Knowledge and attitudes towards baby-led-weaning by health professionals and parents: A cross-sectional study.

OBJECTIVE: Baby-led-weaning (BLW) is a novel model of complementary feeding. Although there is little scientific evidence to support the suitability or superiority of this complementary feeding model, BLW is followed by many families today. The aim was to evaluate the knowledge and attitudes of a group of parents and health professionals regarding BLW in Spain. METHODS: This research was designed as a cross-sectional study in a sample of 502 parents and 364 health professionals. Two questionnaires generated and disseminated through Google forms were used. The differences between groups of professionals were analyzed using the Chi-Square test. RESULTS: 92.3% of professionals and 93.4% of parents knew about BLW. They recommend BLW "always" in 39.8% and 69.3% of the cases, and "sometimes" in 49.7% and 24.9%, respectively. Of the health professionals, 80.5% recommended starting complementary feeding as of six months, 36% of them using BLW, 24% followed traditional weaning, 3.3% bottle feeding and the remaining 36% did not indicate. Eighty-three percent recommended chewing as soon as the child showed interest. CONCLUSION: Both health professionals and parents recommend BLW and consider it helps promote the developmental milestones of the baby. Providing nurses with an adequate number of resources to guide parents on complementary feeding will continue to improve childcare.

Bioavailability of magnesium food supplements: A systematic review.

OBJECTIVES: The market for food supplements is booming thanks to their increased consumption. European regulations include different ways in which vitamins and minerals are administered, without making it clear to the consumer whether one formulation has advantages over the other. The aim of this review was to compare the bioavailability of different forms of magnesium and analyze the differences between them. METHODS: Based on a PICO (population, intervention, comparison, outcome) research question, a search strategy was established for magnesium bioavailability studies comparing different forms in the PubMed, Cochrane, Web of Science, and Scopus databases. We found 433 studies, out of which 14 were finally selected. RESULTS: Inorganic formulations appear to be less bioavailable than organic ones, and the percentage of absorption is dose dependent. CONCLUSIONS: All magnesium dietary supplements can maintain physiological levels in healthy people without prior deficit, although this cannot be assured in older people or those with illnesses or previous subphysiological levels.

Knowledge and attitudes towards baby-led-weaning by health professionals and parents: A cross-sectional study.

OBJECTIVE: Baby-led-weaning (BLW) is a novel model of complementary feeding. Although there is little scientific evidence to support the suitability or superiority of this complementary feeding model, BLW is followed by many families today. The aim was to evaluate the knowledge and attitudes of a group of parents and health professionals regarding BLW in Spain. METHODS: This research was designed as a cross-sectional study in a sample of 502 parents and 364 health professionals. Two questionnaires generated and disseminated through Google forms were used. The differences between groups of professionals were analyzed using the Chi-Square test. RESULTS: 92.3% of professionals and 93.4% of parents knew about BLW. They recommend BLW "always" in 39.8% and 69.3% of the cases, and "sometimes" in 49.7% and 24.9%, respectively. Of the health professionals, 80.5% recommended starting complementary feeding as of six months, 36% of them using BLW, 24% followed traditional weaning, 3.3% bottle feeding and the remaining 36% did not indicate. Eighty-three percent recommended chewing as soon as the child showed interest. CONCLUSION: Both health professionals and parents recommend BLW and consider it helps promote the developmental milestones of the baby. Providing nurses with an adequate number of resources to guide parents on complementary feeding will continue to improve childcare.

Effectiveness of an intermittent fasting diet versus continuous energy restriction on anthropometric measurements, body composition and lipid profile in overweight and obese adults: a meta-analysis.

