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Biomedical subjects

L C de Groot

Publications and source records attributed to L C de Groot.

At least 19 recordsLinked to original sources
PubMed2001

Health effect of improved meal ambiance in a Dutch nursing home: a 1-year intervention study.

BACKGROUND: The aim of this study was to determine the effect of an improved ambiance of food consumption on health and nutritional status of Dutch nursing home elderly residents (n = 38) in a 1-year intervention study. METHODS: A parallel group intervention study was performed. Improvement of ambiance focused on three points: (1) physical environment and atmosphere of the dining room, (2) food service, (3) organization of the nursing staff assistance. Dietary intake, biochemical indicators of nutritional and health status and quality of life (Sickness Impact Profile and Philadelphia Geriatric Center Moral Scale) were assessed at baseline and after 1 year of intervention. Body weight, used as an indicator of compliance and nutritional status, was assessed every 4 months. RESULTS: Twenty-two subjects completed the 1-year intervention trial. Mean body weight significantly increased (+3.3 kg, P < 0.05) in the experimental group (n = 12), not in the control group (-0.4 kg, P = 0.78; n = 10). Health status biochemical indicators and the SIP score remained stable in the experimental group, indicating relatively stable health conditions. On the contrary, negative changes in the control group suggested a decline in health status. Dietary intake, which was insufficient at baseline, increased in both groups. CONCLUSIONS: This study showed that improving the ambiance of food consumption is a non-negligible issue for improving nutritional status and stabilizing health of nursing home residents.

Aged↗
PubMed2001

Evaluation of dietary quality in relationship to nutritional and lifestyle factors in elderly people of the US Framingham Heart Study and the European SENECA study.

OBJECTIVE: To evaluate dietary quality of European and American elderly subjects using different derivatives of dietary patterns (dietary scores and clusters) and to investigate the relationship of these approaches to nutritional and lifestyle factors. DESIGN: Data from the cross-sectional SENECA baseline study and Framingham Heart Study (original cohort and offspring) were used for data analysis. Food intake data were summarised into dietary clusters and into dietary scores (Healthy Diet Indicator and Mediterranean Diet Score). These measures of dietary quality were then tested for associations with lifestyle factors and measures of nutritional status. SUBJECTS/SETTING: The study population, aged 70-77 y, consisted of 828 subjects from Framingham, MA (USA) and 1282 subjects from the following European centres: Hamme, Belgium; Roskilde, Denmark; Padua, Italy; Culemborg, The Netherlands; Vila Franca de Xira, Portugal; Betanzos, Spain; and Yverdon, Burgdorf and Bellinzona, Switzerland. RESULTS: Dietary intake varied widely across the European and American research centres. In general, Southern European centres and Framingham had higher mean diet scores, indicating a higher dietary quality, than Northern European centres (MD-scores: 4.2-4.4 vs 2.7-3.5). Cluster analysis identified the following five dietary patterns characterised by: (1) sugar and sugar products; (2) fish and grain; (3) meat, eggs and fat; (4) milk and fruit; and (5) alcohol intake. The meat, eggs and fat pattern had significantly lower average dietary quality, as measured with all three diet scores than all other groups except the alcohol group. The fish and grain group had significantly better Mediterranean diet scores than all other groups. CONCLUSIONS: Dietary scores and dietary clusters are complementary measures to classify dietary quality. The associations with nutritional and lifestyle factors indicate the adequate categorisation into dietary quality groups. SPONSORSHIP: European Union, US Department of Agriculture, Agriculture Research Service, under agreement (58-1950-9-001), Haak Bastiaanse-Kuneman Foundation.

Aged↗
PubMed2001

Nutrient-dense foods and exercise in frail elderly: effects on B vitamins, homocysteine, methylmalonic acid, and neuropsychological functioning.

