Krondl M, Coleman P H, Bradley C L, Lau D, Ryan N
Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Ontario, Canada.
J Am Diet Assoc. 1999 Dec;99(12):1542-8. doi: 10.1016/S0002-8223(99)00378-8.
To evaluate regular use of a liquid nutrition supplement by subjectively healthy elderly persons in terms of body mass index, nutrient intake, selected biochemical parameters, and perceived quality-of-life changes, and to identify advantages and limitations of use.
A 16-week intervention study in which subjects were assigned randomly to either a supplemented group or a control group and compared in terms of intergroup and intragroup differences in weight, food intake, blood values, and quality-of-life indexes. Adherence to protocol was monitored by monthly visits with an interviewer and food intake records.
SUBJECTS/SETTING: Seventy-one independent living, older Canadian adults (mean age = 70 +/- 7 years) consuming on average less than 4 servings of fruit and vegetables daily and a supplement-free diet before the study. Subjects were without functional limitations and did not require therapeutic diets or medical treatments that affect nutritional status. Data were collected in home interviews. Blood for analysis was obtained from a subsample of 36 subjects.
Inclusion of six 235-mL cans of liquid nutrition supplement weekly into the self-selected dietary patterns of the supplemented group.
Results were analyzed by Student t tests or Wilcoxon rank sum test, analysis of variance, and multiple stepwise regression.
Body mass index, energy intake, and consumption of fruit and vegetables did not change throughout the study. In the supplemented group, statistically significant increases occurred from baseline to termination of the study in these nutrients: protein, calcium, iron, magnesium, and folate. Serum albumin, folate, ferritin, hemoglobin, and zinc values were within the normal range for the supplemented and control groups. Scores for the Medical Outcomes Study 36-Item Short-Form Health Status scales increased for the supplemented group from baseline to termination for vitality and general health perception. Values for the General Well-Being Questionnaire improved for anxiety and general well-being. Of the dietary predictors, folate intake explained the most variance for vitality and for general well-being, 8.6% and 14.2%, respectively.
A liquid nutrition supplement could be recommended to the elderly when energy maintenance and increases in nutrient intake are necessary and convenience is an important consideration. Dietetics professionals should address the issues of affordability of the supplement, the role of food in achieving nutritional adequacy, and overall quality of life of clients. Folate intake as a predictor of perceived general well-being and vitality requires further investigation.
从体重指数、营养摄入、选定的生化指标以及感知到的生活质量变化方面，评估主观健康的老年人定期使用液体营养补充剂的情况，并确定使用的优点和局限性。
一项为期16周的干预研究，将受试者随机分为补充组和对照组，并比较两组间以及组内体重、食物摄入量、血液指标和生活质量指数的差异。通过每月与访员面谈和食物摄入记录来监测对方案的依从性。
受试者/研究环境：71名独立生活的加拿大老年人（平均年龄=70±7岁），研究前平均每天食用水果和蔬菜少于4份，且饮食中不包含补充剂。受试者没有功能限制，不需要影响营养状况的治疗性饮食或医疗。在家访中收集数据。从36名受试者的子样本中采集血液用于分析。
补充组在自行选择的饮食模式中每周加入6罐235毫升的液体营养补充剂。
结果采用学生t检验或威尔科克森秩和检验、方差分析和多元逐步回归进行分析。
在整个研究过程中，体重指数、能量摄入以及水果和蔬菜的摄入量均未改变。在补充组中，从研究基线到结束，蛋白质、钙、铁、镁和叶酸这些营养素出现了具有统计学意义的增加。补充组和对照组的血清白蛋白、叶酸、铁蛋白、血红蛋白和锌值均在正常范围内。补充组的医学结局研究36项简式健康状况量表中活力和总体健康感知评分从基线到结束有所增加。综合幸福感问卷中焦虑和总体幸福感的值有所改善。在饮食预测因素中，叶酸摄入量分别解释了活力和总体幸福感中最大的方差，分别为8.6%和14.2%。
当需要维持能量和增加营养摄入且便利性是重要考虑因素时，可向老年人推荐液体营养补充剂。饮食专业人员应解决补充剂的可负担性问题、食物在实现营养充足方面的作用以及客户的整体生活质量问题。叶酸摄入量作为总体幸福感和活力的预测指标需要进一步研究。