The effects of an intermittent fasting (IF) diet in the overweight or obese adult population are still controversial. This study aimed to evaluate the effectiveness of an IF diet to reduce anthropometric parameters (body mass index, body weight, and waist circumference), change body composition (fat mass, lean body mass and muscle mass) and lipid profile (total cholesterol, HDL-c, LDL-c and triglycerides), and to adhere to the diet in comparison to continuous energy restriction (CER) in overweight or obese adults. A research question PICO (patients, intervention, comparison, outcome) was established. PubMed, Scopus, Web of Science, Cochrane, and Scielo databases were searched to identify randomized clinical trials that compared an IF diet with a CER diet or a regular diet. DeCS and MeSH descriptors and Boolean operators (AND and OR) were used. From 859 studies identified through the literature search, 18 articles were finally selected. Overall, IF diets were associated with higher weight loss in four studies and similar reduction in waist circumference in one study, compared with a CER regimen. Fat mass tended to decrease more in the IF groups in five studies. However, the lean and muscle mass loss was similar in both groups. Only three studies observed significant differences in lipid profile variables, mostly in the IF groups. Adherence to the diet was inconclusive. An IF diet may provide a benefit by improving anthropometry, body composition, and lipid profile in overweight or obese adult population, likewise a CER diet.

Bioelectrical impedance vector reference values for assessing body composition in a Spanish child and adolescent population.

OBJECTIVES: Reference values of the bioelectrical impedance vector for the Spanish child and adolescent population are needed for assessing body composition and hydration status in this population. The aim of this study is to provide reference values of the bioelectrical impedance vector in Spanish children and adolescents aged 4-18 years from Castilla y León. METHODS: This was a cross-sectional descriptive study conducted in 4401 Spanish healthy children and adolescents aged 4-18 years (2265 boys and 2136 girls). Resistance and reactance were measured with a single-frequency impedance analyzer at 50 kHz (tetrapolar analysis). The values of resistance and reactance normalized by height were used to plot the bivariate 50th, 75th, and 95th percentiles of the population by age group. Mean impedance vectors were compared with Hotelling's T2 test for vector analysis (differences being considered significant if p < .05). RESULTS: Tolerance ellipses were drawn for the Spanish child and adolescent population studied. The mean impedance vector showed displacement across all age groups except for (1) girls aged 12-13 years, (2) girls aged 15-18 years, and (3) boys aged 16-18 years. There were sex-related differences in the mean impedance vector in all age ranges, even in prepubertal children. Among adolescents, the patterns of the vector displacement were consistent with the timing of normal growth and development in all groups and are attributable to the maturation process. CONCLUSIONS: New tolerance ellipses have been constructed for Spanish children and adolescents by sex and age. These ellipses reflect the timing of normal childhood growth and development.

Ingesta dietética y adherencia a la dieta mediterránea en un grupo de estudiantes universitarios en función de la práctica deportiva.

Introducción: la alimentación de los jóvenes universitarios se aleja cada vez más de la dieta mediterránea (DM). El binomio alimentación-actividad física es fundamental para mantener un adecuado estado de salud.Objetivo: comparar la ingesta en un grupo de estudiantes universitarios deportistas frente a otro que no realiza deporte habitualmente.Sujetos y métodos:estudio observacional transversal realizado en 49 voluntarios de la Universidad de Valladolid. Se determinaron peso, talla y actividad física (cuestionario GPAQ). La ingesta se evaluó a partir de un cuestionario de frecuencia de consumo y un registro de alimentos de 3 días. La adherencia a la DM se estimó con el Mediterranean Diet Score. Las diferencias entre las variables en función del sexo y la práctica deportiva se analizaron con la t de Student o la U-Mann-Whitney. Significación estadística: p < 0,05.Resultados: todos los sujetos presentaron normopeso, sin diferencias en función de la práctica deportiva. El nivel de actividad física fue inferior en las mujeres. En todos los estudiantes la dieta fue ligeramente hiperproteica, rica en grasas y colesterol, con un inadecuado perfil lipídico y deficiente en hidratos de carbono y fibra. Se cubren los requerimientos de micronutrientes. Destaca un escaso consumo de frutas-verdurashortalizas, cereales, aceite de oliva, pescado y frutos secos; y un exceso de carne, mantequilla, bollería-industrial, dulces, snacksy refrescos. El 50% de la muestra tiene una adherencia baja o muy baja a la DM.Conclusión: las dietas de los jóvenes universitarios no cumplen los objetivos nutricionales para la población española y presentan una adherencia media-baja a la DM, independientemente de la práctica deportiva.

