Health and nutrition promotion program for patients with dementia (NutriAlz): cluster randomized trial.

OBJECTIVE: To assess the effectiveness of health and nutrition program (NutriAlz) versus usual care on functional level in elderly people with dementia living at home, as well as on clinical practice related to nutrition and on the caregiver's burden. DESIGN: Cluster randomized multi-centre study with one-year follow-up. SETTING: 11 Alzheimer outpatients and day care centres (Barcelona, Spain). PARTICIPANTS: Nine hundred and forty six home-living Alzheimer patients with identified caregiver were consecutively recruited (intervention group: 6 centres, 448 patients vs control group: 5 centres, 498 patients). INTERVENTION: The intervention was a teaching and training intervention on health and nutrition program, NutriAlz, directed both to physician and main caregiver, as well as persons affected by Alzheimer's disease or other dementias, including a standardised protocol for feeding and nutrition. MAIN OUTCOME MEASURES: The main outcome measure was the reduction in the loss of autonomy (Activities of daily living (ADL/IADL) scales) assessed at 6 and 12 months. Secondary outcomes measures were Improvement in nutritional status (Mini Nutritional Assessment (MNA), BMI, and weight changes), and caregiver burden (Zarit scale). RESULTS: The one-year assessment was completed for 293 patients (65.4%) in the intervention group and 363 patients (72.9%) in the control group (usual care). The annual rate of ADL change was -0.83 vs -0.62 (p=0.984), and the caregiver's subjective burden 0.59 vs 2.36 (p=0.681) in intervention and control group, respectively. MNA, however, showed an improvement (+0.46 vs -0.66, p=0.028), suggesting an effective nutritional behaviour. CONCLUSION: The NutriAlz program had no effect on functional decline in Alzheimer disease patients living at home over one year, but reduced the risk for malnutrition, as recommendations concerning diet and exercise were provided.

Health and nutritional promotion program for patients with dementia (NutriAlz Study): design and baseline data.

BACKGROUND: There is a lack of data on global weight loss prevention programs for patients with dementia or clear evidence about their impact on a functional level, caregiver burden or the use of healthcare and social resources. NutriAlz is a socio-educative and nutritional intervention program to prevent weight loss and loss of function in dementia patients. STUDY DESIGN AND METHODS: A cluster randomized multi-centre study, which will allow the comparison of a group benefiting from the intervention with a control group after a year of monitoring. Patients were recruited from 11 hospitals in the ambulatory diagnostic units and day care centres. The baseline interview include: sociodemographic and socioeconomic variables (age, gender, educational level, marital status); diagnostic, treatments, MMS, a list of comorbid conditions; activities of daily living (ADL, IADL), Zarit Scale, brief-NPI, Cornell scale and nutritional status as measured by the Mini Nutritional Assessment. All participants or their family signed the inform consent form. BASELINE CHARACTERISTICS: Total of 946 patients were included, with a mean (+/- SD) of 79 +/- 7.3 year of age; 68,1 % were women; 44,9% lives with their partner, only 3% lives alone; 79.8% had Alzheimer's dementia, 5.25 +/- 3.0 years since symptoms of dementia and 2.8 +/- 2.11 years since diagnosis. Mean MMSE score was 15.4 +/- 6.2; mean weight was 64.4 +/- 12.5 kg; mean BMI was 27.0 +/- 4.5 (with 3% below 19, 5% between 19-21, 10% between 21-23, and 82% above 23). Mean ADL without difficulties was 3.2 +/- 2.1; mean IADL without difficulties was 0.7 +/- 1.6; mean number of symptoms in the NPI was 4.4 +/- 2.59, with severity score of 7.9 +/- 5.9 and distress score of 11.3 +/- 9.0; mean Zarit scale was 27.4 +/- 15.5; mean MNA was 23.2 +/- 3.5 with 5 % as malnourished, 32 % at risk of malnutrition, and 63 % with adequate nutritional status.

Effects of non-esterified stanols in a liquid emulsion on cholesterol absorption and synthesis in hypercholesterolemic men.

