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Ricardo Uauy - One of the best experts on this subject based on the ideXlab platform.
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effect of a Nutrition Supplement and physical activity program on pneumonia and walking capacity in chilean older people a factorial cluster randomized trial
PLOS Medicine, 2011Co-Authors: Alan D Dangour, Cecilia Albala, Elizabeth Allen, Emily Grundy, Damian Walker, Cristian Aedo, Hugo Sanchez, Olivia Fletcher, Diana Elbourne, Ricardo UauyAbstract:Background: Ageing is associated with increased risk of poor health and functional decline. Uncertainties about the healthrelated benefits of Nutrition and physical activity for older people have precluded their widespread implementation. We investigated the effectiveness and cost-effectiveness of a national Nutritional Supplementation program and/or a physical activity intervention among older people in Chile. Methods and Findings: We conducted a cluster randomized factorial trial among low to middle socioeconomic status adults aged 65–67.9 years living in Santiago, Chile. We randomized 28 clusters (health centers) into the study and recruited 2,799 individuals in 2005 (,100 per cluster). The interventions were a daily micronutrient-rich Nutritional Supplement, or two 1-hour physical activity classes per week, or both interventions, or neither, for 24 months. The primary outcomes, assessed blind to allocation, were incidence of pneumonia over 24 months, and physical function assessed by walking capacity 24 months after enrolment. Adherence was good for the Nutritional Supplement (,75%), and moderate for the physical activity intervention (,43%). Over 24 months the incidence rate of pneumonia did not differ between intervention and control clusters (32.5 versus 32.6 per 1,000 person years respectively; risk ratio = 1.00; 95% confidence interval 0.61–1.63; p = 0.99). In intention-to-treat analysis, after 24 months there was a significant difference in walking capacity between the intervention and control clusters (mean difference 33.8 meters; 95% confidence interval 13.9–53.8; p = 0.001). The overall cost of the physical activity intervention over 24 months was US$164/participant; equivalent to US$4.84/extra meter walked. The number of falls and fractures was balanced across physical activity intervention arms and no serious adverse events were reported for either intervention. Conclusions: Chile’s Nutritional Supplementation program for older people is not effective in reducing the incidence of pneumonia. This trial suggests that the provision of locally accessible physical activity classes in a transition economy population can be a cost-effective means of enhancing physical function in later life. Trial registration: Current Controlled Trials ISRCTN 48153354 Please see later in the article for the Editors’ Summary.
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a factorial design cluster randomised controlled trial investigating the cost effectiveness of a Nutrition Supplement and an exercise programme on pneumonia incidence walking capacity and body mass index in older people living in santiago chile the cenex study protocol
Nutrition Journal, 2007Co-Authors: Alan D Dangour, Cecilia Albala, Emily Grundy, Damian Walker, Cristian Aedo, Diana Elbourne, Ricardo UauyAbstract:Chile is currently undergoing a period of rapid demographic transition which has led to an increase in the proportion of older people in the population; the proportion aged 60 years and over, for example, increased from 8% of the population in 1980 to 12% in 2005. In an effort to promote healthy ageing and preserve function, the government of Chile has formulated a package of actions into the Programme of Complementary Feeding for the Older Population (PACAM) which has been providing a Nutritional Supplement to older people since 1998. PACAM distributes micronutrient fortified foods to individuals aged 70 years and over registered at Primary Health Centres and enrolled in the programme. The recommended serving size (50 g/day) of these Supplements provides 50% of daily micronutrient requirements and 20% of daily energy requirements of older people. No information is currently available on the cost-effectiveness of the Supplementation programme. The aim of the CENEX cluster randomised controlled trial is to evaluate the cost-effectiveness of an ongoing Nutrition Supplementation programme, and a specially designed physical exercise intervention for older people of low to medium socio-economic status living in Santiago, Chile. The study has been conceptualised as a public health programme effectiveness study and has been designed as a 24-month factorial cluster-randomised controlled trial conducted among 2800 individuals aged 65.0–67.9 years at baseline attending 28 health centres in Santiago. The main outcomes are incidence of pneumonia, walking capacity and change in body mass index over 24 months of intervention. Costing data (user and provider), collected at all levels, will enable the determination of the cost-effectiveness of the two interventions individually and in combination. The study is supported by the Ministry of Health in Chile, which is keen to expand and improve its national programme of Nutrition for older people based on sound science-base and evidence for cost-effectiveness. ISRCTN48153354
Alfonso Jimenez - One of the best experts on this subject based on the ideXlab platform.
