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Lack of meal intake compensation following nutritional supplements in hospitalised elderly women

Published online by Cambridge University Press:  08 March 2007

Amanda Boudville  and
David G. Bruce
Amanda Boudville
Affiliation:
Department of Community and Geriatric Medicine, Fremantle Hospital, Fremantle, Western Australia
David G. Bruce*
Affiliation:
School of Medicine & Pharmacology, University of Western Australia, Western Australia
*
*Corresponding author: Associate Professor David G. Bruce, School of Medicine & Pharmacology, Fremantle Hospital, P.O. Box 480, Fremantle, Western Australia 6959, Australia, fax +61 618 9431 3229, email [email protected]
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Abstract

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Undernutrition contributes to poor clinical outcomes in hospitalised elderly patients but the potential impact of oral nutritional supplements may be reduced by suppressing subsequent food intake. We investigated this possibility in elderly female patients recovering mainly from hip fracture by studying the effect of oral supplements on subsequent food intake during an ad libitum buffet luncheon meal. We tested the effect in seven women by giving the supplement 90 min before the meal and compared energy and macronutrient intake with a control water pre-load condition. A similar study was carried out in another seven women with the supplement or water drink given 30 min beforehand. Both self-rated appetite and energy intake were low in these women. The nutritional supplement did not alter ratings of hunger, fullness or prospective consumption or subsequent energy and macronutrient consumption whether given 90 or 30 min before the meal. There were significant independent correlations between the lack of adequate compensation of energy intake at meals and chronic undernutrition (as assessed by skinfold thickness) and energy intake during the control meal. We conclude that elderly women during the recovery phase after major fractures have low appetites and energy intakes and markedly impaired adjustment of energy intake following liquid oral nutritional supplements. The reasons for this are unknown but are related to anorexia and undernutrition. The consumption of liquid oral supplements given up to 30 min before a meal does not suppress subsequent energy intake from meals.

Keywords

Older womenInpatient careOral supplementsMeal intake compensation
Type
Research Article
Information
British Journal of Nutrition , Volume 93 , Issue 6 , June 2005 , pp. 879 - 884
Copyright
Copyright © The Nutrition Society 2005

