The large individual differences (ranges) in energy, nutrients and water show that the use of mean values when analysing dietary intake data from elderly people is misleading. From a clinical perspective it is more important to consider the individual intake of energy, nutrients and water. Ageism is intrinsic in the realm of 'averageology'.

BackgroundThere is no accepted or standardized definition of ‘malnutrition’. Hence, there is also no definition of what constitutes an adequate nutritional status. In elderly people, assessment of nutritional status is complex and is complicated by multi-morbidity and disabilities combined with nutrition-related problems, such as dysphagia, decreased appetite, fatigue, and muscle weakness.ObjectiveWe propose a nutritional status model that presents nutritional status from a comprehensive functional perspective. This model visualizes the complexity of the nutritional status in elderly people.Design and resultsThe presented model could be interpreted as the nutritional status is conditional to a person’s optimal function or situation. Another way of looking at it might be that a person’s nutritional status affects his or her optimal situation. The proposed model includes four domains: (1) physical function and capacity; (2) health and somatic disorders; (3) food and nutrition; and (4) cognitive, affective, and sensory function. Each domain has a major impact on nutritional status, which in turn has a major impact on the outcome of each domain.ConclusionsNutritional status is a multifaceted concept and there exist several knowledge gaps in the diagnosis, prevention, and optimization of treatment of inadequate nutritional status in elderly people. The nutritional status model may be useful in nutritional assessment research, as well as in the clinical setting.

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Background & aims: The nutritional status is seldom defined in general, but is considered to be important throughout life span, especially in times of diseases and disabilities. We previously proposed a theoretical model of the nutritional status from a functional perspective [1], however without proposing a definition of the nutritional status. The model comprises four domains that might affect the nutritional and functional status in a bidirectional way. These four domains are: Food and nutrition; Health and somatic disorders; Physical function and capacity; and Cognitive, affective, and sensory function. This study contributes to the existing literature and knowledge by empirically analysing patterns and relationships of possible nutritional status indicators within and between the four domains. Methods: This study is based on a sample of 69 men and women; older than 65 years, receiving home health care. They were followed up for three years. A broad set of nutritional status indicators in the participants were assessed in their home yearly. Given the small sample size and large number of variables, we used both correlation and factor analysis to explore patterns of nutritional status indicators within the four domains and relationships between the four domains suggested by the theoretical model of nutritional status which we proposed earlier.Results: At baseline, between 4 and 18 components were extracted from the four domains, separately, using factor analysis. The first three components of each domain (called main components) were correlated (p < 0.05) with at least one of the main components of each of the other three domains (r ¼ À0.34e0.79 at baseline, 0.38e0.74 at year 1, 0.40e0.77 at year 2 and 0.47e0.71 at year 3). At baseline, these main components explained, respectively, 31%, 52%, 57% and 63% of the sample variation in the four domains. This remained stable throughout all three years of follow up. In all four domains, there were statistically significant differences in prevalence of malnutrition, frailty, sarcopenia, and dehydration (all different inadequate nutritional status) between individuals' individual component scores. Conclusions: This study provides empirical evidence for the relationship between nutritional status indicators within and between the four domains suggested by our theoretical model of nutritional status. Components in all four domains were associated with inadequate nutritional status, highlighting that a wide perspective of the nutritional status assessment is necessary to be applied in clinical practice.

Background: A majority of community-dwelling older people will in the near future be in need of increased health care. By investigating the relationship between gut health, well-being and nutrient intake we aim to recognize areas through which health might be promoted. Methods: A cross-sectional observational study was performed enrolling 229 older adults (≥65 years). Validated questionnaires were used to assess gut health, nutrient intake and well-being. Results: 65% of the participant experienced gastrointestinal symptoms. Gastrointestinal symptoms significantly correlated to anxiety, stress and decreased quality of life. Dyspepsia correlated to a lower energy percentage of protein. An intake below the nutritional recommendations was found for protein, fibre, fat (monounsaturated/polyunsaturated), while an intake above the recommendations was found for saturated fats and alcohol Discussion: A majority of the community-dwelling older adults experienced gastrointestinal symptoms and had an imbalanced macronutrient intake. Gut health, diet and well-being all represents important areas for future intervention studies.