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A high energy intake from dietary fat among middle-aged and older adults is associated with increased risk of malnutrition 10 years later
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.ORCID iD: 0000-0003-3691-8326
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
Karolinska Inst, Inst Environm Med, Div Nutr Epidemiol, S-17177 Stockholm, Sweden..
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2015 (English)In: British Journal of Nutrition, ISSN 0007-1145, E-ISSN 1475-2662, Vol. 114, no 6, 915-923 p.Article in journal (Refereed) Published
Abstract [en]

A higher fat content in the diet could be an advantage for preventing malnutrition among older adults. However, there is sparse scientific evidence to determine the optimal fat intake among older adults. This prospective cohort study examined whether a high energy intake of dietary fat among middle-aged and older adults is associated with the risk of malnutrition 10 years later. The study population comprised 725 Swedish men and women aged 53-80 years who had completed a questionnaire about dietary intake and lifestyle factors in 1997 (baseline) and whose nutritional status was assessed when admitted to the hospital in 2008-2009 (follow-up). At the follow-up, 383 (52.8 %) participants were identified as being at risk of malnutrition and fifty-two (7.2 %) were identified as malnourished. Multinomial logistic regression models were used to analyse the association between previous dietary fat intake and nutritional status later in life. Contrary to what was expected, a high energy intake from total fat, saturated fat and monounsaturated fat among middle-aged and older adults increased the risk of exhibiting malnutrition 10 years later. However, this applied only to individuals with a BMI<25 kg/m(2) at the baseline. In conclusion, these findings suggest that preventive actions to counteract malnutrition in older adults should focus on limiting the intake of total fat in the diet by reducing consumption of food with a high content of saturated and monounsaturated fat.

Place, publisher, year, edition, pages
2015. Vol. 114, no 6, 915-923 p.
Keyword [en]
Cohort studies, Dietary fat, Epidemiology, Malnutrition, Mini Nutritional Assessment
National Category
Nutrition and Dietetics
Identifiers
URN: urn:nbn:se:uu:diva-264619DOI: 10.1017/S0007114515002317ISI: 000361380600010OAI: oai:DiVA.org:uu-264619DiVA: diva2:865099
Funder
Swedish Research Council, E0639401Forte, Swedish Research Council for Health, Working Life and Welfare, 11132/2011
Available from: 2015-10-26 Created: 2015-10-15 Last updated: 2017-12-01Bibliographically approved
In thesis
1. Nutritional Screening of Older Adults: Risk Factors for and Consequences of Malnutrition
Open this publication in new window or tab >>Nutritional Screening of Older Adults: Risk Factors for and Consequences of Malnutrition
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aims The overall aim of this thesis was to extend current knowledge about the prevalence of malnutrition, to identify possible risk factors for development of malnutrition, and to describe the consequences of malnutrition in relation to all-cause and cause-specific mortality among older adults admitted to hospital.

Methods The prevalence of malnutrition was estimated in a cohort of 1771 older adults (≥65 years) who were admitted to a Swedish hospital during 2008–2009 (15 months) and screened for malnutrition using the Mini Nutritional Assessment (MNA) instrument. Possible risk factors for malnutrition were recorded during the hospital stay (Study I). Dietary intake 10 years earlier (in 1997) was collected for 725 of these older adults (Study II). All-cause (Study III) and cause-specific (Study IV) mortality were followed up after medians of 3.5 and 5.1 years, respectively, for 1767 of the participants.

Results The prevalence of malnutrition was 9.4% while 55.1% were at risk of malnutrition. Risk factors for malnutrition was an overnight fast >11 hours, <4 eating episodes a day, and not cooking independently. In middle-aged and older adults with a body mass index <25 kg/m2 in 1997, the risk of malnutrition increased for each additional percentage point of energy from total, saturated and monounsaturated fat at follow-up after 10 years. Malnourished older adults had almost four times higher risk of death during follow-up, while those at risk of malnutrition had a 56% higher risk, compared to well-nourished. Furthermore, well-nourished older adults had consistently lower risk of death, regardless of the cause of death.

Conclusions Only 35.5% of older adults admitted to hospital were well-nourished. The identified risk factors could be used in interventions aimed at preventing malnutrition. Normal-weight and underweight middle-aged and older adults should consider limiting the intake of total fat and/or improve the quality of the fat in the diet in order to decrease the risk of becoming malnourished later in life. Malnutrition and risk of malnutrition were associated with increased overall and cause-specific mortality. These relationships emphasize the need for nutritional screening to identify individuals who may require nutritional support in order to avoid preterm death.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2016. 83 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1167
Keyword
Epidemiology, Malnutrition, Mortality, Older adults, Prevalence, Risk factors
National Category
Medical and Health Sciences Geriatrics
Research subject
Nutrition; Geriatrics
Identifiers
urn:nbn:se:uu:diva-267564 (URN)978-91-554-9435-3 (ISBN)
Public defence
2016-02-26, Vårdskolans aula, ing. 21, Västmanlands sjukhus Västerås, Västerås, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2016-01-15 Created: 2015-11-24 Last updated: 2016-02-12

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Söderström, LisaRosenblad, AndreasAdolfsson, Eva T.Bergkvist, Leif

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