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Fijis’ older population aged 55 years and over makes up 14% of the total population and is expected to reach 20% by 2050. This narrative review aimed to examine the health and nutrition status of the aging population of Fiji and sociodemographic determinants. A search strategy was conducted throughout databases, and gray literature from relevant websites was searched. Due to the limited evidence regarding the nutrition, health, and socio-economic factors that impact the aging population in Fiji the inclusion criteria were broad and included both genders (male and female), all publications up until December 2022, all study designs, and gray literature (government/institutional reports, conference proceedings, guidelines, Act, and Policies) . There was no filter for date applied in the search criteria. Studies that did not meet the search criteria were excluded. 20 documents including published articles were included for analysis and result synthesis. Life expectancy at birth for the Fiji population is 68 years. A significant annual increase in mortality rate from endocrine, nutritional, and metabolic diseases has been observed in women aged 75+ but not older men. Women of low-income status are more at risk than men. However, as most investigations aggregate those ≥18 years, there is a lack of information on older adults (≥65 years) health and nutrition status. To improve the health status of older adults, an understanding of the nutritional status of older adults is warranted, especially concerning lifestyle and sociodemographic determinants.

Abstract Background Understanding the metabolic and lipidomic changes that accompany bone loss in osteoporosis might provide insights about the mechanisms behind molecular changes and facilitate developing new drugs or nutritional strategies for osteoporosis prevention. This study aimed to examine the effects of short- or long-term glucocorticoid-induced osteoporosis on plasma metabolites and lipids of ovariectomized (OVX) sheep. Methods Twenty-eight aged ewes were divided randomly into four groups: an OVX group, OVX in combination with glucocorticoids for two months (OVXG2), and OVX in combination with five doses of glucocorticoids (OVXG5) to induce bone loss, and a control group. Liquid chromatography–mass spectrometry untargeted metabolomic analysis was applied to monthly plasma samples to follow the progression of osteoporosis over five months. Results The metabolite profiles revealed significant differences in the plasma metabolome of OVX sheep and OVXG when compared with the control group by univariate analysis. Nine metabolites were altered, namely 5-methoxytryptophan, valine, methionine, tryptophan, glutaric acid, 2-pyrrolidone-5-carboxylic acid, indole-3-carboxaldehyde, 5-hydroxylysine and malic acid. Similarly, fifteen lipids were perturbed from multiple lipid classes such as lysophoslipids, phospholipids and ceramides. Conclusion This study showed that OVX and glucocorticoid interventions altered the metabolite and lipid profiles of sheep, suggesting that amino acid and lipid metabolisms are potentially the main perturbed metabolic pathways regulating bone loss in OVX sheep.

Abstract INTRODUCTIONMalnutrition is an under-recognised and under-treated problem often affecting older adults. AIMThe aim of this study was to evaluate the prevalence of and factors associated with malnutrition and frailty among older adults at early admission to residential aged care. METHODSA cross-sectional study was undertaken among eligible older adults within the first week of admission to residential aged care. Participants were assessed for malnutrition risk using the Mini Nutritional Assessment Short Form, frailty using the Fried phenotype criterion, muscle strength using a grip strength dynamometer and gait speed using a 2.4-m walk test. A Cox regression analysis was conducted to identify factors associated with malnutrition risk and frailty status. RESULTSOf 174 participants (mean age 85.5 years, 61% women), two-thirds (66%) were admitted to residential aged care from the community. Most (93%) were either malnourished (48%) or at risk of malnutrition (45%). A total of 76% of participants were frail and 24% were pre-frail. Forty-three percent were both malnourished and frail. Low risk of malnutrition was associated with increases in muscle strength [0.96 (0.93–0.99)], gait speed [0.27 (0.10–0.73)] and pre-frailty status [0.32 (0.12–0.83)]. DISCUSSIONThis study provides preliminary evidence for high prevalence of malnutrition and frailty at admission to residential aged care. Almost all participants were malnourished or at nutrition risk. Findings highlight the need for strategies to prevent, detect and treat malnutrition in community health care and support nutrition screening at admission to residential aged care.