UNLABELLED: BACKGROUND Numerous studies have shown that dietary plant sterols (phytosterols and phytostanols) and their esters can decrease cholesterol absorption. However, few researchers have examined the effects of plant sterols on cholesterol absorption and synthesis using stable isotope tracers, instead of relying on endogenous pathway precursors. Further, we have worked with non-esterified lecithin-solubilized stanols as opposed to the more frequently studied esterified sterols and stanols. The vehicle was an oil-in-water liquid emulsion rather than the more common spread vehicle typically employed. AIM OF THE STUDY: To determine the effects of relatively low doses of lecithin-solubilized non-esterified stanols in liquid emulsions on cholesterol absorption and synthesis in mildly hypercholesterolemic subjects. METHODS: In a randomized, double blind crossover design, 12 mildly hypercholesterolemic men received either a free phytostanol supplement (3 g/d in 3 servings) or a control treatment for 3 days. Cholesterol endogenous synthesis rate was determined using the rate of incorporation of deuterium from body water into newly formed cholesterol molecules. Cholesterol absorption at the intestinal level was determined using the dual isotope method using 13C cholesterol injected intravenously and 180 cholesterol given orally. RESULTS: Cholesterol absorption was 55.7 +/- 6.5 % for the control and 33.5 +/- 5.3% for the phytostanol treatment. This massive reduction of the cholesterol absorption did not induce, on average, a difference in cholesterol endogenous synthesis which was measured at 0.074 +/- 0.0015 pool/d for plant sterols and 0.0736 +/- 0.0015 pool/d for controls (p > 0.05). CONCLUSIONS: The results demonstrated that lecithin-solubilized stanols administrated during a short period of time (3 days) in an oil-in-water emulsion can dramatically decrease cholesterol absorption, without a consistent, concomitant increase in synthesis, which is highly suggestive of effective LDL cholesterol lowering. The effects of synthesis should be verified in a longer study with more subjects.

Postexercise fat intake repletes intramyocellular lipids but no faster in trained than in sedentary subjects.

The hypotheses that postexercise replenishment of intramyocellular lipids (IMCL) is enhanced by endurance training and that it depends on fat intake were tested. Trained and untrained subjects exercised on a treadmill for 2 h at 50% peak oxygen consumption, reducing IMCL by 26-22%. During recovery, they were fed 55% (high fat) or 15% (low fat) lipid energy diets. Muscle substrate stores were estimated by (1)H (IMCL)- and (13)C (glycogen)-magnetic resonance spectroscopy in tibialis anterior muscle before and after exercise. Resting IMCL content was 71% higher in trained than untrained subjects and correlated significantly with glycogen content. Both correlated positively with indexes of insulin sensitivity. After 30 h on the high-fat diet, IMCL concentration was 30-45% higher than preexercise, whereas it remained 5-17% lower on the low-fat diet. Training status had no significant influence on IMCL replenishment. Glycogen was restored within a day with both diets. We conclude that fat intake postexercise strongly promotes IMCL repletion independently of training status. Furthermore, replenishment of IMCL can be completed within a day when fat intake is sufficient.

Simultaneous assessment of cholesterol absorption and synthesis in humans using on-line gas chromatography/ combustion and gas chromatography/pyrolysis/isotope-ratio mass spectrometry.

A number of dietary components and drugs are known to inhibit the absorption of dietary and biliary cholesterol, but at the same time can compensate by increasing cholesterol synthesis. It is, therefore, necessary to have a convenient and accurate method to assess both parameters simultaneously. Hence, we validated such a method in humans using on-line gas chromatography(GC)/combustion and GC/pyrolysis/isotope-ratio mass spectrometry (IRMS). Cholesterol absorption was measured using the ratio of [(13)C]cholesterol (injected intravenously) to [(18)O]cholesterol (administered orally). Simultaneously, cholesterol synthesis was measured using the deuterium incorporation method. Our methodology was applied to 12 mildly hypercholesterolemic men that were given a diet providing 2685 +/- 178 Kcal/day (mean +/- SD) and 255 +/- 8 mg cholesterol per day. Cholesterol fractional synthesis rates ranged from 5.0 to 10.5% pool/day and averaged 7.36% +/- 1.78% pool/day (668 +/- 133 mg/day). Cholesterol absorption ranged from 36.5-79.9% with an average value of 50.8 +/- 15.4%. These values are in agreement with already known data obtained with mildly hypercholesterolemic Caucasian males placed on a diet similar to the one used for this study. However, our combined IRMS method has the advantage over existing methods that it enables simultaneous measurement of cholesterol absorption and synthesis in humans, and is therefore an important research tool for studying the impact of dietary treatments on cholesterol parameters.