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creatine Supplementation with specific view to exercise sports performance an update
Journal of The International Society of Sports Nutrition, 2012Co-Authors: R G Cooper, Fernando Naclerio, Judith Allgrove, Alfonso JimenezAbstract:Creatine is one of the most popular and widely researched natural Supplements. The majority of studies have focused on the effects of creatine monohydrate on performance and health; however, many other forms of creatine exist and are commercially available in the sports Nutrition/Supplement market. Regardless of the form, Supplementation with creatine has regularly shown to increase strength, fat free mass, and muscle morphology with concurrent heavy resistance training more than resistance training alone. Creatine may be of benefit in other modes of exercise such as high-intensity sprints or endurance training. However, it appears that the effects of creatine diminish as the length of time spent exercising increases. Even though not all individuals respond similarly to creatine Supplementation, it is generally accepted that its Supplementation increases creatine storage and promotes a faster regeneration of adenosine triphosphate between high intensity exercises. These improved outcomes will increase performance and promote greater training adaptations. More recent research suggests that creatine Supplementation in amounts of 0.1 g/kg of body weight combined with resistance training improves training adaptations at a cellular and sub-cellular level. Finally, although presently ingesting creatine as an oral Supplement is considered safe and ethical, the perception of safety cannot be guaranteed, especially when administered for long period of time to different populations (athletes, sedentary, patient, active, young or elderly).
Brett R Loman - One of the best experts on this subject based on the ideXlab platform.
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specialized high protein oral Nutrition Supplement improves home nutrient intake of malnourished older adults without decreasing usual food intake
Journal of Parenteral and Enteral Nutrition, 2019Co-Authors: Brett R Loman, Menghua Luo, G E Baggs, Diane C Mitchell, Jeffrey L Nelson, Thomas R Ziegler, Nicolaas E P Deutz, Laura E MatareseAbstract:Background Reduced nutrient intake is common in patients after hospitalization, contributing to increased risk for readmission and mortality. Oral Nutrition Supplements can improve Nutrition status and clinical outcomes, but intake of food is prioritized by clinicians. This study examines the impact of a high-protein oral Nutrition Supplement (S-ONS) on nutrient intake post discharge. Methods In a subset of patients (14 S-ONS and 16 placebo) from the NOURISH (Nutrition effect On Unplanned ReadmIssions and Survival in Hospitalized patients) trial, 24-hour dietary recalls were conducted on 3 randomly selected days during the weeks of 30, 60, and 90 days post discharge. Nutrient intake was estimated using Nutrition Data System for Research software. Adequate energy and protein intake were defined as 30 kcal/kg/d and 1.2 g/kg/d, respectively. Dietary Reference Intakes (DRIs) were used for other nutrients. Results Less than half of patients met the requirements for energy, protein, and 12 micronutrients from food intake alone during the study. Energy and protein intakes from food were not diminished relative to placebo. Considering nutrient intake from both food and S-ONS, 50% and 71% of patients receiving S-ONSs met energy and protein goals respectively at 90 days (compared with 29% and 36%, in the placebo group), and 100% met the DRI for total carbohydrate, iron, phosphorus, copper, selenium, thiamin, and riboflavin at all time points, all of which were consumed at higher amounts vs placebo. Conclusion Three months of S-ONS consumption increases intake of numerous nutrients without decreasing nutrient intake from food in older malnourished adults post discharge.
Alan D Dangour - One of the best experts on this subject based on the ideXlab platform.
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effect of a Nutrition Supplement and physical activity program on pneumonia and walking capacity in chilean older people a factorial cluster randomized trial
PLOS Medicine, 2011Co-Authors: Alan D Dangour, Cecilia Albala, Elizabeth Allen, Emily Grundy, Damian Walker, Cristian Aedo, Hugo Sanchez, Olivia Fletcher, Diana Elbourne, Ricardo UauyAbstract:Background: Ageing is associated with increased risk of poor health and functional decline. Uncertainties about the healthrelated benefits of Nutrition and physical activity for older people have precluded their widespread implementation. We investigated the effectiveness and cost-effectiveness of a national Nutritional Supplementation program and/or a physical activity intervention among older people in Chile. Methods and Findings: We conducted a cluster randomized factorial trial among low to middle socioeconomic status adults aged 65–67.9 years living in Santiago, Chile. We randomized 28 clusters (health centers) into the study and recruited 2,799 individuals in 2005 (,100 per cluster). The interventions were a daily micronutrient-rich Nutritional Supplement, or two 1-hour physical activity classes per week, or both interventions, or neither, for 24 months. The primary outcomes, assessed blind to allocation, were incidence of pneumonia over 24 months, and physical function assessed by walking capacity 24 months after enrolment. Adherence was good for the Nutritional Supplement (,75%), and moderate for the physical activity intervention (,43%). Over 24 months the incidence rate of pneumonia did not differ between intervention and control clusters (32.5 versus 32.6 per 1,000 person years respectively; risk ratio = 1.00; 95% confidence interval 0.61–1.63; p = 0.99). In intention-to-treat analysis, after 24 months there was a significant difference in walking capacity between the intervention and control clusters (mean difference 33.8 meters; 95% confidence interval 13.9–53.8; p = 0.001). The overall cost of the physical activity intervention over 24 months was US$164/participant; equivalent to US$4.84/extra meter walked. The number of falls and fractures was balanced across physical activity intervention arms and no serious adverse events were reported for either intervention. Conclusions: Chile’s Nutritional Supplementation program for older people is not effective in reducing the incidence of pneumonia. This trial suggests that the provision of locally accessible physical activity classes in a transition economy population can be a cost-effective means of enhancing physical function in later life. Trial registration: Current Controlled Trials ISRCTN 48153354 Please see later in the article for the Editors’ Summary.