References

Avenell, A & Handoll, HHG (2001) Nutritional supplementation for hip fracture aftercare in the elderly (Cochrane review). In The Cochrane Library, issue 4. Oxford: Update Software.Google ScholarPubMed
Banerjee, AK, Brocklehurst, JC, Wainwright, H & Swindell, R (1978) Nutritional status of long stay geriatric inpatients: effects of a food supplement (Complan). Age Ageing 7, 237–243.CrossRefGoogle ScholarPubMed
Bastow, MD, Rawlings, J & Allison, SP (1983) Benefits of supplementary tube feeding after fractured neck of femur: a randomised controlled trial. BMJ 287, 1589–1592.CrossRefGoogle ScholarPubMed
Bruce, D, Laurance, IMcGuiness, MRidley, M & Goldswain, P (2003) Nutritional supplements after hip fracture: poor compliance limits effectiveness. Clin Nutr 22, 497–500.CrossRefGoogle ScholarPubMed
Chumlea, WC, Roche, AF & Mukherjee, D (1988) Nutritional Assessment in the Elderly Through Anthropometry. Monograph no. P527. Columbus, USA: Ross Laboratories.Google Scholar
Detsky, ASMcLaughlin, JRBaker, JP, et al. (1987) What is subjective global assessment of nutritional status? J Parenter Enteral Nutr 11, 8–13.CrossRefGoogle ScholarPubMed
Fiatarone, MA, O'Neill, EF, Ryan, ND, et al. (1994) Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med 330, 1769–1820.CrossRefGoogle ScholarPubMed
Friedman, PJ, Campbell, AJ, Caradoc-Davies, TH (1985) Prospective trial of a new diagnostic criterion for severe wasting malnutrition in the elderly. Age Ageing 14, 149–154.CrossRefGoogle ScholarPubMed
Garner, DM & Garfinkel, PE (1979) The Eating Attitudes Test: an index of the symptoms of anorexia nervosa. Psychiatr Med 9, 273–280.Google ScholarPubMed
Gurney, JM & Jelliffe, DB (1973) Arm anthropometry in nutritional assessment: nomogram for rapid calculation of muscle circumference and cross-sectional muscle over fat areas. Am J Clin Nutr 26, 912–915.CrossRefGoogle Scholar
Jallut, D, Tappy, L, Kohut, M, et al. (1990) Energy balance in elderly patients after surgery for a femoral neck fracture. J Parenter Enteral Nutr 14, 563–568.CrossRefGoogle ScholarPubMed
Kayser-Jones, J, Schell, ES, Porter, C, et al. (1998) A prospective study of the use of liquid dietary supplements in nursing homes. J Am Geriatr Soc 46, 1378–1386.CrossRefGoogle ScholarPubMed
McCrea, D, Arnold, E, Marchevsky, D & Kaufman, BM (1994) The prevalence of depression in geriatric medical outpatients. Age Ageing 23, 465–467.CrossRefGoogle ScholarPubMed
Morley, JE (2001) Decreased food intake with aging. J Gerontol 56A, 81–89.CrossRefGoogle Scholar
Morley, JE (1997) Anorexia of aging: physiologic and pathologic. Am J Clin Nutr 66, 760–773.CrossRefGoogle ScholarPubMed
Paillaud, E, Bories, PNLe Parco, JC & Campillo, B (2000) Nutritional status and energy expenditure in elderly patients with recent hip fracture during a 2-month follow-up. Br J Nutr 83, 97–103.CrossRefGoogle ScholarPubMed
Potter, J, Langhorne, P & Roberts, M (1998) Routine protein energy supplementation in adults: systematic review. BMJ 31, 495–501.CrossRefGoogle Scholar
Rolls, BJ, Dimeo, KA & Shide, DJ (1995) Age-related impairments in the regulation of food intake. Am J Clin Nutr 62, 923–931.CrossRefGoogle ScholarPubMed
Schlettwein-Gsell, DDeCarli, BDe Groot, L (1999) Meal patterns in the SENECA study of nutrition and the elderly in Europe: assessment method and preliminary results of the role of the midday meal. Appetite 23, 15–22.CrossRefGoogle Scholar
Stableforth, PG (1986) Supplement feeds and nitrogen and calorie balance following femoral neck fracture. British Journal of Surgery 73, 651–655.CrossRefGoogle ScholarPubMed
Stunkard, AJ & Messick, S (1985) The three factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res 29, 71–83.CrossRefGoogle ScholarPubMed
Sturm, K, Macintosh, CG, Parker, BA, Wishart, J, Horowitz, M & Chapman, IM (2003) Appetite, food intake, and plasma concentrations of cholecystokinin, Ghrelin, and other gastrointestinal hormones in undernourished older women and well-nourished young and older women. J Clin Endocrinol Metab 88, 3747–3755.CrossRefGoogle Scholar
Sullivan, DH, Walls, RC & Bopp, MM (1995) Protein-energy malnutrition and the risk of mortality within one year of hospital discharge: a follow-up study. J Am Geriatr Soc 43, 507–512.CrossRefGoogle ScholarPubMed
Tucker, H & Miguel, S (1996) Cost containment through nutritional intervention. Nutr Rev 54, 111–121.CrossRefGoogle Scholar
Wilson, MMG, Purushothaman, R & Morley, JE (2002) Effect of liquid dietary supplements on energy intake in the elderly. Am J Clin Nutr 75, 944–947.CrossRefGoogle ScholarPubMed
Zandstra, EH, Mathey, M-FAM, De Graaf, C & Van Staveren, WA (2000) Short-term regulation of food intake in children, young adults and the elderly. Eur J Clin Nutr 54, 239–246.CrossRefGoogle ScholarPubMed