Ingesta dietética y adherencia a la dieta mediterránea en un grupo de estudiantes universitarios en función de la práctica deportiva / Dietary intake and adherence to the Mediterranean diet in a group of university students depending on the sports practice

Introducción: la alimentación de los jóvenes universitarios se aleja cada vez más de la dieta mediterránea (DM). El binomio alimentación-actividad física es fundamental para mantener un adecuado estado de salud. Objetivo: comparar la ingesta en un grupo de estudiantes universitarios deportistas frente a otro que no realiza deporte habitualmente. Sujetos y métodos: estudio observacional transversal realizado en 49 voluntarios de la Universidad de Valladolid. Se determinaron peso, talla y actividad física (cuestionario GPAQ). La ingesta se evaluó a partir de un cuestionario de frecuencia de consumo y un registro de alimentos de 3 días. La adherencia a la DM se estimó con el Mediterranean Diet Score. Las diferencias entre las variables en función del sexo y la práctica deportiva se analizaron con la t de Student o la U-Mann-Whitney. Significación estadística: p < 0,05. Resultados: todos los sujetos presentaron normopeso, sin diferencias en función de la práctica deportiva. El nivel de actividad física fue inferior en las mujeres. En todos los estudiantes la dieta fue ligeramente hiperproteica, rica en grasas y colesterol, con un inadecuado perfil lipídico y deficiente en hidratos de carbono y fibra. Se cubren los requerimientos de micronutrientes. Destaca un escaso consumo de frutas-verdurashortalizas, cereales, aceite de oliva, pescado y frutos secos; y un exceso de carne, mantequilla, bollería-industrial, dulces, snacks y refrescos. El 50% de la muestra tiene una adherencia baja o muy baja a la DM. Conclusión: las dietas de los jóvenes universitarios no cumplen los objetivos nutricionales para la población española y presentan una adherencia media-baja a la DM, independientemente de la práctica deportiva (AU)

Introduction: University students eating habits are moving away increasingly from the Mediterranean Diet (MD) Both nutrition and physical activity are essential to preserve an appropriate health. Objective: To compare food intake between athletes and sedentary University students. Subjects and methods: Cross-sectional study conducted on 49 students from the University of Valladolid. The weight and height were determined. The physical activity was evaluated by the GPAQ questionnaire. A food frequency questionnaire and a three-day food record were completed for the food intake analysis. The MD adherence was estimated by the Mediterranean Diet Score (MDS). Differences by sex and sport practice were analyzed with the T-test or with the Mann-Whitney-test. Statistical significance was reached at p < 0.05. Results: All subjects had normal weight with no significant differences depending on the sports practice. Women had a lower physical activity level than men. The diet in the whole sample was slightly hyperproteic, rich in fats and cholesterol, with an inadequate fat profile and poor in carbohydrates and fiber. Generally, the students covered the micronutrients requirements. There was a scarce consumption of fruits and vegetables, cereals, olive oil, fish and nuts; and an excessive intake of meat, butter, processed bakery foods, sweets, snacks and soft drinks. Around 50% of the sample had a low or very low MD adherence. Conclusion: The University student food pattern does not accomplish the nutritional objectives within the Spanish population and have a medium-low Mediterranean diet adherence, and there are no differences depending on the sports practice (AU)

[Chromium supplementation in patients with type 2 diabetes and high risk of type 2 diabetes: a meta-analysis of randomized controlled trials].

INTRODUCTION: Chromium is an essential trace mineral for carbohydrate and lipid metabolism, which is currently prescribed to control diabetes mellitus. Results of previous systematic reviews and meta-analyses of chromium supplementation and metabolic profiles in diabetes have been inconsistent. AIM: The objective of this meta-analysis was to assess the effects on metabolic profiles and safety of chromium supplementation in type 2 diabetes mellitus and cholesterol. METHODS: Literature searches in PubMed, Scopus and Web of Science were made by use of related terms-keywords and randomized clinical trials during the period of 2000-2014. RESULTS: Thirteen trials fulfilled the inclusion criteria and were included in this systematic review. Total doses of Cr supplementation and brewer's yeast ranged from 42 to 1,000 µg/day, and duration of supplementation ranged from 30 to 120 days. The analysis indicated that there was a significant effect of chromium supplementation in diabetics on fasting plasma glucose with a weighted average effect size of -29.26 mg/dL, p = 0.01, CI 95% = -52.4 to -6.09; and on total cholesterol with a weighted average effect size of -6.7 mg/dL, p = 0.01, CI 95% = -11.88 to -1.53. CONCLUSIONS: The available evidence suggests favourable effects of chromium supplementation on glycaemic control in patients with diabetes.