BACKGROUND: Frail elders are at risk of suboptimal micronutrient status, functional decline, and neurologic disorders. The influence of oral multimicronutrients in physiologic doses and of moderately intense physical exercise on homocysteine (Hcy), methylmalonic acid (MMA), and neurologic functioning have not yet been investigated. OBJECTIVE: Our goal was to determine the effects of enriched foods and exercise on blood vitamins, Hcy, MMA, and neuropsychological functioning in the frail. DESIGN: A 17-wk randomized controlled intervention trial was used to study 1) enriched foods plus a social program, 2) regular foods plus exercise, 3) enriched foods plus exercise, and 4) regular foods plus a social program. Enriched foods contained multiple micronutrients (25-100% of the Dutch recommended dietary allowances); exercises focused on strength, coordination, flexibility, and endurance. Vitamin (cobalamin, red blood cell folate, and pyridoxal 5'-phosphate), Hcy, and MMA concentrations were measured and 2 neuropsychological tests were conducted. RESULTS: Vitamin concentrations were higher in the supplemented groups than in the unsupplemented groups (P < 0.001; total n = 130). Compared with baseline, cobalamin in the supplemented groups was increased by 22%, plasma folate by 101%, red blood cell folate by 87%, and pyridoxal 5'-phosphate by 68%. Concentrations in the unsupplemented groups changed by -2%, -6%, 1%, and -13%, respectively. Hcy decreased by 25% and MMA by 30% in the supplemented groups, compared with a small increase in Hcy (2%) and decrease in MMA (9%) in the unsupplemented groups. Exercise did not significantly affect vitamin, Hcy, or MMA concentrations. No significant effect of either intervention was observed on the neuropsychological tests. CONCLUSIONS: The decrease in Hcy and MMA in frail elders confirms a subclinical metabolic deficiency state. Enriched foods containing physiologic amounts of micronutrients have a beneficial effect on these metabolites. No effects of B vitamins on mental health were identified.

Aged↗
PubMed2000

Variability of micronutrient content in enriched dairy and fruit products. Executive Group for Development of Nutrient Dense Foods for Frail Elderly.

Accurate measures of micronutrient levels in newly developed enriched foods are indispensable for valid labelling, for determination of ultimate levels for possible claimed health effects and for safety. To date, only a limited amount of public literature is available on the reproducibility of laboratory analysis and on the similarity within novel fortified or enriched foods. Within the framework of an intervention trial in frail elderly, the micronutrient content of eight different types of enriched foods were repeatedly examined. The variance in concentrations of the vitamins B1, B2, B6, folic acid, B12, C, D, and E was studied, in addition to levels of the minerals zinc, iodine, calcium, iron and magnesium. Four main factors, possibly contributing to the variability of these micronutrient levels, were investigated: (1) type of product, (2) type of laboratory (between-laboratory) reproducibility), (3) time of the year (month) in which analyses were carried out (May-October) and (4) freshness of the product. The type of product and laboratory emerged as factors contributing mostly to the total variability in concentrations of vitamins (on average approximately 50% explained). However, none of the products consistently contained higher or lower levels compared to the other products and most target levels were met except for vitamin B2 in both dairy and fruit products and for folic acid and vitamin C in some fruit products. Differences between products were regarded as acceptable. Extensive evaluation of multiple lab results should be emphasised within the manufacturing process of enriched foods.

Aged↗
PubMed2000

Dietary supplements and physical exercise affecting bone and body composition in frail elderly persons.

OBJECTIVES: This study determined the effect of enriched foods and all-around physical exercise on bone and body composition in frail elderly persons. METHODS: A 17-week randomized, controlled intervention trial, following a 2 x 2 factorial design--(1) enriched foods, (2) exercise, (3) both, or (4) neither--was performed in 143 frail elderly persons (aged 78.6 +/- 5.6 years). Foods were enriched with multiple micronutrients; exercises focused on skill training, including strength, endurance, coordination, and flexibility. Main outcome parameters were bone and body composition. RESULTS: Exercise preserved lean mass (mean difference between exercisers and non-exercisers: 0.5 kg +/- 1.2 kg; P < .02). Groups receiving enriched food had slightly increased bone mineral density (+0.4%), bone mass (+0.6%), and bone calcium (+0.6%) compared with groups receiving non-enriched foods, in whom small decreases of 0.1%, 0.2%, and 0.4%, respectively, were found. These groups differed in bone mineral density (0.006 +/- 0.020 g/cm2; P = .08), total bone mass (19 +/- g; P = .04), and bone calcium (8 +/- 21 g; P = .03). CONCLUSIONS: Foods containing a physiologic dose of micronutrients slightly increased bone density, mass, and calcium, whereas moderately intense exercise preserved lean body mass in frail elderly persons.

Absorptiometry, Photon↗
PubMed1999

Functional biochemical and nutrient indices in frail elderly people are partly affected by dietary supplements but not by exercise.

