Hohenheimer Konsensusgespräch - Ernährung und Altern

Zusammenfassung

Ziel: Das Verhältnis zwischen Ernährung und Altern zu betrachten. Bestehende Kenntnisse zusammenzufassen und Bereiche des Nichtwissens zu identifizieren. Ausführung: Experten einer Reihe relevanter Disziplinen erhielten und betrachteten eine Reihe von Fragen zu dem Aspekt des aktuellen Themengebietes. Ort: Universität Hohenheim, Stuttgart, Deutschland. Intervention: Die Experten trafen sich, diskutierten die Fragen und kamen zu einem Konsensus. Schlussfolgerung: Viele spezielle Schlussfolgerungen wurden gezogen, die die generelle Sicht unterstützten, dass während unseres Alterungsprozesses eine inadäquate Ernährung zum Verlust von Funktionen und der Entwicklung und dem Fortschreiten von Krankheiten beiträgt. Der Ernährungsstatus wird beeinflusst von einer Reihe medizinischer, physiologischer, psychologischer, sozialer und situativer Variablen. Angemessene Ernährung und körperliche Aktivitäten sind Aspekte eines gesundheitsfördernden Lebensstils. Die Ermutigung zu besserer Ernährung und Bewegung sind kosteneffektive Wege, um das Auftreten und Fortschreiten altersbedingter Krankheiten zu verringern. Je früher solche Interventionen durchgeführt werden, desto besser.

Abstract

Objective: To consider the relationship between nutrition and aging. To summarize existing knowledge and identify areas of ignorance. Design: Experts from a range of relevant disciplines received and considered a series of questions related to aspects of the topic. Setting: University of Hohenheim, Stuttgart, Germany. Interventiuon: The experts met and discussed the questions and arrived at a consensus. Conclusion: Many specific conclusions were drawn that support the general view that as we age an inadequate nutrition contributes to the loss of function and the development and progression of disease. Nutritional status is influenced by a range of medical, physiological, psychological, social, and situational variables. Adequate nutrition and physical activity are aspects of a health-promoting lifestyle. The encouraging of better nutrition and the taking of exercise is a cost-effective way of decreasing the incidence and progression of age-related disease. The earlier such interventions are introduced the better.