Osteoarthritis (OA) is a leading cause of disability in older adults worldwide. This study aimed to determine the associations between inflammatory markers, dietary intake and OA symptoms and pain. Understanding these associations has the potential to improve OA diagnostic and monitoring outcomes. Data from the ROAM (Researching Osteoarthritis and GreenShell Mussels) study collected from adults 55–80 years screened for OA signs and symptoms (n = 107, 65.7 years ± 6.34, 69% female) were assessed for associations between serum inflammatory markers (pg/mL), dietary inflammatory index (DII) scores and participants’ subjective measures of OA pain and symptoms. These included the Knee Injury and Osteoarthritis Outcome Score questionnaire (KOOS) subscales: pain (P), symptoms other than pain (S), function in activities of daily living (ADL), function in sports/recreation (SP) and quality of life (QoL); Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP); Visual Analogue Scales (VAS) of pain (VAS1) and symptoms (VAS2). The DII score was determined from a food frequency questionnaire and based on 34 components. The inflammatory marker IL-23 was negatively associated with all the KOOS subscales P: β coefficient −0.18, (95%CI −0.31, −0.04), S: −0.31 (−0.48, −0.14), ADL: −0.20 (−0.34, −0.05), SP: −0.43 (−0.72, −0.15) and QoL: −0.28 (−0.48, −0.08) and was positively associated with VAS measures, VAS1: 0.36 (0.17, 0.55) and VAS2: 0.25 (0.002, 0.50). MCP-1 was negatively associated and IL-12 was positively associated with KOOS P: −0.14, (−0.28, −0.01) and 0.23 (0.07, 0.40), respectively. IL-17 was positively associated with KOOS SP: 0.45, (0.14, 0.77), and IFN-α2 was positively associated with VAS1: 0.24 (0.003, 0.48). ICOAP was not associated with inflammatory markers. Inflammatory markers and subjective measures were not associated with DII. The levels of IL-23, MCP-1 and IFN-α2 increase as the symptoms worsen, while the levels of IL-12 and IL-17 increase as the symptoms improve. These markers may be useful as diagnostic and assessment tools, however, further research is needed to confirm their exact roles in OA.

Bone remodelling in a healthy body is in constant balance, maintaining an adaptive and robust skeletal system. In osteoporosis this balance is disrupted with the rates of osteoclastic bone resorption exceeding osteoblastic bone formation, resulting in lower bone mineral density. Rooibos tea, is a popular South African drink made from Aspalathus linearis leaves grown in the Western Cape. This tea is rich in phenolic compounds which have been widely investigated in recent years as a potential treatment for many ailments. In this study, aspalathin, a phenolic compound found exclusively in rooibos, increases osteoblast formation and function including increased osteoblast marker expression and mineralisation. In addition, aspalathin decreased differentiation and function of osteoclasts as well as reducing osteoclast formation in an osteoclast/osteoblast co-culture model. These results illustrate bone-protective effects of aspalathin in vitro through the reduction of osteoclast activity and promotion of osteoblast activity, with potential applications in the maintenance of bone density.

The aim of this study was to validate the combination of ovariectomy and glucocorticoid treatment in sheep as a large animal model for osteoporosis by measuring the concentration of specific biomarkers in the blood of the sheep and measuring bone loss over five months. Aged Merino ewes were randomly allocated into four groups: control, ovariectomy (OVX), and two OVX groups receiving glucocorticoids—one group once-monthly for five months (OVXG), and the other for two months followed by no treatment for three months (OVXG2). Parameters measured were biochemical markers of bone turnover, areal bone mineral density, volumetric bone mineral density, and total and trabecular bone parameters. Ovariectomy increased the concentrations of bone resorption marker C-terminal telopeptides of type 1 collagen (CTx-1) and bone turnover marker serum osteocalcin (OC) concentrations in the OVX group compared to control sheep. The combination of ovariectomy and glucocorticoid treatment increased the concentrations of CTx-1 and decreased serum OC concentrations in the OVXG group compared to OVXG2. Femur and lumbar spine bone density were lower in experimentally treated groups when compared with the control group. Total and trabecular vBMD in the proximal tibia were significantly lower in the treatment groups when compared with the control group. A significant negative correlation between femoral bone density and CTx-1 was found. The results of this study suggest that the combination of OVX and glucocorticoids induces bone loss in a short period of time in sheep. Keywords: Osteoporosis, Sheep, Ovariectomy, Glucocorticoids, Bone mineral density, Bone turnover markers