Food and nutrient intakes in a group of 11 to 16 year old Swiss teenagers.

Better knowledge of the dietary intake of teenagers is necessary to help health professionals to provide better advice on an individual and data for prevention and health programme. We carried out a dietary survey by 3-day records technique in a group of adolescents living in the Canton of Vaud, Switzerland. Food habits were traditional but rich in refined products and poor in plant food. Mean daily energy intake, which was 8025 kJ for the girls and 9350 kJ for boys, was lower than the recommended dietary allowances, especially for girls. Independently of the gender, breakfast represented 19% of the total daily energy intake, lunch 31% and dinner 29%. Total energy provided by snacks was 23.0% for girls and 20.4% for boys. The percentage of energy supplied by the afternoon snack was 15.8% for the girls and 13.3% for the boys. The source of energy was 14% from protein, 37% from fat and 49% from carbohydrates. A high percentage of adolescents had low micronutrient intakes (vitamins A, E, B1, B6, C, folates and for minerals magnesium, calcium and iron). An increase intake of vegetables and fruit should thus be strongly encouraged; snacking could offer a target vector to improve dietary nutritional quality.

Food habits and sport activity during adolescence: differences between athletic and non-athletic teenagers in Switzerland.

OBJECTIVE: To describe food habits and dietary intakes of athletic and non-athletic adolescents in Switzerland. SETTING: College, high schools and professional centers in the Swiss canton of Vaud. METHOD: A total of 3,540 subjects aged 9-19 y answered a self-reported anonymous questionnaire to assess lifestyles, physical plus sports activity and food habits. Within this sample, a subgroup of 246 subjects aged 11-15 also participated in an in-depth ancillary study including a 3 day dietary record completed by an interview with a dietician. RESULTS: More boys than girls reported engaging in regular sports activities (P<0.001). Adolescent food habits are quite traditional: up to 15 y, most of the respondents have a breakfast and eat at least two hot meals a day, the percentages decreasing thereafter. Snacking is widespread among adolescents (60-80% in the morning, 80-90% in the afternoon). Food habits among athletic adolescents are healthier and also are perceived as such in a higher proportion. Among athletic adolescents, consumption frequency is higher for dairy products and ready to eat (RTE) cereals, for fruit, fruit juices and salad (P<0.05 at least). Thus the athletic adolescent's food brings more micronutrients than the diet of their non-athletic counterparts. Within the subgroup (ancillary study), mean energy intake corresponds to requirements for age/gender group. CONCLUSIONS: Athletic adolescents display healthier food habits than non-athletic adolescents: this result supports the idea that healthy behavior tends to cluster and suggests that prevention programs among this age group should target simultaneously both sports activity and food habits.

[Nutrition assessment of the elderly based on results of the SENECA Study "Nutrition and the elderly in Europe"]. / Nährstoffaufnahme bei gesunden Betagten aufgrund von Resultaten der SENECA Studie "Nutrition and the elderly in Europe".

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.

Meal patterns in the SENECA study of nutrition and the elderly in Europe: assessment method and preliminary results on the role of the midday meal.

The paper discusses the assessment method for meal patterns in the course of the SENECA follow-up survey in 1993 in eight study towns across Europe and relates the percentage of energy intake at the midday meal to geographical latitude, total energy intake, energy intake as snacks, number of cooked meals, time spent at the main meal and intake of milk products, fat and leafy vegetables. A questionnaire for the assessment of meal patterns in western Europe has to include the possibility to assess more than three meals per day as well as a variety of meals at any time of the day. Meal structures vary between cooked meals, bread- or soup-based meals, but may also consist of spoon food, salads or fruit. Positive correlations were found between the percentage of energy intake at the midday meal and the number of cooked meals consumed per day, negative relations were found between the percentage of energy intake at the midday meal and the geographical latitude as well as total energy intake, energy intake in form of snacks and consumption of milk products.

Assessment of adolescent food habits in Switzerland.