Valoración del estado nutricional en Geriatría: declaración de consenso del Grupo de Nutrición de la Sociedad Española de Geriatría y Gerontología / Nutritional status assessment in Geriatrics: Consensus declaration by the Spanish Society of Geriatrics and Gerontology Nutrition Work Group

El progresivo envejecimiento de la población es uno de los factores que influyen en el aumento de la prevalencia de desnutrición, ya que los ancianos son un colectivo de riesgo por sus características biológicas, psicológicas y sociales. A pesar de su alta prevalencia, la desnutrición está infradiagnosticada en geriatría. Por este motivo, el objetivo del presente documento de consenso es elaborar un protocolo de valoración nutricional geriátrica. En el marco de la SEGG se ha creado un equipo multidisciplinar con el objetivo de darle la debida importancia a la desnutrición y el riesgo de la misma para que sean diagnosticadas y tratadas de forma adecuada. Entre los muchos métodos validados para el cribado nutricional, el MNA-SF representa una herramienta práctica. Tras evidenciar la sospecha o la presencia de desnutrición la valoración completa prevé la realización de una historia nutricional exhaustiva. Las historias clínico-nutricional y dietética pretenden evidenciar los posibles factores de riesgo sobre la base del cuadro de desnutrición. Entonces la valoración antropométrica, asociada a los datos de laboratorio, pretende objetivar las modificaciones físicas y metabólicas asociadas a la desnutrición. Hoy en día cada vez más se tiende a profundizar en la valoración nutricional utilizando técnicas no invasivas de estudio de la composición corporal asociadas al estudio funcional. Esta última representa un índice indirecto del estado nutricional de gran interés para la geriatría. En conclusión, un correcto cribado nutricional es la base fundamental para un temprano diagnóstico de desnutrición y poder valorar la indicación al tratamiento nutricional. Para esto es fundamental fomentar la investigación en el campo de la nutrición geriátrica para aumentar el conocimiento y poder hacer cada vez más una geriatría basada en la evidencia (AU)

Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, as elderly people are a vulnerable group due to their biological, psychological and social characteristics. Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología [SEGG]) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner. The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition, or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories is intended to help in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment, combined with laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is for further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status, which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics (AU)

Chromium supplementation in patients with type 2 diabetes and high risk of type 2 diabetes: a meta-analysis of randomized controlled trials / Suplementación con cromo en pacientes con diabetes tipo 2 y elevado riesgo de diabetes tipo 2: un metaanálisis de ensayos clínicos aleatorizados

Introduction: Chromium is an essential trace mineral for carbohydrate and lipid metabolism, which is currently prescribed to control diabetes mellitus. Results of previous systematic reviews and meta-analyses of chromium supplementation and metabolic profiles in diabetes have been inconsistent. Aim: The objective of this meta-analysis was to assess the effects on metabolic profiles and safety of chromium supplementation in type 2 diabetes mellitus and cholesterol. Methods: Literature searches in PubMed, Scopus and Web of Science were made by use of related terms-keywords and randomized clinical trials during the period of 2000-2014. Results: Thirteen trials fulfilled the inclusion criteria and were included in this systematic review. Total doses of Cr supplementation and brewer’s yeast ranged from 42 to 1,000 µg/day, and duration of supplementation ranged from 30 to 120 days. The analysis indicated that there was a significant effect of chromium supplementation in diabetics on fasting plasma glucose with a weighted average effect size of -29.26 mg/dL, p = 0.01, CI 95% = −52.4 to -6.09; and on total cholesterol with a weighted average effect size of -6.7 mg/dL, p = 0.01, CI 95% = −11.88 to -1.53. Conclusions: The available evidence suggests favourable effects of chromium supplementation on glycaemic control in patients with diabetes. Chromium supplementation may additionally improve total cholesterol levels (AU)