A decline in dietary intake due to inactivity and, consequently, development of a suboptimal nutritional status is a major problem in frail elderly people. However, benefits of micronutrient supplementation, all-round physical exercise or a combination of both on functional biochemical and hematologic indicators of nutritional and health status in frail elderly subjects have not been tested thoroughly. A 17-wk randomized controlled trial was performed in 145 free-living frail elderly people (43 men, 102 women, mean age, 78 +/- 5.7 y). Based on a 2 x 2 factorial design, subjects were assigned to one of the following: 1) nutrient-dense foods, 2) exercise, 3) both (1) and (2) or 4) a control group. Foods were enriched with micronutrients, frequently characterized as deficient [25-100% of the recommended daily allowance (RDA)] in elderly people. Exercises focused on skill training, including strength, endurance, coordination and flexibility. Dietary intake, blood vitamin levels and nutritional and health indicators, including (pre)albumin, ferritin, transferrin, C-reactive protein, hemoglobin and lymphocytes were measured. At baseline, 28% of the total population had an energy intake below 6.3 MJ, up to a maximum of 93% having vitamin intakes below two thirds of the Dutch RDA. Individual deficiencies in blood at baseline ranged from 3% for erythrocyte glutathione reductase-alpha to 39% for 25-hydroxy vitamin D and 42% for vitamin B-12. These were corrected after 17 wk in the two groups receiving the nutrient-dense foods, whereas no significant changes were observed in the control or exercise group. Biochemical and hematologic indicators at baseline were within the reference ranges (mean albumin, 46 g/L; prealbumin, 0.25 g/L; hemoglobin, 8.6 mmol/L) and were not affected by any of the interventions. The long-term protective effects of nutrient supplementation and exercise, by maintaining optimal nutrient levels and thereby reducing the initial chance of developing critical biochemical values, require further investigation. Other indicative functional variables for suboptimal nutritional status, in addition to those currently selected, should also be explored.

Aged↗
PubMed1999

High maternal body weight and pregnancy outcome.

Evidence of adverse perinatal outcomes among infants of obese pregnant women is confirmed by results of a large Swedish, population-based cohort study. Increasing maternal body weight was associated with perinatal mortality, although it protected against the delivery of a small-for-gestational-age infant.

Cohort Studies↗
PubMed1998

Evaluating the DETERMINE Your Nutritional Health Checklist and the Mini Nutritional Assessment as tools to identify nutritional problems in elderly Europeans.

OBJECTIVE: To evaluate two short questionnaires for assessing the nutritional situation of elderly people, the DETERMINE Your Nutritional Health Checklist of the Nutrition Screening Initiative (NSI checklist) and the Mini Nutritional Assessment (MNA), by comparing equivalent cumulative scores with data on dietary intake, anthropometrics and blood biochemistries. DESIGN: Information similar to the questions of the NSI and MNA lists was collected by SENECA: the Survey in Europe on Nutrition and the Elderly, a Concerted Action. SUBJECTS: Records collected in 1993, could be used from 1161 European elderly men and women born between 1913 and 1918, mostly community dwelling, whose diet, lifestyle and health were studied twice, in 1989 and 1993. RESULTS: The MNA classified 55% of the examinees as well-nourished, 44% as at risk of malnutrition and 1% as malnourished. The NSI categorised the elderly people differently: 11% as good, 41% at moderate nutritional risk, 48% at high nutritional risk. Biochemical, dietary and anthropometric indices did not differ either between NSI categories or between MNA categories. Using serum albumin values (< 30 g/l) and lymphocyte counts (< 1500/ml) as standards, specificity and sensitivity of both instruments for identifying at-risk groups were below 0.6. Only with body weight loss (> or = 10%) as criterion variable were higher sensitivities (0.75 (NSI), 0.96 (MNA)) and specificities (0.54 (NSI), 0.60 (MNA)) found. CONCLUSION: It is concluded that in an apparently healthy elderly population both assessment tools are of limited value.

Aged↗
PubMed1998

Role of cobalamin intake and atrophic gastritis in mild cobalamin deficiency in older Dutch subjects.

