary requirements of riboflavin in the elderly do not differ from those of young adults.

Astudy of Guatemalan school-age children to determine their hematocrit values and thus their likelihood for anemia obtained hematocrit data from 1484 children. Roughly half were obtained from the highland province of Alta Verapaz (AV) and half from the coastal province of Retalhuleu (Reu). Two tests for packed cell volumes showed greater subnormality in AV than in Reu. Males had more subnormal hematocrits than females. However, the two testing systems only agreed on 37 of 196 subnormal children. Further assessment of their hematological status should await resolution of these inconsistencies.