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To conduct a needs assessment of all aspects of food provision in a residential home and to evaluate a subsequent nutrition intervention.
An intervention study using a before and after design. A participatory approach was adopted and quantitative and qualitative methods used throughout. The intervention involved a revised menu, kitchen equipment, and establishing wholesale shopping and food donations.
A residential home for senior citizens in Guyana.
Meals at the home were nutritionally inadequate and deeply unpopular with the residents. Intakes of fruits and vegetables were low and the home was heavily reliant on donated soya mince and rice. Meals were served within an eight-hour period to accommodate the staff's hours of work. Cutbacks in the food budget indicated that the financial state of the home explained some of the problems. The intervention was unable to address all problems identified, but led to substantial improvements in the nutritional adequacy of the food provided following the inclusion in the menu of a number of nutrient-dense foods such as chicken liver. The new menu was acceptable to the cooks and largely popular with the residents, although some problems persisted.
The results show that improvements in the nutrient profile of the diet could be achieved with a flexible, community-based, participatory approach that addressed all elements of a home's food provision system. The changes also proved largely popular with the residents, thus potentially contributing to their quality of life.
To examine the relationship between the nutritional status and handgrip strength of older people in rural Malawi.
Lilongwe rural, Malawi, situated approximately 35–50 km from the city.
Ninety seven males and 199 females participated in this study.
Selected anthropometric measurements were taken and nutrition indices were computed using standard equations. Handgrip strength was measured using an electronic grip strength dynamometer.
The mean handgrip strength (in kg) for men was significantly higher than for women (28.0±5.9 vs. 21.7±4.5). In addition, there was a significant decline in handgrip strength with age in both sexes. Furthermore, handgrip strength was positively correlated to the following nutritional status indicators: BMI (r = 0.40 in males and r = 0.34 in females), mid-upper arm circumference (MUAC) (r = 0.45 in males and r = 0.38 in females) and arm-muscle area (AMA) (r = 0.39 in males and r = 0.37 in females). After controlling for potential confounders, namely sex, height and age, the correlations between handgrip strength and the nutrition indices were still significant.
The results of this study support the hypothesis that poor nutritional status is associated with poor handgrip strength. Malawian males had both lower handgrip strength and lower arm muscle area than their counterparts from industrialised countries. However, Malawian females had similar handgrip strength despite lower arm muscle area, in comparison with women from industrialised countries, reflecting perhaps their higher level of physical activity. Further studies are required to determine whether by alleviating nutritional problems a concomitant improvement in handgrip strength can be obtained.
To assess the nutritional status of older people in an unstable situation.
Anthropometric and socioeconomic data were collected cross-sectionally. Body mass index (BMI), arm muscle area (AMA) and arm fat area (AFA) were calculated to evaluate nutritional status. For 41 subjects with kyphosis, height was estimated from arm span using sex-specific regression equations from the non-kyphotic group.
The study was carried out in the post-emergency phase in a Rwandan refugee camp in Karagwe district, north-west Tanzania.
Measurements were obtained from 413 men and 415 women aged 50–92 years.
The prevalence of undernutrition (BMI < 18.5) was 19.5% in men and 13.1% in women and was higher above age 60 years in both sexes: in men the prevalences were 23.2% and 15.0% (P < 0.05) and in women 15.1% and 10.9% for the older and younger age groups respectively. AMA, which is important in relation to the ability to remain active and independent, was also significantly lower in older age groups. No difference was found in AFA. The proportion with low BMI was much higher in the group with kyphosis.
Even in this population of older Rwandans who managed to reach the camp and survive in exile for more than a year, undernutrition does occur and is more prevalent at an advanced age. The higher prevalence of undernutrition in kyphotic people illustrates the importance of including this group in nutritional status assessments.
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