Pouyssegur Valerie, Brocker Patrice, Schneider Stéphane M, Philip Jean Luc, Barat Philippe, Reichert Ewa, Breugnon Frederic, Brunet Didier, Civalleri Bruno, Solere Jean Paul, Bensussan Line, Lupi-Pegurier Laurence
MICORALIS Laboratory, School of Dentistry, University Nice Sophia Antipolis, Nice, France Department of Dentistry, Nice University Hospital, Nice, France.
Department of Geriatrics, Nice University Hospital, Nice, France.
Age Ageing. 2015 Mar;44(2):245-51. doi: 10.1093/ageing/afu150. Epub 2014 Oct 16.
To evaluate the impact of a solid nutritional supplement on the weight gain of institutionalised older adults>70 years with protein-energy malnutrition. The innovation of these high-protein and high-energy cookies was the texture adapted to edentulous patients (Protibis®, Solidages, France).
An open, multicentre, randomised controlled trial.
Seven nursing homes.
One hundred and seventy-five malnourished older adults, aged 86±8 years.
All participants received the standard institutional diet. In addition, Intervention group participants received eight cookies daily (11.5 g protein; 244 kcal) for 6 weeks (w0-w6).
Five visits (w-4, w0, w6, w10 and w18).
Percentage of weight gain from w0 to w6 (body mass in kg).
Appetite, rated using a numerical scale (0: no appetite to 10: extremely good appetite); current episodes of pressure ulcers and diarrhea.
Average weight increased in Intervention group (n=88) compared with Control group (n=87) without cookies supplementation (+1.6 versus -0.7%, P=0.038). Weight gain persisted 1 month (+3.0 versus -0.2%, P=0.025) and 3 months after the end of cookies consumption (+3.9 versus -0.9%, P=0.003), with diarrhea reduction (P=0.027). There was a synergistic effect with liquid/creamy dietary supplements. Subgroup analysis confirmed the positive impact of cookies supplementation alone on weight increase (P=0.024), appetite increase (P=0.009) and pressure ulcers reduction (P=0.031).
The trial suggested that, to fight against anorexia, the stimulation of touch (finger food; chewing, even on edentulous gums) and hearing (intra-oral sounds) could be valuable alternatives to sight, smell and taste alterations.
评估一种固体营养补充剂对70岁以上患有蛋白质 - 能量营养不良的机构养老老年人体重增加的影响。这些高蛋白、高能量饼干的创新之处在于其质地适合无牙患者（Protibis®，Solidages，法国）。
一项开放性、多中心随机对照试验。
七家养老院。
175名营养不良的老年人，年龄86±8岁。
所有参与者均接受标准机构饮食。此外，干预组参与者每天食用八块饼干（含11.5克蛋白质；244千卡），持续6周（第0周 - 第6周）。
五次访视（第 - 4周、第0周、第6周、第10周和第18周）。
从第0周到第6周的体重增加百分比（体重以千克计）。
食欲，采用数字量表评分（0：无食欲至10：食欲极佳）；当前压疮和腹泻发作情况。
与未补充饼干的对照组（n = 87）相比，干预组（n = 88）平均体重增加（分别为 +1.6% 与 -0.7%，P = 0.038）。在停止食用饼干1个月后体重增加持续存在（分别为 +3.0% 与 -0.2%，P = 0.025），在停止食用饼干3个月后仍有体重增加（分别为 +3.9% 与 -0.9%，P = 0.003），腹泻情况有所减轻（P = 0.027）。与液体/乳状膳食补充剂有协同作用。亚组分析证实单独补充饼干对体重增加（P = 0.024）、食欲增加（P = 0.009）和压疮减少（P = 0.031）有积极影响。
该试验表明，为对抗厌食症，刺激触觉（手指食物；咀嚼，即使是无牙牙龈）和听觉（口腔内声音）可能是视觉、嗅觉和味觉改变的有价值替代方法。
