Effectiveness of nutritional interventions in older adults at risk of malnutrition across different health care settings: Pooled analyses of individual participant data from nine randomized controlled trials.


Journal

Clinical nutrition (Edinburgh, Scotland)
ISSN: 1532-1983
Titre abrégé: Clin Nutr
Pays: England
ID NLM: 8309603

Informations de publication

Date de publication:
08 2019
Historique:
received: 15 01 2018
revised: 14 06 2018
accepted: 15 07 2018
pubmed: 18 8 2018
medline: 4 9 2020
entrez: 18 8 2018
Statut: ppublish

Résumé

Protein-energy malnutrition is a health concern among older adults. Improving nutritional status by increasing energy and protein intake likely benefits health. We therefore aimed to investigate effects of nutritional interventions in older adults (at risk of malnutrition) on change in energy intake and body weight, and explore if the intervention effect was modified by study or participants' characteristics, analysing pooled individual participant data. We searched for RCTs investigating the effect of dietary counseling, oral nutritional supplements (ONS) or both on energy intake and weight. Principle investigators of eligible studies provided individual participant data. We investigated the effect of nutritional intervention on meaningful increase in energy intake (>250 kcal/day) and meaningful weight gain (>1.0 kg). Logistic generalized estimating equations were performed and ORs with 95% CIs presented. We included data of nine studies with a total of 990 participants, aged 79.2 ± 8.2 years, 64.5% women and mean baseline BMI 23.9 ± 4.7 kg/m Based on pooled data of older adults (at risk of malnutrition), nutritional interventions have a positive effect on energy intake and body weight. Dietary counseling combined with ONS is the most effective intervention.

Sections du résumé

BACKGROUND & AIMS
Protein-energy malnutrition is a health concern among older adults. Improving nutritional status by increasing energy and protein intake likely benefits health. We therefore aimed to investigate effects of nutritional interventions in older adults (at risk of malnutrition) on change in energy intake and body weight, and explore if the intervention effect was modified by study or participants' characteristics, analysing pooled individual participant data.
METHODS
We searched for RCTs investigating the effect of dietary counseling, oral nutritional supplements (ONS) or both on energy intake and weight. Principle investigators of eligible studies provided individual participant data. We investigated the effect of nutritional intervention on meaningful increase in energy intake (>250 kcal/day) and meaningful weight gain (>1.0 kg). Logistic generalized estimating equations were performed and ORs with 95% CIs presented.
RESULTS
We included data of nine studies with a total of 990 participants, aged 79.2 ± 8.2 years, 64.5% women and mean baseline BMI 23.9 ± 4.7 kg/m
CONCLUSIONS
Based on pooled data of older adults (at risk of malnutrition), nutritional interventions have a positive effect on energy intake and body weight. Dietary counseling combined with ONS is the most effective intervention.

Identifiants

pubmed: 30115460
pii: S0261-5614(18)31225-1
doi: 10.1016/j.clnu.2018.07.023
pii:
doi:

Types de publication

Journal Article Meta-Analysis Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1797-1806

Informations de copyright

Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Auteurs

Ilse Reinders (I)

Amsterdam Public Health Research Institute, Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Department of Nutrition and Dietetics, Internal Medicine VU University Medical Center, Amsterdam, The Netherlands. Electronic address: ilse.reinders@vu.nl.

Dorothee Volkert (D)

Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany.

Lisette C P G M de Groot (LCPGM)

Wageningen University, Division of Human Nutrition, Wageningen, The Netherlands.

Anne Marie Beck (AM)

Herlev and Gentofte University Hospital, and Metropolitan University College, Denmark.

Ilana Feldblum (I)

The S. Daniel Abraham International Center for Health and Nutrition, Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel.

Inken Jobse (I)

Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany.

Floor Neelemaat (F)

Amsterdam Public Health Research Institute, Department of Nutrition and Dietetics, Internal Medicine VU University Medical Center, Amsterdam, The Netherlands.

Marian A E de van der Schueren (MAE)

Amsterdam Public Health Research Institute, Department of Nutrition and Dietetics, Internal Medicine VU University Medical Center, Amsterdam, The Netherlands; Department of Nutrition and Health, Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands.

Danit R Shahar (DR)

The S. Daniel Abraham International Center for Health and Nutrition, Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel.

Ellen T H C Smeets (ETHC)

Wageningen University, Division of Human Nutrition, Wageningen, The Netherlands.

Michael Tieland (M)

Wageningen University, Division of Human Nutrition, Wageningen, The Netherlands.

Jos W R Twisk (JWR)

Amsterdam Public Health Research Institute, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.

Hanneke A H Wijnhoven (HAH)

Amsterdam Public Health Research Institute, Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, The Netherlands.

Marjolein Visser (M)

Amsterdam Public Health Research Institute, Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, The Netherlands.

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