The purpose of the present study was to evaluate the capacity of the 'Determine Your Nutritional Health' Checklist (NSI Checklist) and the 'Mini Nutritional Assessment' (MNA) methods to predict nutrition-related health problems. Data were from the Danish part of the 'Survey in Europe of Nutrition in the Elderly, a Concerted Action' (SENECA) baseline survey from 1988, and the follow-up study from 1993. Based on the baseline survey thirty-nine (19.3%) of the subjects were classified at high nutritional risk, 103 (51%) were considered at moderate nutritional risk and sixty (29.7%) were within the 'good' range according to the criteria in the NSI Checklist. With the MNA, 171 subjects were classified according to their nutritional risk into a well-nourished group, comprising 78.4%, and a group who were at risk of undernutrition, comprising 21.6% at baseline. A total of 115 subjects participated in the follow-up study. The mortality rate and the prevalence of various morbidity indicators were compared between the different risk groups. The analysis showed that subjects with a high MNA score (> or = 24) had significantly lower mortality (rate ratio estimate: 0.35; 95% Cl 0.18, 0.66) compared with subjects with a low MNA score (
OBJECTIVE: To validate the Nutrition Questionnaire for Elderly (NQE) aimed at health care personnel -and develop and validate a modified version of the questionnaire (MNQE) to improve its sensitivity in detecting elderly people with inadequate intake of specific nutrients and energy. DESIGN: The NQE was used to rank the nutrient intake of participants as 'acceptable' (OK-->) or 'at risk' (OBS-->) with respect to energy, calcium, vitamin C and vitamin D--nutrients with a high risk of deficiency, especially among the homebound or institutionalised elderly. The sensitivity, specificity and predictive capacity were calculated by means of a 4 d estimated record (study 1). Based on the results minor adjustments of the NQE was made, and the already obtained information was used to assess the theoretical validity of the MNQE (study 2). Finally the MNQE was validated in a new population (study 3). SETTING AND SUBJECTS: Ninety-five old people ( > 65 y) living in nursing-homes (Bagsvaerd or Havdrup), or at home in the same home-care district (Valby) or in the same preventive home-visit district (Rødovre) were recruited. Excluded were those who declined to participate or who were in a terminal condition (n = 3). RESULTS: The sensitivity of the NQE regarding the intakes of energy, calcium, vitamin C and vitamin D was quite low (respectively 0.46, 0.08, 0.05 and 0.38) (study 1). However minor adjustments of the NQE increased the sensitivity both in theory (energy: 0.64, calcium: 0.95, vitamin C: 1.00 and vitamin D: 0.84) (study 2) and in practice (energy: 1.00, calcium: 0.40, vitamin C: 0.86 and vitamin D: 0.85) (study 3). Modification of the NQE did not reduce the high specificity and predictive capacity of the original version. CONCLUSIONS: Modifications of the NQE resulted in a questionnaire with a high sensitivity, specificity and predictive capacity for detecting inadequate intake of energy, calcium, vitamin C and vitamin D in elderly people.
Trans fatty acids constitute 0-30% of the fat in Danish margarines, most in industry and bakery margarines and usually less in table margarine. The trans fatty acids make margarines more solid at room temperature and therefore provide an economical storage advantage. In British and U.S. reports from 1984-1989, the trans fatty acids were more or less acquitted of unhealthy effects. During the last 5-6 years, however, a series of new studies has been published regarding both the connection between the consumption of trans fatty acids and the occurrence of coronary heart disease and the impact on the lipoprotein level in plasma. Studies suggest that the consumption of trans fatty acids from margarine is equally, or perhaps more, responsible for the development of arteriosclerosis than saturated fatty acids. In addition, it is now clear that both the fetus and the breast-fed baby are exposed to trans fatty acids in relation to the mother's consumption. A couple of recent studies suggest a possible restrictive influence of the trans fatty acids on the weight of the fetus. The average consumption of trans fatty acids from margarine in Denmark in 1991 was approximately 2.5 g/day per person. For about 150,000 adult Danes, the consumption is assumed to be more than 5 g/day per person. On this basis, the Danish Nutrition Council recommend that the consumption of trans fatty acids is reduced as much as possible. This can be done by reducing the fat content in food and by reducing the trans fatty acid content in all Danish margarine products to 5% or less. Thereafter, the group of adult Danes, including pregnant and breast-feeding women, with a large consumption of margarine and margarine-containing products, will on average only consume 2 g of vegetable trans fatty acids/day. This corresponds to the consumption in the low-risk groups in the above-mentioned epidemiological studies. In addition, the Danish Nutrition Council encourage the producers of margarines to make products that can be marketed as 'free of trans fatty acids'.
OBJECTIVE: To assess the prevalence of old people at risk of undernutrition according to the Mini Nutritional Assessment (MNA), characterise the at risk group with regard to nutritional state, energy intake, and physical and mental functioning, and to assess the consequences of the MNA score over a 6 month period. DESIGN: A cross-sectional prospective study. SETTING: The clinic of a general practitioner. SUBJECTS: Ninety-four patients 65+-y-old with no acute illness contacted at the clinic. Sixty-one subjects (65%) agreed to participate at baseline and 34 (56%) showed up at the follow-up 6 months later. RESULTS: At baseline, 23 (38%) participants were assessed as being at risk of undernutrition (17-23.5 MNA points). The remaining were classified as well-nourished (>23.5 MNA points). The 23 participants at risk had a higher prevalence of body mass index (BMI)
OBJECTIVE: To determine the vitamin D status (serum 25-hydroxyvitamin D; S-25OHD) in adolescent girls and elderly community-dwelling women living in four countries of northern Europe and to explain differences in S-25OHD concentrations between and within the countries. DESIGN: A cross-sectional observational study conducted in a standardised way during February-March. S-25OHD was analysed by high-performance liquid chromatography. Vitamin D and calcium intake was calculated using a standardised food composition database. SETTING: Denmark, Finland, Ireland, and Poland. SUBJECTS: A total of 199 girls (mean (s.d.) age 12.6 (0.5) y) and 221 women (mean (s.d.) age 71.8 (1.4) y). RESULTS: The median (inter quartiles) concentration of S-25OHD was 29.4 (20.3, 38.3) nmol/l for the girls and 40.7 (28.0, 54.2) nmol/l for the women. S-25OHD below 25 nmol/l was found in 37% of the girls and 17% of the women, and S-25OHD below 50 nmol/l was found in 92% of the girls and 37% of the women. Positive significant determinants for S-25OHD in girls were use of vitamin D supplements, and in women sun habits, dietary vitamin D intake, use of vitamin D and calcium supplements. Body mass index and smoking were negative determinants in women. For women predictors could explain the differences between countries (P(country) = 0.09, R(2) = 0.39), but for girls the difference remained significant even after including predictors (P(country) = 0.03, R(2) = 0.15). CONCLUSION: Vitamin D status is low in northern Europe during winter. More than one-third of the adolescent girls have vitamin D status below 25 nmol/l and almost all are below 50 nmol/l. Two-thirds of the elderly community-dwelling women have vitamin D status below 50 nmol/l. Use of vitamin D supplements is a significant positive determinant for S-25OHD for both girls and women (P = 0.001). SPONSORSHIP: The European Fifth Framework Programme (Contract No. QLK1-CT-2000-00623).