Several physical, psychological and behavioural changes may affect food habits during adolescence and have long-term consequences on adult health status. Also, as food habits are related to lifestyle and physical activity, all should be assessed together. This paper describes a self-administered food frequency questionnaire (FFQ) designed to assess semi-quantitatively food habits of adolescents, and evaluates its use in a study of lifestyle and physical activity. A FFQ was developed, tested in 20 adolescents and compared with a modified version of the diet history method (a combination of a 3-day dietary record and an interview with a dietitian). This validated semi-quantitative questionnaire was later included in a larger questionnaire on lifestyle and physical activity in a study of 3540 adolescents aged 9-19 years. In the validation study with 20 adolescents, the FFQ showed a good agreement with the modified version of the diet history. During the survey several consumption frequencies were found to be low. In the group of adolescents aged 14-19 years old, dairy products were consumed daily by less than 50% of the sample. About 53% girls but only 33% boys consumed one fruit daily. For one vegetable portion, these proportions were 17 and 8%, respectively. The self-administered food frequency questionnaire correctly describes food consumption in adolescents. Moreover, it was well accepted by the target group, easily understood and completed with very few problems. The results show that a significant proportion of adolescents didn>>t consume milk, fruit and vegetable on a daily basis.

[Swiss Survey in Europe on Nutrition and the Elderly: nutritional status of a Yverdon population aged 74 to 79 years old over a period of four years]. / SENECA Suisse: état nutritionnel d'une population yverdonnoise âgée de 74 à 79 ans, et son évolution sur une période de quatre ans.

In Switzerland the longitudinal SENECA study (Survey in Europe on Nutrition and the Elderly, a Concerted Action of the 3rd European Framework Programme) was implemented in the city of Yverdon-les-Bains. The study investigated the nutritional and health status of 70 to 75-year old elderly living at home, in relation with their food habits, life style, social network and physical activity with a follow-up study 4 years later. Results of the follow-up study, with the subjects aged 74 to 79 years, and changes observed over the 4 years are presented here. The participants reported a rather good self-assessed health and were quite independent in their daily activities. Food and nutrient intakes decreased over the 4-year follow-up, as did physical activity, independence in daily activities and height. However, biological markers (haemoglobin, haematocrit, albumin, lipids and vitamins) of nutritional status showed little change and remained mostly in the normal range. Low energy intake was measured in 21% of the men (< 1500 kcal/d) and in 24% of the women (< 1200 kcal). This is a source of concern since such low energy intakes make it difficult to cover micronutrient requirements. It is therefore important to find ways to maintain or increase the quality of the diet and adequate nutrient intakes.

Cross-cultural variations and changes in food-group intake among elderly women in Europe: results from the Survey in Europe on Nutrition and the Elderly a Concerted Action (SENECA).

To study cross-cultural variations and changes in intake of food groups in elderly Europeans, longitudinal data on food-group intake from Danish (n = 55), Dutch (n = 65), Swiss (n = 79), and Spanish (n = 46) female participants in the Survey in Europe on Nutrition and the Elderly a Concerted Action (SENECA) were compared. Participants were born between 1913 and 1918. Information on food intake was obtained with use of the same diet-history method at all sites and in both 1988-1989 and 1993. Actual food intake was coded according to the Eurocode system, the applicability of which for European multicenter studies was evaluated in this study. All participants, regardless of site, reported consumption of milk, grain products, and vegetables, and almost all ate meat, fats, and fruit. Fewer women ate eggs, fish, and sugar. The variations between the sites were in the food groups consumed and the types of foods within the groups. Spanish women appeared to have the most healthy food-intake pattern. They also had more changes in their dietary pattern than did women in the other countries. The Eurocode was adequate for describing the actual food intake of elderly women in four European towns. The coding for meat, however, was ambiguous and should be revised.

Longitudinal changes in iron and protein status of elderly Europeans. SENECA Investigators.

