居家饮食干预改善老年人出院后营养状况的可行性

Feasibility of home-based dietetic intervention to improve the nutritional status of older adults post-hospital discharge.

作者信息

Hamirudin Aliza Haslinda, Walton Karen, Charlton Karen, Carrie Amanda, Tapsell Linda, Milosavljevic Marianna, Pang Glen, Potter Jan

机构信息

School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.

Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia.

出版信息

Nutr Diet. 2017 Jul;74(3):217-223. doi: 10.1111/1747-0080.12305. Epub 2016 Sep 7.

DOI:10.1111/1747-0080.12305

PMID:28731606

Abstract

AIM

To determine if a model of home-based dietetic care improves dietary intake and weight status in a specific group of older adults post-hospitalisation.

METHODS

The Department of Veterans' Affairs clients aged 65 years and over were recruited from hospitals in a regional area of New South Wales, Australia (n = 32 men, n = 36 women). Nutritional status was assessed at home at baseline (within two weeks post-discharge) and three months post-discharge using a diet history, a food frequency checklist and Mini Nutritional Assessment (MNA). Personalised dietary advice was provided by a single dietitian according to participants' nutritional status.

RESULTS

Mean body weight improved significantly (P = 0.048), as well as mean MNA score (21.9 ± 3.5 vs 25.2 ± 3.1) (P < 0.001). Mean energy, protein and micronutrient intakes were adequate at baseline and three months, except for vitamin D. At three months, the underweight group (body mass index (BMI) < 23 kg/m ) had significantly higher mean protein intake per body weight (1.7 ± 0.4 g/kg) compared to those who were a desirable weight (BMI 23-27 kg/m ) (1.4 ± 0.3 g/kg) or overweight (BMI>27 kg/m ) (1.1 ± 0.3 g/kg) peers (P < 0.001). There was significant improvement in energy intake contributed from oral nutrition supplements (+95.5 ± 388.2 kJ/day) and milk (+259.6 ± 659.8 kJ/day).

CONCLUSIONS

Dietetic intervention improved nutritional status 3 months after hospital discharge in older adults living in the community.

摘要

目的

确定居家饮食护理模式是否能改善特定老年人群出院后的饮食摄入和体重状况。

方法

从澳大利亚新南威尔士州某地区的医院招募65岁及以上的退伍军人事务部客户（32名男性，36名女性）。在基线期（出院后两周内）和出院后三个月在家中使用饮食史、食物频率清单和微型营养评定法（MNA）评估营养状况。由一名营养师根据参与者的营养状况提供个性化饮食建议。

结果

平均体重显著改善（P = 0.048），平均MNA评分也显著改善（21.9 ± 3.5 vs 25.2 ± 3.1）（P < 0.001）。除维生素D外，基线期和三个月时平均能量、蛋白质和微量营养素摄入量均充足。三个月时，体重过轻组（体重指数（BMI）< 23 kg/m²）每体重的平均蛋白质摄入量（1.7 ± 0.4 g/kg）显著高于体重正常（BMI 23 - 27 kg/m²）（1.4 ± 0.3 g/kg）或超重（BMI > 27 kg/m²）（1.1 ± 0.3 g/kg）的同龄人（P < 0.001）。口服营养补充剂（+95.5 ± 388.2 kJ/天）和牛奶（+259.6 ± 659.8 kJ/天）所提供的能量摄入有显著改善。