BACKGROUND: The reason for the high prevalence of mild cobalamin (vitamin B-12) deficiency in the elderly is poorly understood. OBJECTIVE: We aimed to determine the reason for this high prevalence. DESIGN: We examined cobalamin intake, the presence and severity of atrophic gastritis, the presence of Helicobacter pylori infection, and plasma cobalamin and methylmalonic acid (MMA) concentrations in 105 healthy, free-living, older subjects aged 74-80 y. RESULTS: Mild cobalamin deficiency, ie, low to low-normal plasma cobalamin concentrations (< 260 pmol/L) and elevated plasma MMA concentrations (> 0.32 micromol/L), were found in 23.8% of subjects; 25.7% of subjects were not cobalamin deficient (plasma cobalamin > or = 260 pmol/L and plasma MMA < or = 0.32 micromol/L). Six subjects (5.8%), including 1 with mild cobalamin deficiency, had dietary cobalamin intakes below the Dutch recommended dietary intake of 2.5 microg/d. Mildly cobalamin-deficient subjects had lower total (diet plus supplements) cobalamin intakes (median: 4.9 microg/d; 25th and 75th percentiles: 3.9, 6.4) than did non-cobalamin-deficient subjects (median: 6.3 microg/d; 25th and 75th percentiles: 5.4, 7.9) (P = 0.0336), mainly because of less frequent use of cobalamin supplements (8% compared with 29.6%; chi2 = 3.9, P = 0.048). Atrophic gastritis was found in 32.4% of the total study group: mild to moderate in 19.6% and severe in 12.7%. The prevalence of severe atrophic gastritis, but not mild-to-moderate atrophic gastritis, was higher in mildly cobalamin-deficient subjects (25%) than in non-cobalamin-deficient subjects (3.7%) (chi2 = 4.6, P = 0.032). The prevalence of immunoglobulin G antibodies to H. pylori was similar in mildly cobalamin-deficient subjects (54.2%) and in non-cobalamin-deficient subjects (44.4%) (chi2 = 0.5, P = 0.5). CONCLUSIONS: The high prevalence of mild cobalamin deficiency in healthy, free-living, older Dutch subjects could be explained by inadequate cobalamin intake or severe atrophic gastritis in only 28% of the study population. Other mechanisms explaining mild cobalamin deficiency in older people must be sought.

Aged↗
PubMed1998

Moderate alcohol intake and mortality.

A prospective study of middle-aged Chinese men contributes to existing evidence that moderate alcohol intake may improve chances of longevity. The consumption of no more than two drinks per day was associated with a 19% reduction in mortality risk. This protective effect was not restricted to a specific type of alcoholic drink.

Adult↗
PubMed1997

Factors related to plasma folate and vitamin B12. The SENECA study.

The effects of body weight, body mass index, waist-to-hip ratio, living situation, smoking status, alcohol consumption, energy intake and animal protein intake, chronic diseases, health judgement, and ability to perform activities of daily living on plasma folate and vitamin B12 concentrations in elderly people were studied. Cross-sectional data were collected in 570 males and 554 females, aged 70-75 years and living in 17 towns in 11 European countries. The data collection was part of the SENECA study on nutrition and health in the elderly. Most of the associations with plasma vitamin B12 and plasma folate were either non significant or very small, with the exception of the relation between subjective health judgement and plasma folate levels in women. The anthropometric, life-style, and dietary factors do not seem to be major risk factors for low plasma vitamin B12 and folate concentrations in this relatively healthy elderly population.

Activities of Daily Living↗
PubMed1997

Fluid intake of elderly Europeans.

Dehydration is a common fluid disorder which occurs in residents, hospitalised and community-dwelling elderly people. In this study the intake of water and fluids of community-dwelling elderly Europeans is presented in relation to risk factors of dehydration: mental state, ability to perform activities of daily living (ADL), medicine use and body composition. As part of the SENECA-study of 1993, data were collected from a random age-stratified sample (birth cohorts 1913-1918) of inhabitants of small traditional towns in Europe. Food intake data were collected by using the dietary history method. The study population consisted of 629 men and 696 women of the following towns: Hamme/Belgium, Roskilde/Denmark, Haguenau/France, Romans/France, Padua/Italy, Culemborg/the Netherlands, Lisbon/Portugal, Yverdon/Switzerland, Marki/Poland and Ballymoney-Limavady-Portstewart/Northern Ireland/United Kingdom. Fluid intake of elderly people varied between the towns of Europe and between men and women. A high percentage of the female population had a water intake below the cut-off value of 1,700 g. In most towns about 70 percent of daily water intake came from the food groups 'Milk products', 'Alcoholic drinks', 'Juices' and 'Other non-alcoholic drinks'. The consumption of 'Other non-alcoholic drinks' contributed most to daily fluid intake. In the total female population, women with the lowest water intake (first tertile) scored negatively on factors influencing fluid intake (mental state, ADL) in comparison to women of the second and third tertile. However, in the distinct towns no unequivocal relationship emerged between those factors and fluid intake. Yet, women were found to be at higher risk of dehydration because of much lower water intakes than men and because of the overall relationship between a low fluid intake and a poor mental state and ADL problems.

Activities of Daily Living↗
PubMed1996

Dietary intakes of energy and water-soluble vitamins in different categories of aging.

