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.