In non-malnourished older adults with and without sarcopenia, we observed that sarcopenia substantially impacted self-reported quality of life and physical activity levels. Differences in nutrient concentrations and dietary intakes were identified, which might be related to the differences in muscle mass, strength and function between the two groups. This study provides information to help strengthen the characterization of this geriatric syndrome sarcopenia and indicates potential target areas for nutritional interventions.
Micronutrient deficiencies and low dietary intakes among community-dwelling older adults are associated with functional decline, frailty and difficulties with independent living. As such, studies that seek to understand the types and magnitude of potential dietary inadequacies might be beneficial for guiding future interventions. We carried out a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Observational cohort and longitudinal studies presenting the habitual dietary intakes of older adults ( ≥ 65 years) were included. Sex-specific mean (and standard deviation) habitual micronutrient intakes were extracted from each article to calculate the percentage of older people who were at risk for inadequate micronutrient intakes using the estimated average requirement (EAR) cut-point method. The percentage at risk for inadequate micronutrient intakes from habitual dietary intakes was calculated for twenty micronutrients. A total of thirty-seven articles were included in the pooled systematic analysis. Of the twenty nutrients analysed, six were considered a possible public health concern: vitamin D, thiamin, riboflavin, Ca, Mg and Se. The extent to which these apparent inadequacies are relevant depends on dynamic factors, including absorption and utilisation, vitamin and mineral supplement use, dietary assessment methods and the selection of the reference value. In light of these considerations, the present review provides insight into the type and magnitude of vitamin and mineral inadequacies.
Background: Micronutrient supplementation has been shown to reduce the progression of HIV but does not have an effect on the intestinal barrier or the intestinal microbiota of HIV patients. Studies have suggested that probiotics could potentially complement micronutrients in preserving the immune-function of HIV patients. Objective: Assess the impact of micronutrient supplemented probiotic yogurt on the immune function of HIV patients. Design:We performed a randomized, double blind, controlled trial with CD4 count as primary outcome among HIV patients naïve to anti-retroviral treatment. Secondary outcomes included hematological parameters, incidence of diarrhea and clinical symptoms. A total of 112 HIV patients were randomized to receive a micronutrient fortified yogurt with (n = 55) or without additional probiotic Lactobacillus rhamnosus GR-1 (n = 57) for four weeks. Results:An average decline in CD4 count of −70 cells/μL (95% CI: −154 to −15) was observed in the micronutrient, probiotic group versus a decrease of −63 cells/μL (95% CI: −157 to −30) in the micronutrient control group (p = 0.9). Additional probiotic supplementation was well tolerated and not associated with adverse events. No difference between groups was detected in incidence of diarrhea or clinical symptoms. An improvement of hemoglobin levels was observed for all subjects, based upon a mean difference from baseline of 1.4 g/L (SD = 6) (p = 0.02). Conclusion:The addition of probiotics to a micronutrient fortified yogurt was well tolerated by HIV patients but was not associated with a further increase in CD4 count after one month.
The Human Immunodeficiency Virus has devastating effects worldwide. The burden is less pronounced, but still present in Canada where approximately 64,000 men and women are HIV positive. The virus and the life-saving antiretroviral therapies often contribute to diarrhea and other gastrointestinal disturbances. Certain probiotic organisms, such as Lactobacillus rhamnosus GR-1, have been shown to alleviate diarrhea as well as delay the decline of CD4 lymphocytes in some subjects. In addition, micronutrient formulae have been used extensively among HIV positive persons as a cost-effective method for improving quality of life and immune function. The objective of the present study was to combine probiotics and micronutrients into an affordable and highly palatable nutritional supplement and assess outcomes in 21 HIV-positive participants receiving highly active antiretroviral therapy in London, Ontario, Canada. The design was a randomized, double blind, three-period, cross-over controlled trial with three different formulations of supplemented yogurt; micronutrient and probiotic (A), micronutrient alone (B) and probiotic alone (C). The period of intake for each of the types was 30 days with a 14 day wash-out period between the intervention types. The mean increase in CD4 was greatest with B (41 cells/µL, SD 221). Supplement A showed a mean change of +19 cells/µL (SD 142) and supplement C a mean change of - 7 cells/µL (SD 154). All yogurt types caused an increase in subjective energy and ability to perform daily activity scores. According to the safety measures taken to assess the tolerance of the yogurt, there were no adverse events and the yogurt was well-tolerated. These preliminary findings suggest that micronutrient supplemented probiotic yogurt may support immune function among people living with HIV.
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