OBJECTIVE: Describe the iron and protein status of European elderly people studied in 1993, together with changes observed in the previous four years. DESIGN: Two optional designs: (1) A transversal study from a randomly selected group of female and male elderly subjects born between 1913 and 1914. (2) A longitudinal study including base-line measurements in 1988/1989 in subjects born in 1913-1918, which were repeated and extended in 1993. SETTING: Nineteen towns in 12 European countries participated in the baseline study in 1988/ 1989. Eleven centres in nine countries completed the follow-up study in 1993, and two new towns joined in 1993. The study included blood sampling for analysis of markers of nutritional status. RESULTS: The mean haemoglobin (Hb) values during the follow-up study for the different town populations ranged from 142 to 159 g/l for men and from 129 to 146 g/l for women. Prevalences of anaemia, based on WHO criteria (Hb < 130 g/l for men, and Hb < 120 g/l for women), amounted to 6.0% and 5.0% for men and women, respectively, and were very close to the baseline prevalences of 5.6% and 5.5%. A small decrease in Hb was observed after 4y in men. The mean haematocrit (Hct) values for the different towns ranged from 42% to 48% in men and from 39% to 44% in women. For both sexes, a decrease in Hct was observed. White blood cell (WBC) counts and differentials were measured in the follow-up study only. Mean WBC counts ranged from 5.8 x 10(3)/microliter to 7.1 x 10(3)/microliter in men and from 5.6 x 10(3)/microliter to 6.7 x 10(3)/microliter in women. Mean lymphocyte counts ranged from 1.6 x 10(3)/microliter to 2.4 x 10(3)/microliter in men and from 1.7 x 10(3)/microliter to 2.3 x 10(3)/microliter in women and mean neutrophile counts ranged from 3.4 x 10(3)/microliter to 4.4 x 10(3)/microliter and from 3.1 x 10(3)/microliter to 4.0 x 10(3)/microliter, respectively. The mean serum albumin values for the different towns varied from 39.9 g/l to 43.2 g/l for men, and from 39.3 g/l to 42.4 g/l for women, quite similar to the baseline study. In 25 subjects (2.2%) only serum albumin level was below 35 g/l and five subjects (0.4%) had a serum albumin level below 30 g/l. No albumin changes were detected for either sex over the four year period. The group of survivors in the follow-up study had higher mean albumin concentrations at baseline than the group of subjects who had died between the baseline and the follow-up study. CONCLUSION: In this population of elderly subjects in their seventies, Hb, Hct and albumin showed little change over the 4 year follow-up period. The prevalence of anaemia and low serum albumin values was relatively low, which is indicative of a relatively good health.

Food patterns of elderly Europeans. SENECA Investigators.

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.

Food intake and nutritional status during EXEMSI. Experimental Campaign for the European Manned Space Infrastructure.

Modifications of food intake by astronauts during long-duration spaceflights have been observed. Various psychological stress factors, such as isolation, confinement, constrained community and boredom, are thought to play a role in this phenomenon. For this reason it was decided to include a nutritional investigation in the EXEMSI simulation study, in which four crew members (1 female and 3 males) were isolated and confined for 60 days in a space station-like environment. The Food and Nutritional Management System, developed for this experiment, provided on-line analysis of all available foods in terms of their nutrient content (macronutrients, water, minerals, vitamins). It permitted to keep an accurate record of the daily food intake of each crew member. The system has been shown to be a powerful tool for future missions, either simulations or actual spaceflights. It permits optimal management of food and eating on board, and offers the possibility of online analysis of the nutritional status of the crew. It can provide readily usable data for future analysis of nutritional variables in relation to other physiological and metabolic parameters. It could also supply a periodic feedback to the subject for the purpose of adjusting food intake. Eating and nutrition during the experiment were not a problem, but a pleasure, and therefore played an important role in its success. Confinement and isolation apparently had no effect on either the eating habits or the nutritional status of the crew members. The good food rather helped to decrease the potentially induced stress by providing daily periods of pleasure and of social activities. Detailed analysis of food intake showed erratic eating patterns, both before and during the experiment. However, the weekly averages of macro- and micronutrient intakes were in the normal range, except for vitamins B1 and B6 that were rather low and showed the need for supplements. Food appreciation was assessed by daily questionnaires. Satisfaction with the food provided during isolation was rated very high, and there was no feeling of hunger or monotony. The satisfaction with the food was mainly due to its high palatability, the adequate selection made with direct prior involvement of the crew, the large variety, and the extra supply that allowed the crew to choose and feel free regarding food intake. Comments from the crew afterwards clearly demonstrated that food had not been considered critical during the 60 days of isolation. This is an important fact considering the importance of food in such a restricted living environment.

