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      Doença de Parkinson em idosos: ingestão alimentar e estado nutricional Translated title: Parkinson's disease: dietary intake and nutritional status

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          Abstract

          OBJETIVO: Avaliar o estado nutricional e ingestão alimentar dos idosos portadores da doença de Parkinson. MÉTODOS: Estudo transversal, realizado com pacientes portadores da doença de Parkinson (DP), atendidos em ambulatório. O estado nutricional foi avaliado utilizando a mini-avaliação nutricional (MAN), registro de consumo alimentar estimado de três dias e antropometria. Para avaliação da adequação de ingestão de nutrientes e energia, utilizou-se a ingestão dietética de referência, considerando valores da ingestão adequada, requerimento médio estimado e ingestão dietética recomendada. RESULTADOS: Foram avaliados 36 indivíduos, com idade média de 70,9±7,3 anos, sendo que 55% dos pacientes apresentaram risco de desnutrição de acordo com a MAN. Todavia, quando classificados pelo índice de massa corporal (IMC), 33% dos pacientes apresentaram sobrepeso e 39% não apresentaram perda nos últimos três meses. A ingestão energética foi de 1.632 e 1.840kcal/dia; proteínas, 71,2 e 61,9g/dia; ferro, 15,8 e 15,6mg/dia; sódio, 1.798 e 1.843mg/dia, para homens e mulheres, respectivamente, e ficaram acima das recomendações. Verificou-se ingestão inferior à recomendação para fibras (13,5 e 13,6g/dia), cálcio (694 e 552mg/dia) e potássio (1.637 e 1.476mg/dia). A ingestão energética apresentou correlação com ferro e proteína (r=0,581 e r=0,582) e a proteína apresentou correlação com a ingestão de ferro (r=0,600). CONCLUSÃO: Embora a ingestão energética da maioria se apresente adequada, observou-se o desequilíbrio dietético, com consumo insuficiente de fibras, cálcio e potássio. Além disso, metade da população encontrava-se em risco nutricional, segundo a MAN.

          Translated abstract

          OBJECTIVE: To evaluate the dietary intake of elderly patients with Parkinson's disease and to correlate it with nutritional status. METHODS: Cross-sectional study with patients with Parkinson's disease (PD) treated as outpatients. Nutritional status was evaluated by the Mini Nutritional Assessment (MAN) and food intake was assessed by three-day estimated food record. The Dietary Reference Intakes were used to assess the adequacy of nutrients and energy intake, considering adequate intake values, estimated average requirement and recommended dietary allowance. RESULTS: We evaluated 36 subjects with mean age of 70.9±7.3 years; 55% of patients were at risk of malnutrition according to MNA. However, when classified by body mass index (BMI), 33% of patients were overweight and 39% had no weight loss in the past three months. Energy intake was 1,632 and 1,840kcal/day; proteins, 71.2 and 61.9g/day; iron, 15.8 and 15.6mg/day; sodium, 1,798 and 1,843mg/day for men and women, respectively, and were above recommendations. There was less than the recommended intake for fiber (13.5 and 13.6g/day), calcium (694 and 552mg calcium/day), and potassium (1,637 and 1,476mg/day). Energy intake was correlated with iron and protein (r=0.581 and r=0.582) and protein correlated with iron intake (r=0.600). CONCLUSION: Although energy intake of the majority was adequate, dietary imbalance was observed, with insufficient intake of fiber, calcium, and potassium. Moreover, half the population was at nutritional risk according to the MNA.

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          Screening for nutritional status in the elderly.

          A comprehensive assessment of nutritional status is a critically important component of any patient evaluation. Based upon clinical information, anthropometric data, and a small number of laboratory investigations, an accurate appraisal of nutritional status should be possible and an appropriate intervention plan can be developed. The actual approach depends on the particular problem discovered. These are discussed in detail elsewhere in this issue.
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            The Mini Nutritional Assessment (MNA) review of the literature--What does it tell us?

            Y Guigoz (2015)
            To review the literature on the MNA to Spring 2006, we searched MEDLINE, Web of Science and Scopus, and did a manual search in J Nutr Health Aging, Clin Nutr, Eur J Clin Nutr and free online available publications. The MNA was validated against two principal criteria, clinical status and comprehensive nutrition assessment using principal component and discriminant analysis. The MNA shortform (MNA-SF) was developed and validated to allow a 2-step screening process. The MNA and MNA-SF are sensitive, specific, and accurate in identifying nutrition risk. The prevalence of malnutrition in community-dwelling elderly (21 studies, n = 14149 elderly) is 2 +/- 0.1% (mean +/- SE, range 0- 8%) and risk of malnutrition is 24 +/- 0.4% (range 8-76%). A similar pattern is seen in out-patient and home care elderly (25 studies, n = 3119 elderly) with prevalence of undernutrition 9 +/- 0.5% (mean +/- SE, range 0-30%) and risk of malnutrition 45 +/- 0.9% (range 8-65%). A high prevalence of undernutrition has been reported in hospitalized and institutionalized elderly patients: prevalence of malnutrition is 23 +/- 0.5% (mean +/- SE, range 1- 74%) in hospitals (35 studies, n = 8596) and 21 +/- 0.5% (mean +/- SE, range 5-71%) in institutions (32 studies, n = 6821 elderly). An even higher prevalence of risk of malnutrition was observed in the same populations, with 46 +/- 0.5% (range 8-63%) and 51 +/- 0.6% (range 27-70%), respectively. In cognitively impaired elderly subjects (10 studies, n = 2051 elderly subjects), detection using the MNA, prevalence of malnutrition was 15 +/- 0.8% (mean +/- SE, range 0-62%), and 44 +/- 1.1% (range 19-87%) of risk of malnutrition. The large variability is due to differences in level of dependence and health status among the elderly. In hospital settings, a low MNA score is associated with an increase in mortality, prolonged length of stay and greater likelihood of discharge to nursing homes. Malnutrition is associated with functional and cognitive impairment and difficulties eating. The MNA(R) detects risk of malnutrition before severe change in weight or serum proteins occurs. Intervention studies demonstrate that timely intervention can stop weight loss in elderly at risk of malnutrition or undernourished and is associated with improvements in MNA scores. The MNA can also be used as a follow up assessment tool. The MNA is a screening and assessment tool with a reliable scale and clearly defined thresholds, usable by health care professionals. It should be included in the geriatric assessment and is proposed in the minimum data set for nutritional interventions.
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              Pesquisa de Orçamentos Familiares 2008-2009: análise do consumo alimentar pessoal no Brasil

              (2011)
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rbgg
                Revista Brasileira de Geriatria e Gerontologia
                Rev. bras. geriatr. gerontol.
                Universidade do Estado do Rio Janeiro (Rio de Janeiro )
                1981-2256
                September 2013
                : 16
                : 3
                : 503-511
                Affiliations
                [1 ] Universidade Federal de Ciências da Saúde de Porto Alegre Brazil
                [2 ] Universidade Federal de Santa Maria Brazil
                Article
                S1809-98232013000300009
                10.1590/S1809-98232013000300009
                b01196eb-f45f-4faf-b923-d04e8474635f

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1809-9823&lng=en
                Categories
                GERIATRICS & GERONTOLOGY

                Geriatric medicine
                Parkinson Disease,Nutritional Status,Diet,Doença de Parkinson,Estado nutricional,Dieta

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