ΔΙΑΤΑΡΑΧΕΣ ΘΡΕΨΗΣ ΣΕ ΕΛΛΗΝΕΣ ΥΠΕΡΗΛΙΚΕΣ, ΠΡΟΣΔΙΟΡΙΣΜΟΣ ΤΩΝ ΠΑΡΑΓΟΝΤΩΝ ΠΟΥ ΤΗΝ ΕΠΗΡΕΑΖΟΥΝ ΚΑΙ ΔΙΑΤΡΟΦΙΚΗ ΠΑΡΕΜΒΑΣΗ

 

ΣΥΝΤΟΜΗ ΠΕΡΙΓΡΑΦΗ ΠΡΟΓΡΑΜΜΑΤΟΣ

Το επίπεδο θρέψης επηρεάζει τη λειτουργική κατάσταση των υπερηλίκων και το επίπεδο υγείας τους. Η βελτίωση του επιπέδου της θρέψης έχει θετικά κλινικά και κοινωνικοοικονομικά αποτελέσματα. Σκοπός της έρευνας είναι η εκτίμηση της κατάστασης θρέψης πληθυσμού υπερηλίκων στην Κεντρική Μακεδονία, και των παραγόντων που την επηρεάζουν με στόχο το σχεδιασμό και εφαρμογή μέτρων για βελτίωση της. Το πρόγραμμα γίνεται σε συνεργασία με τη Γηριατρική μονάδα της Β’ Παθολογικής Κλινικής του ΑΠΘ. Η μεθοδολογία που θα χρησιμοποιηθεί περιλαμβάνει ένα γενικό ερωτηματολόγιο με στόχο την αναγνώριση παραγόντων υψηλού κινδύνου για δυσθρεψία, πρωτόκολλα γνωστικής, λειτουργικής και οδοντιατρικής εκτίμησης, ανθρωπομετρικές μετρήσεις, ποιοτική και ποσοτική εκτίμηση της διατροφής, φυσική εξέταση και βιοχημικές εξετάσεις. Τα παραδοτέα του προγράμματος θα συμπληρώσουν τις υπηρεσίες υγείας που προσφέρονται σήμερα οι οποίες δεν περιλαμβάνουν ειδική διατροφική αγωγή. Τα αναμενόμενα αποτελέσματα περιλαμβάνουν λεπτομερή εκτίμηση της κατάστασης θρέψης των υπερηλίκων, προσδιορισμό των διατροφικών παραγόντων που την επηρεάζουν και σχεδιασμό δοκιμασιών ανίχνευσης δυσθρεψίας και πρωτοκόλλων βελτίωσης της θρεπτικής κατάστασης νοσηλευομένων και μη.

 

 

ΣΤΟΙΧΕΙΑ ΕΠΙΣΤΗΜΟΝΙΚΟΥ ΥΠΕΥΘΥΝΟΥ
ONOMAΤΕΠΩΝΥΜΟ: Καλλιόπη Μιχαήλ-Κλεφτούρη
TMHMA: ΔΙΑΤΡΟΦΗΣ
e-mail: kmichael@nutr.teithe.gr

 

ΜΕΛΗ ΤΗΣ ΕΡΕΥΝΗΤΙΚΗΣ ΟΜΑΔΑΣ:

ΟΝΟΜΑΤΕΠΩΝΥΜΟ

ΙΔΙΟΤΗΤΑ

ΤΗΛΕΦΩΝΟ

E-MAIL

Καλλιόπη Μιχαήλ-Κλεφτούρη

Καθηγήτρια ΑΤΕΙΘ

2310 791390

kmichael@nutr.teithe.gr

Χαράλαμπος Κατσίκας

Καθηγητής ΑΤΕΙΘ

2310 791389

babkats@nutr.teithe.gr

Μαρία Μπαμπατζιμοπούλου

Καθηγήτρια ΑΤΕΙΘ

2310 791384

mbabatz@nutr.teithe.gr

Δημήτρης Οικονομίδης Καθηγητής ΑΠΘ 2310 992813 demetri@auth.gr
Ελισάβετ Ιωαννίδου Επίκουρη Καθγήτρια ΑΠΘ 2310 892287  
Ελένη Φωτιάδου Διαιτολόγος-Διατροφολόγος    
Κωνσταντίνα Αποστολίδου Διαιτολόγος-Διατροφολόγος    
Ευαγγελία Σωσσίδου Στατιστικός    
Θέκλα Χατζηαδαμίδου Ιατρός Παθολόγος    
Ελένη Μακρυγιαννάκη Βιοπαθολόγος    
Πέτρος Θανούλης Οδοντίατρος    
Σουλτάνα Κακογιάννη Κλινικός Ψυχολόγος    
Χρυσοβαλάντω Δερμιτζάκη Διαιτολόγος-Διατροφολόγος    
Σκαρμούτσου Χριστίνα Διαιτολόγος-Διατροφολόγος    
Συμεωνίδου Συμέλα Διαιτολόγος-Διατροφολόγος    
Κατταβένου Ελευθερία Διαιτολόγος-Διατροφολόγος    
Παπακώστα Πύρρος Διαιτολόγος-Διατροφολόγος    
Νικολέτα Μπακαλίδου Διαιτολόγος-Διατροφολόγος    
Κων/νος Χρυστόπουλος Διαιτολόγος-Διατροφολόγος    

Παναγιώτα Τζιόλα

Διαιτολόγος-Διατροφολόγος

 

 

 

 

ΑΛΛΕΣ ΠΛΗΡΟΦΟΡΙΕΣ - ΔΗΜΟΣΙΕΥΣΕΙΣ
1. CHANGES IN BODY COMPOSITION IN ELDERLY GREEKS

The purpose of the study is to describe body composition and its relation to BMI in a Greek elderly population. The study sample included 31 men and 196 women, aged above 60 years, recruited from the outpatients’ clinic of the Geriatric Department of Ippokration Hospital of Thessaloniki during the time period 2004-2005.

The methods used included anthropometric measurements of weight, height, thickness of skinfolds, calf, waist and hip circumferences, and calculations of indices of nutritional status such as BMI, subcutaneous fat indices, abdominal fat index and muscle mass indices.

According to the results of the study, the changes in body composition are different in the two genders. In females there was a decrease in height and weight after 60 years of age whereas BMI remained constant. Body composition changes included a decrease in muscle mass and an increase in abdominal fat while subcutaneous fat remained constant. In males, the decrease in height and weight after 70 years of age was accompanied by a decrease in BMI, in muscle mass and in subcutaneous fat while abdominal fat remained constant. BMI was correlated with all indices of muscle and fat mass, including abdominal fat, in ages 60-69 years, in both genders, but in more advanced ages the correlation with abdominal fat was not significant. In males above 80 years there was not a statistically significant correlation of BMI with the indices of muscle mass studied.

The interpretation of the results must take into consideration the cross-sectional study design. They suggest however that BMI which often is used as an indicator of health and longevity might have a different meaning in the two genders and in different ages. It might not be related with abdominal fat in any of the two genders after 70 years of age, and also it might not be related with muscle mass in males above 80 years of age. Therefore, in advanced ages it might not have the same relation with health that it has in younger ages.

The project is co-funded by the European Social Fund & National Resources – EPEAEK II – ARCHIMIDIS.

2. Plasma total homocysteine and its association with dietary intakes of folate, vitamin B12 and vitamin B6 in a nonsupplemented elderly Greek population

A moderately elevated plasma homocysteine concentration is an independent risk factor for atherothrombogenic vascular disease. Nutritional deficiencies in the B vitamin cofactors (folate, vitamin B12 and vitamin B6) required for homocysteine metabolism may promote hyperhomocysteinaemia.
The aim of this study was to determine the dietary intakes of folate, vitamin B12 and vitamin B6 in an elderly population consuming typical Greek diets and not taking any vitamin supplements, and the association of the vitamin status with total plasma homocysteine (tHcy).
It was a cross-sectional analysis of a sample of elderly visiting the Outpatients Clinic of the Geriatrics

Department of a large University Hospital in Northern Greece. Dietary intake was assessed by a 7-day Recall Questionnaire, and serum folate, B12 and tHcy were determined in fasting blood samples.

There was a large variation in the daily intakes of folate among subjects ranging from 16 to 611 μg (with 20 % below the RNI value and 79 % below 400 μg the level suggested for therapeutic purposes), in the daily intakes of vitamin B12 ranging from 1 to 41 μg (with 9 % below the RNI value), and in the daily intakes of vitamin B6 ranging from 0.7 to 26.5 mg (with 88 % below the RNI value). Serum B12 concentration was normal in all subjects studied, serum folate concentration was below normal range in 10 % of the population studied, and 30 % of the elderly had moderate hyperhomocysteinaemia. The tHcy concentration was inversely correlated with serum folate.

In conclusion, a large proportion of the population studied did not meet the recommendations for B6 and folate although individual intakes were sometimes much higher than recommended levels. Vitamin B12 intakes were adequate and serum concentrations were normal for all the elderly studied. Adequate folate intakes resulted in adequate serum status which was inversely related to total plasma homocysteine levels.