The dietary intakes of energy and the vitamins thiamin, riboflavin, B6, and C were assessed in four groups of elderly people, using the same modified dietary history method. The groups consisted of female nursing home residents (n = 40), people at admission to a nursing home (n = 21), free-living elderly people with a sedentary life style (n = 120), and physically active free-living elderly people (n = 66). Mean energy intake varied from 6.5 +/- 1.2 Megajoule (MJ)/day (nursing home residents) to 8.8 +/- 2.2 MJ/day (physically very active persons) in females and from 8.8 +/- 2.5 MJ/day (admission to nursing home) to 10.1 +/- 2.3 MJ/day (physically very active persons) in males. Dietary intakes of the selected vitamins were below the minimum requirements in almost half of the nursing home residents. However, the relative contribution of the various food groups to the dietary intake of these vitamins was similar in the four groups of elderly people. Stimulation of physical activity to increase energy requirements and use of foods with a high nutrient density may result in an improvement of dietary adequacy.

Aged↗
PubMed1996

Low-protein intakes and protein turnover in elderly women.

A weight maintenance diet containing either low or adequate amounts of protein was provided to 12 elderly women for a period of 10 weeks. Leucine oxidation reflected the changes in nitrogen balance that occurred over time with low-protein feeding. Adaptation to the low-protein diet was not achieved. The women accommodated to the low-protein intake with decreases in body cell mass, immune response, and muscle function.

Aged↗
PubMed1996

Survival beyond age 70 in relation to diet.

Overall survival was studied in men and women over 70 years of age in relation to the Greek variant of the traditional Mediterranean diet. According to a dietary score based on eight characteristics, a significant 17% reduction in overall mortality was observed with each unit increase in diet score. The results suggest that closer adherence to the traditional Greek diet favorably affects life expectancy among elderly people.

Aged↗
PubMed1995

Serum vitamin D concentrations among elderly people in Europe.

Vitamin D status decreases with age, mainly as a result of restricted sunlight exposure, reduced capacity of the skin to produce vitamin D, and reduced dietary vitamin D intake. We measured wintertime serum 25-hydroxyvitamin D [25(OH)D] concentrations in 824 elderly people from 11 European countries. 36% of men and 47% of women had 25(OH)D concentrations below 30 nmol/L. Users of vitamin D supplements and/or sunlamps had higher 25(OH)D (median 54 nmol/L) than non users (median 31 nmol/L). Surprisingly, lowest mean 25(OH)D concentrations were seen in southern European countries. Low 25(OH)D concentrations could largely be explained by attitudes towards sunlight exposure and factors of physical health status, after exclusion of users of vitamin D supplements or sunlamps. Problems with daily living activities and wearing clothes with long sleeves during periods of sunshine were strong predictors of low wintertime serum 25(OH)D concentrations. These findings show that free-living elderly Europeans, regardless of geographical location, are at substantial risk of inadequate vitamin D status during winter and that dietary enrichment or supplementation with vitamin D should be seriously considered during this season.

Activities of Daily Living↗
PubMed1995

Energy cost of physical activities in healthy elderly women.

In recent studies, daily physical activity ratios (PARs) greater than the Food and Agriculture Organization/World Health Organization/United Nations University (FAO/WHO/UNU) reference value of 1.5 have been reported for elderly men and women. The purpose of this study was to investigate whether a high PAR in elderly subjects can be explained by a higher energy cost of physical activities (EEact). To this end, 12 elderly women aged 69 to 82 years, completed physical activity diaries during a 2-day stay in a respiration chamber. From these diaries, total daily energy expenditure (TEE) in the calorimeter was estimated (TEEfac) using FAO/WHO/UNU PARs for physical activities and measured resting metabolic rate (RMR). TEEfac was 7.0 +/- 0.9 MJ/d (PAR, 1.35 +/- 0.06). TEE was also measured in the chamber (TEEcal) and was 8.3 +/- 1.3 MJ/d (PAR, 1.60 +/- 0.16). TEEfac was 14.8% +/- 8.1% lower than TEEcal. To investigate whether the underestimation of TEEcal was due to a higher EEact in the elderly women as compared with the FAO/WHO/UNU references, EEact of six specific activities ranging from sitting at rest to walking on a treadmill at self-chosen speed was measured with a ventilated-hood system. Individually measured PARs of the six activities were similar to FAO/WHO/UNU reference PARs. This study suggests that in elderly women a high TEEcal is not explained by EEact during nonstandardized physical activities performed at self-chosen speeds. Whether these results can be extrapolated to the free-living environment needs to be investigated further.

Activities of Daily Living↗