Literatur

• 1 Abbasi A A, Rudman D. Undernutrition in the nursing home: prevalence, consequences, causes and prevention.  Nutr Rev. 1994;  52 (4) 113-122
• 2 Allison D B, Gallagher D, Heo M. Body mass index and all-cause mortality among people age 70 and over: the Longitudinal Study of Aging.  Int J Obes Relat Metab Disord. 1997;  21 424-431
• 3 Alpert J E, Mischoulon D, Nierenberg A A, Fava M. Nutrition and depression: focus on folate.  Nutrition. 2000;  16 544-581
• 4 Amorim Cruz J A, Moreiras O, Brzozowska A. The SENECA Investigators Longitudinal changes in the intake of vitamins and minerals of elderly Europeans.  Eur J Clin Nutr. 1996;  50 (2) 77-85
• 5 Andres E, Goichot B, Schlienger J L. Food cobalamin malabsorption: a usual cause of vitamin B12 deficiency.  Arch Intern Med. 2000;  160 2061-2062
• 6 Andres R, Muller D C, Sorkin J D. Long-Term Effects of Change in Body Weight on All-Cause Mortality.  Ann Intern Med. 1993;  119 (2) 737-743
• 7 Baik I. Adiposity and Mortality in Men.  Am J Epidemiol. 2000;  152 264-271
• 8 Baik H W, Russell R M. Vitamin B12 deficiency in the elderly.  Ann Rev Nutr. 1999;  19 357-377
• 9 Barnett Y. Ageing - biological aspects. In: Sadler MJ, Strain JJ, Caballero B (eds) Encyclopedia of human nutrition. London; Academic Press 1999: 29-35
• 10 Bates C J. Vitamin Analysis.  Annals of Clinical Biochemistry. 1997;  34 599-626
• 11 Bates C J. Diagnosis and detection of vitamin deficiencies.  British Medical Bulletin. 1999;  55 643-657
• 12 Bates C J, Mansoor M A, van der Pols J C, Prentice A, Cole T J, Finch S. Plasma total homocysteine in a representative sample of 972 British men and women aged and over.  Eur J Clin Nutr. 1997;  51 1-7
• 13 Bates C J, Mansoor M A, van der Pols J C, Prentice A, Cole T J, Finch S. Plasma total homocysteine in 972 people aged 65 years and over, representative of Britain, in a National Diet and Nutrition Survey.  Proceedings of the Nutrition Society. 1998a;  57 35A
• 14 Bates C J, Pentieva K D, Prentice A, Mansoor M A, Finch S. Plasma pyridoxal phosphate and pyridoxic acid in a representative sample of British men and women aged 65 years and over and their relationship to plasma homocysteine.  Brit J Nutr. 1999b;  81 191-201
• 15 Bates C J, Prentice A, Finch S. Gender differences in food and nutrient intakes and status indices from the National Diet sand Nutrition Survey of People Aged 65 years and Over.  Eur J Clin Nutr. 1999c;  53 694-699
• 16 Bates C J, Prentice A, Cole T J, van der Pols J C, Doyle W, Finch S, Smithers G, Clarke P C. Micronutrients - Highlights and Research Challenges from the 1994/5 National Diet and Nutrition Survey of People Aged 65 Years and Over.  Brit J Nut. 1999a;  82 7-15
• 17 Bell I R, Amend D, Kaszniak A W, Schwartz G E. Memory deficits, sensory impairment and depression in the elderly.  Lancet. 1993;  341 62
• 18 Bergstrom N, Braden B. A prospective study of pressure sore risk among institutionalized elderly.  J Am Geriatr Soc. 1992;  40 747-758
• 19 Berkhout A M, van Houwelingen J C, Cools H J. Increased chance of dying among nursing home patients with lower body weight.  Ned Tijdschr Geneeskd. 1997;  141 2184-2188
• 20 Block G, Weindruch R. The retardation of aging by caloric restriction: studies in rodents and primates.  Toxicol Pathol. 1996;  24 (6) 742-745
• 21 Booth S L. Dietary vitamin K intakes are associated with hip fracture but not with bone mineral density in elderly men and women.  Am J Clin Nutr. 2000;  71 1201-1208
• 22 Bowman B A, Rosenberg I H, Johnson M A. Gastrointestinal function in the elderly. In: Munro HN, Schlierf G (eds) Nestlé Nutrition Workshop Series,. New York; Raven Press 1992: 43-50
• 23 Cantuti-Castelvetri I, Shukitt-Hale B, Joseph J A. Neurobehavioral aspects of antioxidants in aging.  Int J Devl Neuroscience. 2000;  18 367-381
• 24 Carmel R, Sinow R M, Siegel M E, Samloff I M. Food cobalamin malabsorption occurs frequently in patients with unexplained low serum cobalamin levels.  Arch Intern Med. 1988;  148 1715-1719
• 25 Chapuy M C, Arlot M E, Delmas P D, Meunier P J. Effecty of calcium and cholecalciferol treatment for three years on hip fractures in elderly women.  Br Med J. 1994;  308 1081-1082
• 26 Chernoff R. Meeting the nutritional needs of the elderly in the institutional setting.  Nutr Rev. 1994;  52 132-136
• 27 Chidester J C, Spangler A A. Fluid intake in the institutionalized elderly.  J Am Diet Assoc. 1997;  97 23-28
• 28 Christmas C, Andersen R A. Exercise and older patients: guidelines for clinicians.  J Am Geriatr Soc. 2000;  48 318-324
• 29 Clarke D M, Wahlqvist M L, Strauss B JG. Undereating and undernutrition in old age: integrating bio-psychosocial aspects.  Age and Ageing. 1998;  27 527-534
• 30 Cornoni-Huntley J C, Harris T B, Everett D F. An overview of body weight of older persons including the impact of mortality. The National Health and Nutrition Examination Survey. Epidemiologic Follow-up Study.  J Clin Epidemiol. 1991;  44 743-753
• 31 Day N E, Oakes S, Luben R. EPIC - Norfolk: study design and characteristics of the cohort.  British Journal of Cancer. 1999;  80 (1) 95-103