The project is co-funded by the European Social Fund & National Resources – EPEAEK II – ARCHIMIDIS.

3. Quality of life of free-living and institutionalized Greek elderly

The most rapidly growing segment of the population in all industrialized countries is the elderly, whose life expectancy has also increased. Thus, the increased number of elderly will have major impact on health care needs and costs. Appropriate strategies need to be implemented to maximize the quality of life for the elderly population and reduce the cost of health care.

The aim of this study was to assess the wellbeing of free-living and institutionalized Greek elderly people. Several parameters (physical, psychological, social, medical and nutritional) were used as indicators of wellbeing. Data was collected with the use of a General History Questionnaire, which was completed by trained personnel during an interview. Subjects were recruited from the Outpatients Clinic of the Geriatrics Department of a large University Hospital and a Home Institution for elderly people.

Obesity and hypertension were the most frequent diseases among both free-living and institutionalized elderly. Smoking and low water intake were frequent factors affecting wellbeing especially in the institutionalized elderly. Malnourishment according to the MNA score was more prevalent in the institutionalized elderly where it was found in 4.8 % of women and in 6.7 % of men. Physical activity, water and alcohol intake and the habit of laughing were higher in free-living elderly than in institutionalized elderly. In women, unlike men, the feeling of loneliness was related to the way of living. In general the quality of life of free-living elderly was higher than in institutionalized elderly.

These findings suggest that many physical, psychological, social and nutritional factors are affected by the way of living. They also indicate that social and psychological factors interrelate with nutritional and other health related parameters.

The project is co-funded by the European Social Fund & National Resources – EPEAEK II – ARCHIMIDIS.

4. Μεταβολές στη σωματική σύσταση σε Έλληνες υπερήλικες

Η σωματική σύσταση χρησιμοποιείται ως δείκτης του επιπέδου θρέψης και γενικότερα του επιπέδου υγείας σε όλες τις ηλικίες. Ο Δείκτης σωματικής μάζας ορίζεται ως ο λόγος του σωματικού βάρους σε κιλά προς το τετράγωνο του σωματικού ύψους σε μέτρα και χρησιμοποιείται διεθνώς ως δείκτης παχυσαρκίας και γενικότερα ως δείκτης υγείας και μακροβιότητας για όλες τις ηλικιακές ομάδες.

Σκοπός της εργασίας είναι να περιγράψει τη σωματική σύσταση, και τη σχέση της με το Δείκτη σωματικής μάζας σε Έλληνες υπερήλικες. Το δείγμα της έρευνας αποτελείται από 31 άντρες και 196 γυναίκες ηλικίας άνω των 60 ετών που επισκέφθηκαν τα εξωτερικά ιατρεία του Γηριατρικού Τμήματος της Β’ Παθολογικής κλινικής του Ιπποκρατείου Γενικού Νοσοκομείου Θεσσαλονίκης κατά τη διάρκεια του 2004-2005.

Οι μέθοδοι που χρησιμοποιήθηκαν περιλάμβαναν ανθρωπομετρικές μετρήσεις βάρους, ύψους, πάχους δερματοπτυχής σε διάφορες περιοχές του σώματος, περιμέτρους κνήμης, μέσης και ισχίου καθώς και υπολογισμούς δεικτών θρέψης όπως Δείκτη σωματικής μάζας, % σωματικού (υποδόριου) λίπους, Δείκτη λίπους βραχίονα, Δείκτη μυικής μάζας βραχίονα, Λόγο των περιμέτρων μέσης : ισχίο και Λόγο των δερματοπτυχών υποπλάτιου : τρικέφαλο.

Στους Έλληνες υπερήλικες που εξετάστηκαν, ο Δείκτης σωματικής μάζας στη δεκαετία 60-69 έτη σχετίζεται με όλους τους δείκτες λιπώδους και άλιπης μάζας, αλλά δεν περιγράφει τις μετακινήσεις υποδόριου λίπους από τον κορμό προς τα άκρα και από υποδόριες προς εσωτερικές περιοχές. Σε άτομα από 70 έως 79 ετών, ο Δείκτης σωματικής μάζας δεν είχε στατιστικά σημαντική συσχέτιση με το κοιλιακό λίπος που είναι σημαντικός παράγοντας κινδύνου για καρδιαγγειακά νοσήματα και φαίνεται να περιγράφει μόνο υποδόριο λίπος και μυική μάζα. Μετά τα 80 έτη ο Δείκτης σωματικής μάζας έχει διαφορετική σημασία στα δυο φύλα : στους άντρες φαίνεται να περιγράφει μόνο μεταβολές στο υποδόριο λίπος ενώ στις γυναίκες περιγράφει και μεταβολές στη μυική μάζα. Συμπερασματικά, τα αποτελέσματα της μελέτης δείχνουν ότι η σημασία του Δείκτη σωματικής μάζας ως δείκτη υγείας μειώνεται με την ηλικία

5. DIETARY ASSESSMENT IN A MEDITERRANEAN ELDERLY POPULATION

Objectives: To evaluate the diet of an elderly population in Northern Greece, using nutritional recommendations for the prevention of chronic diseases.

