Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028Lisboa, Portugal.
Laboratório de Nutrição, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028Lisboa, Portugal.
Br J Nutr. 2022 Sep 14;128(5):921-931. doi: 10.1017/S0007114521003925. Epub 2021 Sep 29.
Malnutrition (synonym: undernutrition) is prevalent among older adults, which may be partly related to changes in dietary intake, but evidence on the link between malnutrition and diet is scarce. The aims of this study were to estimate the association between energy/nutrients intake and malnutrition, and to characterise nutritional inadequacy in institutionalised and non-institutionalised older adults. A national survey was conducted including a Portuguese representative sample of nursing home (NH) residents ( 563) and community-dwellers ( 837) aged ≥ 65 years. Data included socio-demographic characteristics, self-reported health, loneliness feelings, nutritional status (Mini Nutritional Assessment) and dietary intake (two non-consecutive 24-h recalls). A higher energy intake was associated with lower odds of malnutrition risk (being 'at risk of malnutrition' or 'malnourished') in both settings, but only significant among NH residents after adjusting for confounders (NH: OR = 0·66, 95 % CI 0·50, 0·86; community: OR = 0·64, 95 % CI 0·37, 1·10). The intake of carbohydrates, fat, fibre, vitamin C, Na, K and Mg was inversely associated with malnutrition risk in NH residents, and protein, fat, vitamin B, folates, Na, K, Ca and Mg intake in community-dwellers. After additional adjustment for total energy, only Na and Mg intake of community-dwellers remained significantly associated. The prevalence of inadequate nutrient intake was generally higher for the malnutrition risk group, which was particularly evident among community-dwellers. The effect of dietary intake on nutritional status seems more dependent on total energy and carbohydrates intake in institutionalised elders, whereas among community-dwellers protein and some micronutrients appear to have a greater impact.
营养不良（同义词：营养不足）在老年人中很普遍，这可能部分与饮食摄入的变化有关，但关于营养不良与饮食之间的联系的证据很少。本研究的目的是评估能量/营养素摄入与营养不良之间的关联，并描述机构化和非机构化老年人的营养不足情况。进行了一项全国性调查，包括葡萄牙的养老院（NH）居民（563 人）和社区居民（837 人）的代表性样本，年龄均≥65 岁。数据包括社会人口统计学特征、自我报告的健康状况、孤独感、营养状况（迷你营养评估）和饮食摄入（两次非连续 24 小时回忆）。在这两种情况下，较高的能量摄入与较低的营养不良风险（“存在营养不良风险”或“营养不良”）几率相关，但在调整混杂因素后，仅在 NH 居民中具有统计学意义（NH：OR=0.66，95%CI 0.50，0.86；社区：OR=0.64，95%CI 0.37，1.10）。NH 居民中碳水化合物、脂肪、纤维、维生素 C、Na、K 和 Mg 的摄入量与营养不良风险呈负相关，而社区居民中蛋白质、脂肪、维生素 B、叶酸、Na、K、Ca 和 Mg 的摄入量也与营养不良风险呈负相关。在进一步调整总能量后，仅社区居民的 Na 和 Mg 摄入量仍与营养不良风险显著相关。营养不足的营养素摄入不足的患病率在营养不良风险组中普遍较高，在社区居民中尤为明显。饮食摄入对营养状况的影响似乎更多地取决于机构化老年人的总能量和碳水化合物摄入，而在社区居民中，蛋白质和一些微量营养素的影响似乎更大。
