Biomedical subjects
Publications and source records attributed to C P de Groot.
In old age, the complex relation of food consumption with energy and nutrient requirements finds expression in both single and multiple nutritional problems. Addressing conditions affecting intake -- either from foods or from supplements -- endogenous production, bioefficacy and/or requirements can benefit nutritional health in old age through balancing requirements and supply.
An understanding of the determinants of nutritional intake may be helpful in the early detection and prevention of malnutrition. A vast amount of literature exists on factors influencing daily energy or food intake. Although far less is known about population and subject characteristics influencing the macronutrient composition of the diet, associations appear to exist with cultural factors, snacking and disease. The literature does not provide sufficient evidence in support of relationships with other factors such as living situation, dentition, disability, depression and drug use, partly because information on determinants of macronutrient intake is scarce.
The SENECA Study "Nutrition and the elderly in Europe" investigates men and women born 1913-1918 in 20 small traditional towns in Europe. At the age of 74-79 years subjective health was satisfactory or good in 95% of 399 men and 93% of 414 women in 6 study towns. In these subjects suboptimal nutritional blood values were virtually nonexistent. Food intake was low in energy and rich in protein and fat. Lowest European recommended dietary allowances were not reached by all subjects. The even higher values recommended as potentially protective factors were not met by a substantial part of subjects with energy intakes below 6.3 MJ/d. Regularity of food intake was high and had increased over 4 years. Living alone did not adversely affect food intake while low economic situation did.
OBJECTIVE: To examine energy intake of elderly people participating in the Survey in Europe on Nutrition and the Elderly, a Concerted Action (SENECA) study in relation to the adequacy of micronutrient intake. DESIGN: Data from eight countries on 486 men and 519 women who were 74-79 years old. Dietary intakes of energy, iron, thiamine, riboflavin and pyridoxine were calculated. RESULTS: There was inadequate intake of one or more nutrients in 23.9% of men and 46.8% of women. The prevalence of inadequate intakes decreased gradually with higher energy intakes. Of all people with energy intakes exceeding 1500 kcal, 19% of men and 26% of women still had an inadequate intake of at least one micronutrient. CONCLUSION: We found no single criterion ensuring level of energy intake with an adequate micronutrient supply. The prevalence of an inadequate intake of micronutrients was high at all energy intake levels, especially in women.
In 1988 a European multicenter study, named SENECA, was initiated. Nine of the original 19 participating towns in 12 European countries decided to continue the longitudinal study by conducting a second survey in 1993. The aim of the longitudinal part of the SENECA study was to provide measurements of diet, lifestyle, health and performance as such at two points in time and to analyze the direction of changes and possible interrelationships between the factors studied. For the present paper the experience with the SENECA study has been used to illustrate the problems related to nutritional longitudinal studies in different stages of dietary research. In the examples we have focused on results relating changes in body weight to energy intake and changes in total cholesterol to intakes of fat and fatty acids of participants from four SENECA sites. To examine dietary habits a modified dietary history was chosen consisting of two parts: an estimated record and a checklist of foods. The results demonstrate that the special design of the study and adaptation of methods made it possible to deal with several problems encountered in nutritional longitudinal studies in elderly people. Nevertheless the changes in diet are most likely underestimated. Consequently in the interpretation of data and further analysis we have to consider this problem as well as other remaining problems.
OBJECTIVE: Assess longitudinal changes in height, body weight, triceps skinfold thickness and circumferences in elderly Europeans. DESIGN: Longitudinal study including baseline measurements taken in 1988/1989 which were repeated in 1993. SETTING: Baseline and follow-up data were collected in nine European research towns: Hamme/Belgium (H/F), Roskilde/Denmark (R/DK), Haguenau/France (H/F), Romans/France (R/F), Padua/Italy (P/I), Culemborg/the Netherlands (C/NL), Vila Franca de Xira/Portugal (V/P), Betanzos/Spain (B/E), Yverdon/Switzerland (Y/CH). Single 1993 measurements were carried out in 4 towns: Coimbra/Portugal (C/P), Marki/Poland (M/PL), Ballymoney-Limavady-Portstewart/Northern Ireland/UK (BLP/NI/UK), Mansfield/Connecticut/USA (M/CT/USA). SUBJECTS: Using standardized methodologies data were collected from a random stratified sample of elderly men and women born between 1913 and 1918 including a total of 1242 subjects in 1993. RESULTS: At most sites stature had decreased by 1-2cm. Median weight changed by -1.5 kg to -3.5 kg in only three towns. An increase of at least 5 kg of body weight had taken place in 9% of men and 6% of women whereas 16% of both men and women had lost at least 5 kg of their baseline weight. Serial changes in triceps skinfold thickness, arm circumference and waist-to-hip ratio were small. CONCLUSIONS: Height declined with age. Median changes in other anthropometric characteristics of interest were small. These changes resulted from both considerable gains and losses of body weight in a significant proportion of the SENECA populations.
