Department of Laboratory Medicine, Division of Clinical Physiology, Karolinska Institutet, Karolinska University Hospital, 141 86 Stockholm, Sweden.
J Nutr Health Aging. 2012 Feb;16(2):162-7. doi: 10.1007/s12603-011-0157-7.
To analyse the effect of nutritional intervention and physical training on energy intake, resting metabolic rate (RMR) and body composition in the frail elderly.
Open, randomised, controlled pilot treatment study.
Community-based research centre.
Ninety-six community-dwelling frail elderly people aged 75 and older, 40% men.
Four treatment arms: i) individual nutritional advice and group sessions on nutrition for the elderly, ii) physical training 2 x 45 minutes per week for 3 months, iii) combined nutritional and physical intervention and iv) control group.
The outcomes were energy intake (4-day food diary); resting metabolic rate (indirect calorimetry) and body composition (anthropometry) performed at baseline, after 3 months' intervention (completed by 79 individuals), and as a follow-up at 9 months (completed by 64 individuals).
The training group showed a significantly increased RMR at 3 months. Otherwise, there were no observed differences within or between the four groups. There was no correlation over time between energy intake, RMR and fat free mass. The participants with a low energy intake who managed to increase their energy intake during the study ('responders') had a statistically significantly lower BMI (21 vs. 24) and a lower fat percentage (23 vs. 30) at baseline than the 'non-responders'. The 'non-responders' showed a small but statistically significant decrease in body fat percentage at F1, and in body weight, BMI and FFM at 9 months (F3).
Individual nutrition counselling and physical exercise had no effect on energy intake, RMR or fat free mass in community-dwelling frail elderly people aged 75 and older. Interventions in frail elderly people should be targeted according to the needs of the individual patients. The issues of randomisation, targeting and responders in are problematised and discussed.
分析营养干预和体育锻炼对虚弱老年人能量摄入、静息代谢率（RMR）和身体成分的影响。
开放、随机、对照的初步治疗研究。
社区为基础的研究中心。
96 名居住在社区中的虚弱老年人，年龄在 75 岁以上，其中 40%为男性。
四个治疗组：i）个体营养建议和老年人营养小组会议，ii）每周 2 次，每次 45 分钟的身体锻炼，持续 3 个月，iii）营养和身体干预联合组，iv）对照组。
结果是能量摄入（4 天食物日记）；静息代谢率（间接测热法）和身体成分（人体测量法），在基线时、3 个月的干预后（由 79 人完成）以及 9 个月的随访时（由 64 人完成）进行测量。
训练组在 3 个月时 RMR 显著增加。否则，四个组之间或组内没有观察到差异。能量摄入、RMR 和去脂体重之间没有随时间的相关性。在研究期间设法增加能量摄入的低能量摄入参与者（“应答者”）在基线时的 BMI（21 与 24）和体脂肪百分比（23 与 30）较低，与“非应答者”相比有统计学意义。“非应答者”在 F1 时体脂肪百分比略有但具有统计学意义的下降，在 9 个月（F3）时体重量、BMI 和去脂体重均下降。
对于 75 岁及以上居住在社区中的虚弱老年人，个体营养咨询和体育锻炼对能量摄入、RMR 或去脂体重没有影响。在虚弱老年人中，干预措施应根据个体患者的需求进行针对性治疗。随机化、针对性和应答者的问题进行了探讨和讨论。