Energy, protein, and substrate metabolism in simulated microgravity.

Whole body protein turnover and energy expenditure before and during an oral glucose tolerance test (1 g/kg body wt) were studied on separate occasions in six healthy young men before and during 3 days of simulated microgravity using the 6 degrees head-down tilt (HDT) method. After 42-47 h of HDT, basal insulin concentrations increased significantly from 9.4 +/- 1.9 to 13.1 +/- 0.1 microU/ml (P < 0.002). No significant differences in glycemia, insulinemia, or free fatty acid concentrations were observed in response to the oral glucose load. With HDT, increases were observed in basal postabsorptive resting metabolic rate (8%; P < 0.05), lipid oxidation (33 +/- 2 to 51 +/- 5 mg/min; P < 0.02), and the thermic effect of glucose (7.7 +/- 1 to 10.7 +/- 0.6%; not significant). Protein turnover (arithmetic mean of ammonia and urea flux rates) was unchanged by HDT, but a significant increase was seen when calculated from ammonia alone (P < 0.02). The present data show that HDT results in an increased energy requirement through elevations in both the basal metabolic rate and the thermic response to food ingestion. These changes may have been brought about by a cephalic shift of body fluids similar to that experienced in microgravity.

Effect of age on concentrations of serum antibodies to viral, bacterial, and food antigens in elderly Swiss people.

Serum antibody concentrations to two viral, five bacterial, and two food antigens were investigated in 307 elderly Swiss subjects, and the hypothesis of whether serum antibody titers decreased with age was tested. The cross-sectional part of the study consisted of 216 unselected consecutive patients hospitalized in one geriatric hospital. The patients were divided into two age groups (65 to 84 and 85 to 102 years old), and their antibody titers were compared. No age-related decreases in antibody titers were observed. The members of the two age groups were well matched for medical diagnosis and nutritional and inflammatory status. The prospective part of the study consisted of 91 healthy elderly subjects living in the community; they were 71 to 76 years old when they were enrolled in the study. Their serum antibody status was measured at the beginning of the study and 4 years later. We observed a significant decrease in diphtheria antitoxin levels and a significant increase in antibody titer to the capsular polysaccharide of Streptococcus pneumoniae. No change in antibody titer to rotavirus, respiratory syncytial virus, lipopolysaccharide of Escherichia coli, C polysaccharide of S. pneumoniae, or the polyribosyl-ribitol phosphate of Haemophilus influenzae was observed. Thus, no signs of B-cell immunosenescence were seen in these two groups of elderly Swiss people.

Nutritional status: haematology and albumin. Euronut SENECA investigators.

In the context of the Euronut SENECA study of nutrition and the elderly, performed in 19 towns situated in 12 European countries, blood haemoglobin and haematocrit, and serum albumin were measured in a large sample of 70-75-year-old subjects. The mean haemoglobin (Hb) values for the different towns ranged from 144 g l-1 to 157 g l-1 for men and from 131 g l-1 to 150 g l-1 for women. The town haematocrit (Hct) means ranged from 43.0% to 48.9% for men and from 39.7% to 46.4% for women. No clear geographical pattern emerged for either Hb or Hct. The 95% ranges (2.5-97.5 percentile intervals) for Hb and Hct for all towns combined (without any claim of being representative of Europe) were very similar to those reported in the NHANES II study of the USA. Prevalences of anaemia, using the WHO definition (Hb less than 130 g l-1 for men and Hb less than 120 g l-1 for women) were 5.2% for men and 5.7% for women. The town mean serum albumins ranged from 40.3 g l-1 to 44.3 g l-1 for men and from 40.3 g l-1 to 43.2 g l-1 for women. No clear geographical pattern emerged. Mean values were somewhat lower than for younger adults and comparable to other published data. Most albumin values were in the normal range, with only 2.0% of both men and women having levels below 35 g l-1 and only 0.4% of men and no women having levels below 30 g l-1. These results show that these 70-75-year-old subjects who chose to participate in the study were in relatively good health as judged from their haemoglobin, haematocrit and serum albumin levels.