Introducción: el cromo es un oligoelemento esencial para el metabolismo de carbohidratos y lípidos, que actualmente está prescrito para controlar la diabetes mellitus. Los resultados de las revisiones sistemáticas anteriores y metaanálisis de los suplementos de cromo y de perfiles metabólicos en diabetes han sido inconsistentes. Objetivo: el objetivo de este metaanálisis fue evaluar los efectos sobre los perfiles y la seguridad de la suplementación de cromo en la diabetes mellitus tipo 2 y el colesterol. Métodos: se realizaron búsquedas bibliográficas en PubMed, Scopus y Web of Science mediante el uso de palabras clave relacionadas y ensayos clínicos aleatorios durante el período de 2000-2014. Resultados: trece ensayos cumplieron los criterios de inclusión y se incluyeron en esta revisión sistemática. Las dosis totales de la suplementación con Cr y levadura de cerveza oscilaron desde 42 hasta 1.000 mg/día, y la duración de la suplementación varió de 30 a 120 días. El análisis indicó que hubo un efecto significativo de la suplementación de cromo en los diabéticos en la glucemia en ayunas, con un tamaño del efecto promedio ponderado de -29,26 mg/dl, p = 0,01, IC del 95% = -52,4 a -6,09; y sobre el colesterol total, con un efecto promedio ponderado de -6,7 mg/dl, p = 0,01, IC del 95% = -11,88 a -1,53. Conclusiones: la evidencia disponible sugiere efectos favorables de la administración de suplementos de cromo sobre el control glucémico en pacientes con diabetes. Los complementos de cromo pueden además mejorar los niveles de colesterol total (AU)

[Nutritional status assessment in Geriatrics: Consensus declaration by the Spanish Society of Geriatrics and Gerontology NutritionWork Group]. / Valoración del estado nutricional en Geriatría: declaración de consenso del Grupo de Nutrición de la Sociedad Española de Geriatría y Gerontología.

Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, as elderly people are a vulnerable group due to their biological, psychological and social characteristics. Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología [SEGG]) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner. The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition, or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories is intended to help in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment, combined with laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is for further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status, which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics.

Diseño y aplicación de un cuestionario de calidad dietética de los menús escolares / Design and implementation of a questionnaire to evaluate the dietary quality of school meals

Introducción: El comedor escolar es el centro de comida habitual para muchos niños. Aunque actualmente se dispone de guías y recomendaciones para los menús escolares, resulta difícil evaluar su calidad dietética. Objetivos: Diseñar un cuestionario para evaluar la calidad desde el punto de vista dietético de los menús escolares de forma rápida y sencilla. Material y métodos: Partiendo de las recomendaciones, se ha diseñado un cuestionario (COMES) de 15 ítems que hacen referencia a la frecuencia de consumo de alimentos y otras características de los menús escolares. A continuación se realizó un estudio longitudinal prospectivo en el que se analizaron con este cuestionario 36 planillas de menús de 4 empresas de restauración colectiva que prestaban l servicio de comedor escolar en Castilla y León durante los cursos 2006-2007 a 2010-2011. Se analizaron las diferencias en función del sistema de gestión de las empresas mediante la prueba U de Mann-Whitney y el test de Kruskal- Wallis. La significación se alcanzó con una p<0,05. Resultados: Se observó un incumplimiento de la recomendación de ingesta de derivados cárnicos, lácteos y precocinados por exceso en el 97,2%, 94,4% y 27,8% de los menús analizados, respectivamente; y un incumplimiento por defecto en la ingesta de pescado, fruta, legumbre y guarniciones de verduras y hortalizas en el 83,3%, 94,4%, 91,7% y 75% de los menús, respectivamente, aunque sí cumplían las recomendaciones del consenso de comedores para todos los grupos excepto frutas y lácteos. La variedad de alimentos y de técnicas culinarias fue adecuada. No se encontraron diferencias estadísticamente significativas en la puntuación del COMES en función del tipo de gestión (p=0,87), aunque se observó que el sistema de catering ofrece mayor calidad dietética. Conclusiones: Se ha propuesto una herramienta que permite valorar la calidad dietética de los menús escolares de forma rápida y sencilla. La valoración de la frecuencia de consumo de los alimentos más problemáticos para la edad escolar con esta escala es mucho más exigente que las de las recomendaciones actuales. Aún así, los menús analizados presentaban una calidad aceptable en cuanto a variedad de alimentos y técnicas culinarias, pero una excesiva oferta de lácteos a expensas de un déficit de fruta fresca. Por otra parte, el sistema de gestión transportado (catering caliente y línea fría) ofrece menús más acordes con las recomendaciones dietéticas (AU)