OBJECTIVE: To compare actual food intake of elderly people in Europe and further identify food patterns, which mediate favourable or unfavourable nutrient intakes from cluster analysis of pooled data. DESIGN: Cross-sectional analysis of food patterns of participants of the SENECA follow-up study (1993). SETTING: Twelve traditional European towns. SUBJECTS: Men (n = 647) and women (n = 710) aged 74-79 y in 1993. METHODS: Food intake data were assessed using the same validated dietary history technique in all SENECA towns. Cluster analysis was used to classify subjects into groups based on similarities in dietary variables. RESULTS: A northern and southern European eating pattern emerged. The southern food pattern appeared to be the most healthful being rich in grain, vegetables, fruit, lean meat and olive oil. The north-south gradient did, however, not systematically segregate into the same clusters. All dietary profiles were represented in all sites. The four dietary profiles, identified by cluster analysis, were: 'Lean and green eaters': high carbohydrate and vitamin C intake, 'gourmands': high intake of energy and nutrients, 'milk drinkers': high intake of calcium and vitamin B2 and 'small eaters': marginal energy and nutrient consumption. Marital status, education, smoking, health status and physical activity level differed between clusters. CONCLUSIONS: A north-south gradient of food patterns was identified. The southern diet agreed better with guidelines for healthy eating. A sufficient energy intake seemed, however, to be necessary for an adequate nutrient intake, beside a good choice of food types.
OBJECTIVE: To quantify the consumption of unfiltered coffee brews, which contain the cholesterol-raising diterpenes cafestol and kahweol, in elderly subjects. DESIGN: Interviews of randomly selected elderly in the 1993 SENECA Study on Nutrition and the Elderly in Europe. SETTING: Nine towns in eight European countries (Denmark, France, Italy, the Netherlands, Portugal, Switzerland, Poland, and Northern Ireland/United Kingdom). SUBJECTS: 962 relatively healthy elderly persons (460 men, 502 women) born between 1913 and 1918. MAIN OUTCOME MEASURE: Daily coffee consumption, classified by brewing technique. RESULTS: About 90 percent of the examinees were daily coffee users in Roskilde/Denmark (population means; men 530 ml/d, women 425 ml/d) and Culemborg/the Netherlands (men 513 ml/d, women 285 ml/d), against only 12% in Marki/Poland (population means; men 14 ml/d, women 36 ml/d) and 7% in Coimbra/Portugal (men 8 ml/d, women 0 ml/d). Drip-filtered and instant coffee, which are poor in diterpenes, were the prevalent types in most survey towns. Espresso and mocha coffee, which contain intermediate amounts of diterpenes, were consumed daily by 31% of the coffee drinkers in Switzerland and by all coffee drinkers in Italy, but intake was too low to substantially affect serum cholesterol levels. Consumption of brews that are rich in diterpenes, such as cafetiere, boiled, or Turkish/Greek coffee, was negligible in all survey towns. CONCLUSIONS: Coffee drinking is common among elderly people in some European countries, but intake of cafestol and kahweol with unfiltered coffee brews is low.
In 1988 SENECA (Survey in Europe on Nutrition and the Elderly, a Concerted Action) was initiated to study cross cultural differences in nutritional issues and life style factors affecting health and performance of elderly Europeans. Nine of the original 19 participating towns in 12 European countries decided to conduct a longitudinal study. This supplement presents the findings of the second data collection period and the first longitudinal analyses of these nine towns. In addition, cross-sectional results are discussed for two towns from which few baseline data were collected, and for two towns which were only involved in the 1993 survey: one from the United Kingdom and one from the United States. Ethical permission for the studies was obtained from local ethical committees.
OBJECTIVE: To assess the nutritional status of female elderly nursing home residents and to study the effect of dietary supplementation with a physiological dose of water-soluble vitamins. DESIGN: Single-blind, randomised, placebo-controlled intervention trial. Daily consumed supplement consisted of fortified fruit juice containing 50 g carbohydrate and 50% of the daily dietary recommendations of water-soluble vitamins. Regular fruit juice was used as placebo. Dietary intake assessment at baseline. Fasting blood sample, anthropometric measurements and medical record at baseline and after 4 and 12 weeks of supplementation. SETTING: Three nursing homes within 40 km of the coordination centre (Department of Human Nutrition, Wageningen Agricultural University, the Netherlands). SUBJECTS: Forty-two female nursing home residents aged 60 years and older, in relatively stable health condition, at least 3 months resident at baseline. In each nursing home, 14 subjects were randomly assigned to the supplement or control group. INTERVENTIONS: Twelve weeks of supplementation. RESULTS: Participants had a poor nutritional status. Dietary supplementation significantly improved the concentrations of thiamin pyrophosphate and pyridoxal 5'-phosphate, increased body weight and decreased serum homocysteine concentration in the supplement group. Plasma vitamin C levels were significantly increased in both supplement and control group. CONCLUSIONS: Even in this heterogeneous population of female nursing home elderly it is possible to improve the nutritional status through dietary intervention with a physiological dose of water-soluble vitamins.