Heavily exercising endurance athletes experience extreme physiologic stress, which is associated with temporary immunodepression and higher risk of infection, particularly upper respiratory tract infections (URTI). The aim of this review is to provide a critical up-to-date review of existing evidence on the immunomodulatory potential of selected macronutrients and to evaluate their efficacy. The results of 66 placebo-controlled and/or crossover trials were compared and analysed. Among macronutrients, the most effective approach to maintain immune function in athletes is to consume ≥6% carbohydrate during prolonged exercise. Because inadequate nutrition affects almost all aspects of the immune system, a well-balanced diet is also important. Evidence of beneficial effects from other macronutrients is scarce and results are often inconsistent. Using a single nutrient may not be as effective as a mixture of several nutritional supplements. Due to limited research evidence, with the exception of carbohydrate, no explicit recommendations to reduce post-exercise URTI symptoms with single macronutrients can be derived.

Due to numerous causes and health consequences of olfactory impairment in older people, early detection of olfactory malfunction by rapid, inexpensive but valid tests, which could be used by geriatricians and other healthcare professionals, might be useful in patient counselling by identifying individuals at nutritional risk.

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Background Nutritional standards in community catering facilities are essential for adequate quality of care. As part of the initiative GEMEINSAM G'SUND GENIESSEN of the Health Fund Styria, minimum standards for nursing homes were published. The aim was to investigate the current situation of the implementation of selected minimum standards for food and drink supply in Styrian nursing homes to create appropriate measures for healthy living for elderly people. Methodology Of 81 defined minimum standards, two thirds were examined in the study (n = 54; 66.6 %). To get detailed insights into the current degree of implementation, the project team worked with a mixed- methods-basis, consisting of an online survey (n = 94; 41.4% of all Styrian nursing homes), 46 guideline interviews and 169 weeks of menu analysis. Results Of the 54 minimum standards analysed, 34 were fulfilled (63.0%), nine were rather fulfilled (16.6%), five were rather not fulfilled (9.2%), four standards could not be fulfilled (7.4%) and two standards could not be investigated (3.7%). Nursing homes prefer seasonal and regional products, but pay less attention to the use of fair trade products or organic food. In addition, the food choice is determined by the preferences and acceptance of the residents, which are the main reasons for the low use of whole grain products and the rare offer of vegetarian dishes. With regard to the design of the menus, almost all plans are age-appropriate and attractively presented, but rarely meet the standard with regard to recommended labelling (e.g. alcohol aromas). Challenges in the daily practise are finding a way between the self-determination of the residents, the arranged diets as wells as meeting the minimum standards. Conclusions Results indicate that minimum standards in nursing homes are taken into account. In order to achieve a comprehensive implementation, further development of the standards as well as information and awareness-building interventions are needed. Key messages Challenges in the daily practise are finding a way between the self-determination of the residents, the arranged diets as wells as meeting the minimum standards. The range of vegetarian dishes, dishes with legumes and wholemeal products should be focused in the future. In addition, the provision of tools (age-and target-group- specific-menus) is recommended.