Introduction: The school canteen provides a substantial proportion of the daily nutritional intake for manychildren. There are nutritional standards for school meals, however, it is still difficult to assess the dietary quality. Aims: To design a questionnaire for assessing the dietary quality of school meals, quickly and easily. Methods: A dietary questionnaire (COMES) was designed on the basis of the current recommendations. COMES consist of 15 items related to the foodfrequency and to other characteristics of school meals. Then, a longitudinal prospective study was performed in order to analyze, with COMES, 36 school meals of 4 catering companies from Castilla y León during the academic years 2006-2007 to 2010-2011. Differences in dietary quality menus according to the management system of catering companies (in situ vs. transported) were analyzed by using the Mann-Whitney and the Kruskal-Wallis tests. The significance was reached at p <0,05. Results: The frequency intake of meat, dairy and prepared products was higher to the recommended in 97,2%, 94,4% and 27,8% of the analyzed menus, respectively. By contrast, the frequency intake of fish, fruit, legume, and vegetable garnishes were lower to the recommended in 83,3%, 94,4%, 91,7% and 75% of menus, respectively. Nevertheless, recommendations established by our consensus document for school meals are complied for all food groups, except for dairy and fruits. The variety of foods and culinary techniques were appropriate. No significant differences were found in the COMES score according to the management system (p=0,87), although catering system provides higher dietary quality. Conclusions: A new tool to assess quickly and easily the nutritional quality of school meals has been proposed. The assessment of the frequency intake of the most problematic foods for schoolchildren with this scale is much more demanding than the current recommendations. Even so, menus analyzed showed an acceptable quality in terms of variety of foods and culinary techniques, although milk frequency in the menus was excessive at the expense of fresh fruit. On the other hand, the transported system (i.e. catering, both hot and cold-holding) provides menus more consistent with the dietary recommendations (AU)

Bioimpedance vector analysis and conventional bioimpedance to assess body composition in older adults with dementia.

OBJECTIVE: Although dementia and nutritional status have been shown to be strongly associated, differences in body composition (BC) among older people with dementia have not yet been firmly established. The aim of this study was to assess BC through conventional and vector bioimpedance analysis (BIA and BIVA, respectively) in a sample of institutionalized older men with and without dementia, in order to detect dementia-related BC changes. METHODS: Forty-one institutionalized men ages ≥ 65 y (23 without dementia [CG] and 18 with dementia [DG]) were measured with BIA and interpreted with BIVA and predictive equations. RESULTS: Age (74.4 and 75.7 y) and body mass index (22.5 and 23.6 kg/m(2)) were similar for DG and CG, respectively. Resistance and ratio of resistance to height did not differ significantly between the two groups. Reactance and ratio of reactance to height were 21.2% and 20.4% lower in DG than in CG. Phase angle was significantly lower in DG (mean = 4.0; 95% confidence interval [CI], 3.6°-4.3°) than in CG (mean = 4.7; 95% CI, 4.3°-5.1°). Mean fat mass index (6 and 7 kg/m(2)), and mean fat-free mass index (16.4 and 16.6 kg/m(2)) were similar in both groups. BIVA showed a significant downward migration of the ellipse in DG with respect to CG (T(2) = 15.1; P < 0.01). CONCLUSION: Conventional BIA showed no significant differences in BC between DG and CG, although reactance and ratio of reactance to height were about 21% lower in DG. Nevertheless, a body cell mass depletion and an increase in the ratio of extracellular to intracellular water were identified in DG using BIVA. BIVA reflects dementia-related changes in BC better than BIA.