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      Micronutrient intake in elderly living in nursing homes Translated title: Ingesta de micronutrientes en ancianos residentes en instituciones de larga permanencia

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          Abstract

          Abstract Objective: The aim of this study was to evaluate the ingestion of micronutrients in elderly living in nursing homes. Methods: This is a cross-sectional study, conducted with 216 individuals of both sexes, age equal or greater than 60 years, living in nursing homes for elderly in Salvador, Bahia, Brazil. Direct weighing of the food was used to get food intake, and prevalence of inadequacy was obtained using the software Multiple Source Method (MSM) and evaluated by estimated average requirement (EAR). Results: A high prevalence of inadequate intake of micronutrients was observed, being over 90% for vitamins E, folate, pyridoxine and calcium, in both sexes and between 50 and 70% for selenium, retinol, riboflavin, cyanocobalamin and vitamin C. Conclusion: The high prevalence of inadequate intake of micronutrients in elderly living on nursing homes observed in this study may be used for planning public health strategies aiming to improve the nutritional context of this population and their quality of life, reducing the costs of health care.

          Translated abstract

          Resumen Objetivo: el objetivo de este estudio fue evaluar la ingesta de micronutrientes en ancianos residentes en instituciones de larga permanencia. Métodos: se trata de un estudio transversal, realizado con 216 individuos de ambos sexos, con edad igual o superior a 60 años y residentes en instituciones de larga permanencia en la ciudad de Salvador, Bahia, Brasil. Para la evaluación del consumo alimentario se utilizó el pesaje directo del alimento y la comparación con los valores de referencia del requerimiento promedio estimado (RPE). La prevalencia de ingesta inadecuada fue obtenida a través del software Multiple Source Method (MSM). Resultados: se observó una alta prevalencia de ingesta inadecuada de micronutrientes por encima de 90% para las vitaminas E, folato, piridoxina y calcio, en ambos sexos, y entre el 50% y el 70% para selenio, retinol, riboflavina, cianocobalamina y vitamina C. Conclusión: la elevada prevalencia de ingesta inadecuada de micronutrientes en los ancianos residentes en instituciones de larga permanencia observada en este estudio puede ser utilizada para la planificación de estrategias en salud pública, con el objetivo de mejorar la situación nutricional de esta población y su calidad de vida, reduciendo los costes derivados de la asistencia sanitaria.

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          Most cited references40

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          Role of homocysteine in the development of cardiovascular disease

          It is well known that neuronal damage following a stroke has been attributed to the over stimulation of excitatory amino acids such as glutamate and aspartate through activation of NMDA receptors. The brain is exposed to most of the constituents of plasma including homocysteine as a result of the disruption of the blood–brain barrier after stroke, head trauma and stress. The question, therefore, arises as to whether or not homocysteine is able to selectively stimulate the release of excitatory amino acids in stroke. This review article will address the importance of homocysteine in nervous system specifically how these amino acids may trigger the release of catecholamines. Our data will thus strengthen the view that a mechanism for the association of hyperhomocysteinemia with increased brain lesion in stroke. As hypothalamus also controls the cardiac function via sympathetic system, the contractility of heart will be compromised. Homocysteine is also known to mediate cardiovascular problems by its adverse effects on cardiovascular endothelium and smooth muscle cells with resultant alterations in subclinical arterial structure and function. The present review will thus summarize both central and peripheral effects of homocysteine and will highlight some of the controversies associated with hyperhomocysteinemia-induced cardiovascular problems.
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            Use of medications and polypharmacy are increasing among the elderly.

            To assess changes in medicine use and polypharmacy, two cross-sectional surveys were carried out among community-dwelling persons aged 64 years or over in 1990-91 (n = 1,131) and 1998-99 (n = 1,197) in the municipality of Lieto in southwestern Finland. In addition to drug use, the questionnaire included items on social background, quality of life, and home nursing services. Among those surveyed, 78% in 1990-1991 and 88% in 1998-1999 (P =.001) used prescription drugs during 7 days prior to the interview. The most commonly used medications were for the cardiovascular and central nervous systems. The number of medications per person increased from 3.1 (SD 2.8) to 3.8 (SD 3.1) (P =.0001), and polypharmacy (concominant use of over five medications) increased from 19 to 25% (P =.006). These changes were most prominent among persons aged 85 years or over, especially among women. Polypharmacy is a complex and worrying phenomenon that merits more research.
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              The MSM program: web-based statistics package for estimating usual dietary intake using the Multiple Source Method.

              The Multiple Source Method (MSM) is a new statistical method for estimating usual dietary intake including episodically consumed foods on the basis of two or more short-term measurements such as 24-h dietary recalls. Optional information regarding habitual use or non-use of a food can be included as a covariate in the model estimating the intake, as well as a parameter for identifying consumers and non-consumers. The objective was to implement the MSM algorithms into an easy-to-use statistical program package. The implementation was realized as a web-based application using the Perl application framework Catalyst. As the engine for the statistical calculations, the R system was used. To allow simultaneous use of the program by different users, a multiuser system with a resource bag pattern design was implemented. We established a software program that implements the algorithms of the MSM and allows interactive usage of the method, using standard web technologies. The program is hosted on a website established at the DIFE and can be accessed at https://nugo.dife.de/msm. The communication between users and the program web site is encrypted, securing transmitted data against unauthorized use. Users can interactively import several data sets, define the analysis model, review and export results and graphs. The use of the program is supported by online help and a user guide. The MSM website provides a program package that allows nutritional scientists to calculate usual dietary intakes by combining short-term and long-term measurements (multiple sources). It promotes simple access to the MSM to estimate usual food intake for individuals and populations.
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                Author and article information

                Journal
                nh
                Nutrición Hospitalaria
                Nutr. Hosp.
                Grupo Arán (Madrid, Madrid, Spain )
                0212-1611
                1699-5198
                February 2018
                : 35
                : 1
                : 59-64
                Affiliations
                [1] Bahia Bahia orgnameUniversidade Federal da Bahia orgdiv1Nutrition and Health Brazil
                [4] São Paulo orgnameUniversity São Judas Tadeu Brazil
                [3] Bahia Bahia orgnameUniversidade Federal da Bahia orgdiv1School of Nutrition Brazil
                [2] Bahia Bahia orgnameUniversidade Federal da Bahia orgdiv1Center of Studies and Intervention about Aging Brazil
                Article
                S0212-16112018000100059 S0212-1611(18)03500100059
                10.20960/nh.1348
                29565150
                2ce08ce8-a1a3-4dd1-bbda-d1a3265aa1a3

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 10 June 2017
                : 24 August 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 40, Pages: 6
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                SciELO Spain

                Categories
                Original Papers

                Residencias para la tercera edad,Micronutrients,Ingesta alimentaria,Nursing homes,Elderly,Micronutrientes,Ancianos,Food intake

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