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a factorial design cluster randomised controlled trial investigating the cost effectiveness of a Nutrition Supplement and an exercise programme on pneumonia incidence walking capacity and body mass index in older people living in santiago chile the cenex study protocol
Nutrition Journal, 2007Co-Authors: Alan D Dangour, Cecilia Albala, Emily Grundy, Damian Walker, Cristian Aedo, Diana Elbourne, Ricardo UauyAbstract:Chile is currently undergoing a period of rapid demographic transition which has led to an increase in the proportion of older people in the population; the proportion aged 60 years and over, for example, increased from 8% of the population in 1980 to 12% in 2005. In an effort to promote healthy ageing and preserve function, the government of Chile has formulated a package of actions into the Programme of Complementary Feeding for the Older Population (PACAM) which has been providing a Nutritional Supplement to older people since 1998. PACAM distributes micronutrient fortified foods to individuals aged 70 years and over registered at Primary Health Centres and enrolled in the programme. The recommended serving size (50 g/day) of these Supplements provides 50% of daily micronutrient requirements and 20% of daily energy requirements of older people. No information is currently available on the cost-effectiveness of the Supplementation programme. The aim of the CENEX cluster randomised controlled trial is to evaluate the cost-effectiveness of an ongoing Nutrition Supplementation programme, and a specially designed physical exercise intervention for older people of low to medium socio-economic status living in Santiago, Chile. The study has been conceptualised as a public health programme effectiveness study and has been designed as a 24-month factorial cluster-randomised controlled trial conducted among 2800 individuals aged 65.0–67.9 years at baseline attending 28 health centres in Santiago. The main outcomes are incidence of pneumonia, walking capacity and change in body mass index over 24 months of intervention. Costing data (user and provider), collected at all levels, will enable the determination of the cost-effectiveness of the two interventions individually and in combination. The study is supported by the Ministry of Health in Chile, which is keen to expand and improve its national programme of Nutrition for older people based on sound science-base and evidence for cost-effectiveness. ISRCTN48153354
Tsan Hon Liou - One of the best experts on this subject based on the ideXlab platform.
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effects of protein Supplementation combined with resistance exercise on body composition and physical function in older adults a systematic review and meta analysis
The American Journal of Clinical Nutrition, 2017Co-Authors: Chun De Liao, Jauyih Tsauo, Yentzu Wu, Chin Pao Cheng, Hui Chuen Chen, Yi Ching Huang, Hung Chou Chen, Tsan Hon LiouAbstract:: Background: Overweight and obese older people face a high risk of muscle loss and impaired physical function, which may contribute to sarcopenic obesity. Resistance exercise training (RET) has a beneficial effect on muscle protein synthesis and can be augmented by protein Supplementation (PS). However, whether body weight affects the augmentation of muscular and functional performance in response to PS in older people undergoing RET remains unclear.Objective: This study was conducted to identify the effects of PS on the body composition and physical function of older people undergoing RET.Design: We performed a comprehensive search of online databases to identify randomized controlled trials (RCTs) reporting the efficacy of PS for lean mass gain, strength gain, and physical mobility improvements in older people undergoing RET.Results: We included 17 RCTs; the overall mean ± SD age and body mass index (BMI; in kg/m2) in these RCTs were 73.4 ± 8.1 y and 29.7 ± 5.5, respectively. The participants had substantially greater lean mass and leg strength gains when PS and RET were used than with RET alone, with the standard mean differences (SMDs) being 0.58 (95% CI: 0.32, 0.84) and 0.69 (95% CI: 0.39, 0.98), respectively. The subgroup of studies with a mean BMI ≥30 exhibited substantially greater lean mass (SMD: 0.53; 95% CI: 0.19, 0.87) and leg strength (SMD: 0.88; 95% CI: 0.42, 1.34) gains in response to PS. The subgroup of studies with a mean BMI <30 also exhibited relevant gains in response to PS.Conclusions: Compared with RET alone, PS combined with RET may have a stronger effect in preventing aging-related muscle mass attenuation and leg strength loss in older people, which was found in studies with a mean BMI ≥30 and in studies with a mean BMI <30. Clinicians could use Nutrition Supplement and exercise strategies, especially PS plus RET, to effectively improve the physical activity and health status of all older patients.