Abstract Background Malnutrition in patients admitted to hospital may have detrimental effects on recovery and healing. Malnutrition is preceded by a state of malnutrition risk, yet malnutrition risk is often not detected during admission. The aim of the current study was to investigate the magnitude and potential predictors of malnutrition risk in older adults, at hospital admission. Methods A cross-sectional was study conducted in 234 older adults (age ≥ 65 or ≥ 55 for Māori or Pacific ethnicity) at admission to hospital in Auckland, New Zealand. Assessment of malnutrition risk status was performed using the Mini Nutritional Assessment Short-Form (MNA®-SF), dysphagia risk by the Eating Assessment Tool (EAT-10), muscle strength by hand grip strength and cognitive status by the Montreal Cognitive Assessment (MoCA) tool. Results Among 234 participants, mean age 83.6 ± 7.6 years, 46.6% were identified as at malnutrition risk and 26.9% malnourished. After adjusting for age, gender and ethnicity, the study identified [prevalence ratio (95% confidence interval)] high dysphagia risk [EAT-10 score: 0.98 (0.97–0.99)], low body mass index [kg/m2: 1.02 (1.02–1.03)], low muscle strength [hand grip strength, kg: 1.01 (1.00–1.02)] and decline in cognition [MoCA score: 1.01 (1.00–1.02)] as significant predictors of malnutrition risk in older adults at hospital admission. Conclusion Among older adults recently admitted to the hospital, almost three-quarters were malnourished or at malnutrition risk. As the majority (88%) of participants were admitted from the community, this illustrates the need for routine nutrition screening both at hospital admission and in community-dwelling older adults. Factors such as dysphagia, unintentional weight loss, decline in muscle strength, and poor cognition may indicate increased risk of malnutrition.

Osteoporosis is a significant public health issue around the world, with post-menopausal osteoporosis due to estrogen deficiency resulting in approximately ¾ of cases. In this study, 18 aged Merino ewes were ovariectomized, and 10 were controls. Three of the ovariectomized ewes were treated weekly with 400 mg of methylprednisolone for 5 months and three were treated weekly for 2 months, followed by a 3-month recovery period. At 2 months, five control animals and six ovariectomized animals were euthanized. At 5 months, all the remaining ewes were euthanized. Kidney samples were collected postmortem for qPCR analysis of NPT1, PTH1R, NPT2a, NPT2c, Klotho, FGFR1IIIc, VDR, CYP24A1, CYP27B1, TRPV5, TRPV6, CalD9k, CalD28k, PMCA and NCX1. Ovariectomized sheep had significantly greater VDR expression compared with other groups. Ovariectomized sheep treated with glucocorticoids for 2 months followed by euthanasia at 5 months showed significant differences in TRPV5, CYP24A1 and klotho gene expression compared to other groups. Differences in klotho expression were most marked after adjustment for repeated measures (p = 0.1). Klotho is known as the “anti-aging” hormone and is involved in calcium and phosphorus metabolism. Klotho may be involved in the recovery of bone mineral density in ovariectomized sheep treated with glucocorticoids for 2 months followed by euthanasia at 5 months. Further research on the role of klotho is recommended.

An amendment to this paper has been published and can be accessed via the original article.

Bone loss and osteoporosis is a serious health problem worldwide. The impact of osteoporosis is far greater than many other serious health problems, such as breast and prostate cancers. Statistically, one in three women and one in five men over 50 years of age will experience osteoporotic fractures in their life. In this paper, the design and development of a portable IoT-based sensing system for early detection of bone loss have been presented. The CTx-I biomarker was measured in serum samples as a marker of bone resorption. A planar interdigital sensor was used to evaluate the changes in impedance by any variation in the level of CTx-I. Artificial antibodies were used to introduce selectivity to the sensor for CTx-I molecule. Artificial antibodies for CTx-I molecules were created using molecular imprinted polymer (MIP) technique in order to increase the stability of the system and reduce the production cost and complexity of the assay procedure. Real serum samples collected from sheep blood were tested and the result validation was done by using an ELISA kit. The PoC device was able to detect CTx-I concentration as low as 0.09 ng/mL. It exhibited an excellent linear behavior in the range of 0.1–2.5 ng/mL, which covers the normal reference ranges required for bone loss detection. Future possibilities to develop a smart toilet for simultaneous measurement of different bone turnover biomarkers was also discussed.

The objective of this paper is to report a novel non-invasive, real-time, and label-free smart assay technique for the prognostic detection of bone loss by electrochemical impedance spectroscopy (EIS). The proposed system incorporated an antibody-antigen-based sensor functionalization to induce selectivity for the C-terminal telopeptide type one collagen (CTx-I) molecules—a bone loss biomarker. Streptavidin agarose was immobilized on the sensing area of a silicon substrate-based planar sensor, patterned with gold interdigital electrodes, to capture the antibody-antigen complex. Calibration experiments were conducted with various known CTx-I concentrations in a buffer solution to obtain a reference curve that was used to quantify the concentration of an analyte in the unknown serum samples. Multivariate chemometric analyses were done to determine the performance viability of the developed system. The analyses suggested that a frequency of 710 Hz is the most discriminating regarding the system sensitivity. A detection limit of 0.147 ng/mL was achieved for the proposed sensor and the corresponding reference curve was linear in the range of 0.147 ng/mL to 2.669 ng/mL. Two sheep blood samples were tested by the developed technique and the results were validated using enzyme-linked immunosorbent assay (ELISA). The results from the proposed technique match those from the ELISA.