Materials & Methods: The subjects studied were 167 elderly who visited the outpatients’ clinic of the Department of Geriatrics of a large University Hospital in Northern Greece during the period of one year. Dietary intake was recorded by a trained dietitian during an interview, using a 7-day diet history questionnaire.

Results: The food habits reported by the elderly studied had the characteristics of traditional Mediterranean diet. However, mean daily energy intake for both males and females corresponded to low physical activity levels. Although mean daily protein intake was adequate, individual daily intakes were low for most of the elderly studied. Mean daily fat energy and mean daily saturated fat energy were higher than recommended but the ratio of monounsaturated to saturated fat was high. The mean daily intake of dietary fiber was low for males and females, as well as the mean daily intakes of several micronutrients including folate and vitamins B6 and E. There was a large variation in individual intakes of all micronutrients and a large number of the elderly studied had low intakes of folate, vitamins B6 and E, calcium and iron. Conclusions: The diet of the elderly studied was low in energy, corresponded to low physical activity levels and showed several nutritional imbalances, which might affect protein and micronutrient status.

The project is co-funded by the European Social Fund & National Resources – EPEAEK II – ARCHIMIDIS.

6. ANTHROPOMETRIC MEASUREMENTS IN INSTITUTIONALIZED AND FREE-LIVING GREEK ELDERLY

Objectives: To evaluate the nutritional status and body composition profile in an elderly Greek population and to document any differences between institutionalized and free-living elderly subjects.

Materials & Methods: The subjects studied were 167 free-living elderly who visited the outpatients’ clinic of the Department of Geriatrics of a large University Hospital in Northern Greece and 60 institutionalized elderly. Anthropometric measurements included height, weight, skin fold thickness, and mid-arm, calf, waist and hip circumferences.

Results: Males were taller and had lower values for Body Mass Index (BMI) than females in all ages. They also had lower fat mass (FM), higher waist : hip ratios and similar fat free mass (FFM) compared to females. The subscapular : triceps skin folds ratio was higher in males than in females. The frequency of low BMI and low FM was small among the elderly studied, unlike that of low FFM which was high, especially among free-living females. The prevalence of overweight and obesity including central obesity was higher in institutionalized than in free-living elderly and was related to lower physical activity levels.
Conclusions: Body composition was different between males and females among the Greek elderly studied, and the differences were age related. More institutionalized elderly were overweight or obese and had low physical activity levels than free-living elderly.

The project is co-funded by the European Social Fund & National Resources – EPEAEK II – ARCHIMIDIS.

7. VALIDATION OF A DIET HISTORY QUESTIONNAIRE FOR USE IN A NUTRITION STUDY OF GREEK ELDERLY

Objectives: To assess the validity of a diet history questionnaire, especially developed for a cross sectional study on nutrition in an elderly Greek population.

Materials & Methods: A trained dietitian completed the diet history questionnaire during an interview by asking the subjects to report all foods and drinks consumed during a period of one week. Portion sizes of the foods and drinks consumed were estimated as multiples of standard Greek servings described by food models. The validity of the questionnaire was evaluated by means of nitrogen excretion in 24-h urinary collections in 13 institutionalized elderly, and by comparing the ratio of energy intake (EI) and estimated basal metabolic rate (BMR) in 167 free living elderly with self-reported energy expenditure.

Results: There was no significant difference between calculated mean nitrogen intake and mean nitrogen excretion and Spearman’s correlation coefficient between the two sets of values was 0.56 (p < 0.05). The ratio between EI and BMR was 1.25 ± 0.50 which was in agreement with self-reported energy expenditure. Regarding energy intake, 10 % of the elderly were classified as under-reporters according to study specific cut-off limits.
Conclusions: The results suggest that the diet history questionnaire developed for the study on nutrition of Greek elderly was suitable to determine energy and protein intake.

The project is co-funded by the European Social Fund & National Resources – EPEAEK II – ARCHIMIDIS.