Objective: To investigate the associations between nutrition risk status, body composition and physical performance among community‐dwelling older New Zealanders. Methods: This cross‐sectional study enrolled 257 community‐dwelling older adults (median age 79 years). Assessments included the Mini Nutritional Assessment‐Short Form (MNA®‐SF) for nutrition risk; the Eating Assessment Tool‐10 for dysphagia risk; bioimpedance analysis for body composition (free fat mass (FFM) and percentage body fat) and gait speed for physical performance. A multiple logistics regression analysis was conducted, to determine factors associated with lower odds [OR (95% CI)] for nutrition risk. Results: Every yearly increase in age was associated with higher odds 1.09 (1.01–1.17) for nutrition risk. Additionally, nutrition risk was less likely to occur among participants of age <85 years 0.30 (0.11–0.79), with no dysphagia 0.29 (0.09–0.97) and those with a healthy gait speed 0.29 (0.09–0.97). Lower odds for nutrition risk were also found with increasing values of FFM index 0.51 (0.34–0.77), and percentage body fat 0.81 (0.72–0.90). Gait speed was positively correlated with FFM index (r=0.19 p<0.022), percentage body fat (r=0.23, p=0.006) and BMI (r=0.29, p<0.001). Conclusion: Among these participants, associations between nutrition risk, body composition and physical performance were found. Implications for public health: Routine screening of nutrition risk and/or physical performance among vulnerable older adults is key towards identifying those in need of assessment and dietary intervention. Alongside strategies to encourage physical activity, this may help to slow losses of FFM and protect physical performance.

BackgroundMalnutrition in patients admitted to hospital may have detrimental effects on recovery and healing. Malnutrition is preceded by a state of malnutrition risk, yet malnutrition risk is often not detected during admission. The aim of the current study was to investigate the magnitude and potential predictors of malnutrition risk in older adults, at hospital admission.MethodsA cross-sectional was study conducted in 234 older adults (age ≥ 65 or ≥ 55 for Māori or Pacific ethnicity) at admission to hospital in Auckland, New Zealand. Assessment of malnutrition risk status was performed using the Mini Nutritional Assessment Short-Form (MNA®-SF), dysphagia risk by the Eating Assessment Tool (EAT-10), muscle strength by hand grip strength and cognitive status by the Montreal Cognitive Assessment (MoCA) tool.ResultsAmong 234 participants, mean age 83.6 ± 7.6 years, 46.6% were identified as at malnutrition risk and 26.9% malnourished. After adjusting for age, gender and ethnicity, the study identified [prevalence ratio (95% confidence interval)] high dysphagia risk [EAT-10 score: 0.98 (0.97–0.99)], low body mass index [kg/m2: 1.02 (1.02–1.03)], low muscle strength [hand grip strength, kg: 1.01 (1.00–1.02)] and decline in cognition [MoCA score: 1.01 (1.00–1.02)] as significant predictors of malnutrition risk in older adults at hospital admission.ConclusionAmong older adults recently admitted to the hospital, almost three-quarters were malnourished or at malnutrition risk. As the majority (88%) of participants were admitted from the community, this illustrates the need for routine nutrition screening both at hospital admission and in community-dwelling older adults. Factors such as dysphagia, unintentional weight loss, decline in muscle strength, and poor cognition may indicate increased risk of malnutrition.

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INTRODUCTIONMalnutrition is an under-recognised and under-treated problem often affecting older adults. AIMThe aim of this study was to evaluate the prevalence of and factors associated with malnutrition and frailty among older adults at early admission to residential aged care. METHODSA cross-sectional study was undertaken among eligible older adults within the first week of admission to residential aged care. Participants were assessed for malnutrition risk using the Mini Nutritional Assessment Short Form, frailty using the Fried phenotype criterion, muscle strength using a grip strength dynamometer and gait speed using a 2.4-m walk test. A Cox regression analysis was conducted to identify factors associated with malnutrition risk and frailty status. RESULTSOf 174 participants (mean age 85.5 years, 61% women), two-thirds (66%) were admitted to residential aged care from the community. Most (93%) were either malnourished (48%) or at risk of malnutrition (45%). A total of 76% of participants were frail and 24% were pre-frail. Forty-three percent were both malnourished and frail. Low risk of malnutrition was associated with increases in muscle strength [0.96 (0.93–0.99)], gait speed [0.27 (0.10–0.73)] and pre-frailty status [0.32 (0.12–0.83)]. DISCUSSIONThis study provides preliminary evidence for high prevalence of malnutrition and frailty at admission to residential aged care. Almost all participants were malnourished or at nutrition risk. Findings highlight the need for strategies to prevent, detect and treat malnutrition in community health care and support nutrition screening at admission to residential aged care.

Intrahepatic lipid (IHL) accumulation is considered the hepatic manifestation of the metabolic syndrome. Obesity, in particular abdominal obesity, is associated with increased hepatic lipid accumulation. Lifestyle factors, like diet and physical activity play an important role in IHL accumulation. Caloric restriction (CR) results in lower IHL levels [Petersen et al., Diabetes 2005, 54:603–60] and several nutrients can be linked to hepatic lipid accumulation [de Wit et al, J Hepatol 2012, 57:1370–1373]. In the Wageningen Belly Fat Study our objective was to compare the effects of two different caloric‐restricted diets that differ in nutrient quality on IHL content.The Belly Fat Study is a parallel, randomized intervention study of 12 weeks. 110 healthy overweight males and females aged 40–70 with abdominal obesity were randomly assigned to either one of two dietary advice intervention groups or a control group (CON, n=30). Dietary advice in the interventions was provided in two variants; a Western‐type caloric restricted diet (− 30en%, CR‐WD, n=40) and a targeted caloric restricted diet (−30en%, CR‐TD, n=40) that specifically aimed to improve organ health and to reduce lipid accumulation in the liver. The targeted diet was enriched in monounsaturated as well as polyunsaturated fatty acids including n‐3 fatty acids; contained an increased proportion of complex carbohydrates, whilst fructose being low; and had an increased soy protein content. Dietary advice was given on a weekly basis by skilled dieticians, and key food products were provided. The control group did not receive any dietary advice and were instructed to maintain their habitual diet. IHL content was measured by image‐guided single‐voxel spectroscopy, a quantitative version of 1H‐magnetic resonance spectroscopy. Measurements were performed on a 3.0T magnetic resonance scanner before and after intervention.Change in IHL was evaluated in 80 subjects (19 CON, 33 CR‐WD, 28 CR‐TD). Average weight change was +0.5 ± 0.7 kg in CON, −6.4 ± 0.6 kg in CR‐WD, and −8.5 ± 0.6 kg in CR‐TD group. Weight‐loss in both CR diets was significantly different from CON, and a bigger weight loss was seen in the targeted diet group compared to the western diet group (p=0.016). Before intervention no difference in IHL was seen between groups (p=0.27). After 12 weeks, IHL was slightly increased in the control group, while strongly decreased in the CR groups (CON: 5.0 [3.7–6.7] % of H2O resonance; CR‐WD: 2.4 [1.9–3.1]%; CR‐TD: 1.9 [1.5–2.4]%, baseline IHL‐adjusted geometric means [95%CI]). Both CR groups were significantly lower than the control group (p<0.001, ANCOVA), while no difference was seen between the two caloric restricted groups (p=0.39, ANCOVA). The change in IHL was strongly correlated to the change in bodyweight (R=0.584, p< 0.001).In conclusion, body weight loss through caloric restriction did strongly reduce intrahepatic lipid accumulation. There was no clear additional advantage of an improved nutrient quality on weight‐loss induced improvement in IHL.