Effects of nutritional intervention and physical training on energy intake, resting metabolic rate and body composition in frail elderly. A randomised, controlled pilot study

• Published in: The Journal of nutrition, health & aging health & aging, 2012, Vol.16 (2), p.162-167
• Main Authors: Lammes, E., Rydwik, E., Akner, Gunnar
• Format: Article
• Language: English
• Subjects: Activities of daily living; Aged; Aged, 80 and over; Aging; Basal Metabolism - physiology; Biological and medical sciences; body composition; Body Composition - physiology; Calorimetry, Indirect; Energy intake; Energy Intake - physiology; Exercise - physiology; Feeding. Feeding behavior; Female; Follow-Up Studies; Frail Elderly; Frailty; Fundamental and applied biological sciences. Psychology; Geriatrics; Geriatrics/Gerontology; Geriatrik; Humans; Male; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Neurosciences; Nutrition; Nutritional Intervention and Physical Training of the Frail Elderly; Nutritional Sciences - education; Older people; physical training; Pilot Projects; Primary Care Medicine; Quality of Life Research; resting metabolic rate; Treatment Outcome; Vertebrates: anatomy and physiology, studies on body, several organs or systems
• ISSN: 1279-7707; 1760-4788; 1760-4788
• DOI: 10.1007/s12603-011-0157-7

Objectives To analyse the effect of nutritional intervention and physical training on energy intake, resting metabolic rate (RMR) and body composition in the frail elderly. Design Open, randomised, controlled pilot treatment study. Setting Community-based research centre. Participants Ninety-six community-dwelling frail elderly people aged 75 and older, 40% men. Intervention Four treatment arms: i) individual nutritional advice and group sessions on nutrition for the elderly, ii) physical training 2 × 45 minutes per week for 3 months, iii) combined nutritional and physical intervention and iv) control group. Measurements The outcomes were energy intake (4-day food diary); resting metabolic rate (indirect calorimetry) and body composition (anthropometry) performed at baseline, after 3 months’ intervention (completed by 79 individuals), and as a follow-up at 9 months (completed by 64 individuals). Results The training group showed a significantly increased RMR at 3 months. Otherwise, there were no observed differences within or between the four groups. There was no correlation over time between energy intake, RMR and fat free mass. The participants with a low energy intake who managed to increase their energy intake during the study (‘responders’) had a statistically significantly lower BMI (21 vs. 24) and a lower fat percentage (23 vs. 30) at baseline than the ‘non-responders.’ The ‘non-responders’ showed a small but statistically significant decrease in body fat percentage at F1, and in body weight, BMI and FFM at 9 months (F3). Conclusion Individual nutrition counselling and physical exercise had no effect on energy intake, RMR or fat free mass in community-dwelling frail elderly people aged 75 and older. Interventions in frail elderly people should be targeted according to the needs of the individual patients. The issues of randomisation, targeting and responders in are problematised and discussed.