• 32 de Groot C P, van Staveren W A. Older people: Nutritionally related problems. In: Sadler MJ, Strain JJ, Caballero B (eds) Encyclopedia of Human Nutrition. London; Academic Press 1999: 1479-1485
• 33 de Groot C P, van der Broek T, van Staveren W A. Energy intake and micronutrient intake in elderly Europeans: seeking the minimum requirement in the SENECA study.  Age Ageing. 1999;  6 468-474
• 34 de Groot C PG, Beck A M, Schroll M, van Staveren W A. Evaluating the DETERMINE your nutritional health checklist and the mini nutritional assessment as tools to identify nutritional problems in elderly Europeans.  Eur J Clin Nutr. 1998;  52 877-883
• 35 de Groot C P, van Staveren W A, Burema J. Survival beyond age 70 in relation to diet.  Nutr Rev. 1996;  54 211-212
• 36 de Groot C P, West C E, van Staveren W A. Meeting nutrient and energy requirements in old age. Maturitas in press, 2001
• 37 Department of Health Report of the Working Group on the Nutrition of Elderly People of the Committee on Medical Aspects of Food Policy .Report on Health and Social Subjects: The Nutrition of Elderly People (43). London; HMSO Publications Centre 1992
• 38 Deutsche Gesellschaft für Ernährung, Österreichische Gesellschaft für Ernährung, Schweizerische Gesellschaft für Ernährung, Schweizerische Vereinigung für Ernährung .Referenzwerte für die Nährstoffzufuhr. (1e druk). Frankfurt am Main; Umschau/Braus 2000
• 39 Dutta C, Hadley E C. The significance of sarcopenia in old age.  J Gerontol. 1995;  50A 1-4
• 40 Dwyer J T, Campbell D. Screening Older Americans' Nutritional Health Current Practices and Future Possibilities. 1991
• 41 Joosten E, Vanderelst B, Pelemans W. The effect of different diagnostic criteria on the prevalence of malnutrition in a hospitalized geriatric population.  Aging Clin Exp Res. 1999;  11 (6) 390-394
• 42 Egbert A M. The Dwindles: failure to thrive in older patients.  Nutr Rev. 1996;  54 25-30
• 43 Elahi D, Muller D C. Carbohydrate metabolism in the elderly.  Eur J Clin Nutr. 2000;  54 (3) 112-120
• 44 Elia M, Ritz P, Stubbs R J. Total energy expenditure in the elderly.  Eur J Clin Nutr. 2000;  54 (3) 92-103
• 45 Euronut SENECA Investigators . Nutrition and the Elderly in Europe.  Eur J Clin Nutr. 1991;  45 (3) 191-195
• 46 European Commission .Report on osteoporosis in the European Community - Action for prevention. Luxembourg; Office for Official Publications of the European Communities 1998
• 47 Feskanich D. Vitamin K intake and hip fractures in women: a prospective study.  J Clin Nutr. 1999;  69 74-79
• 48 Finch S, Doyle W, Lowe C, Bates C J, Prentice A, Smithers G, Clarke P. National Diet and Nutrition Survey: People Aged 65 Years or Over. Report of the Diet and Nutrition Survey. London; The Stationery Office 1998 Volume 1
• 49 Flodin L, Svensson S, Cederholm T. Body mass index as a predictor of 1 year mortality in geriatric patients.  J Clin Nutr. 2000;  19 121-125
• 50 Forbes G B. Body composition: overview.  J Nutr. 1999;  129 270-272
• 51 Fukagawa N K, Minkaer K L, Rowe J W, Matthews D E, Bier D M, Young V R. Glucose and amino acid metabolism in aging man: differential effects of insulin.  Metabolism. 1996;  37 371-377
• 52 Garry P J, Vellas B J. Aging and Nutrition. In: Ziegler EE, Filer LJ Present (eds) Knowledge in Nutrition. Washington; ILSI Press 1996: 414-419
• 53 Gey K F. Ten-year retrospective on the antioxidant hypothesis of arteriosclerosis: Threshold plasma levels of antioxidant micronutrients related to minimum cardiovascular risk.  Nutr Biochem. 1994;  6 206-236
• 54 Gezondheidsraad .Voedingsnormen: calcium, vitamine D, thiamine, riboflavine, niacine, pantotheenzuur en biotine. Den Haag; Gezondheidsraad 2000 nr. 12
• 55 Glenister D. Exercise and mental health: a review.  J R Soc Health. 1996;  116 7-13
• 56 Goodwin J S, Goodwin J M, Garry P J. Association between nutritional status and cognitive functioning in a healthy elderly population.  JAMA. 1983;  249 2917-2921
• 57 Gregory J, Foster K, Tyler H, Wiseman M. The Dietary and Nutritional Survey of British Adults. London; HMSO 1990
• 58 Gregory J, Lowe S, Bates C, Prentice A, Jackson L, Smithers G, Wenlock R, Farron M. National Diet and Nutrition Survey: Young People Aged 4 to 18 Years: Report of the diet and nutrition survey. London; The Stationery Office 2000 Vol. 1
• 59 Gregory J R, Collins D L, Davies P SW, Hughes J M, Clarke P C. National Diet and Nutrition Survey: Children Aged 1.5 to 4.5 Years: Report of the diet and nutrition survey. London; HMSO 1995 Vol. 1
• 60 Guigoz Y, Vellas B. The mini nutritional assessment (MNA) for grading the nutritional ststae of elderly patients, presentation of the MNA, history and validation.  Facts Res and Intervention Geriatr Newsletter, Nutrition. 1997;  6 2
• 61 Haller J, Weggemans R M, Ferry M, Guigoz Y. Mental health, minimental state examination and geriatric depression score of elderly Europeans in the SENECA Study of 1993.  Europ J Clin Nutr. 1993;  50 112-116
• 62 Haveman-Nies A, de Groot C PG, van Staveren W A. Fluid intake of elderly Europeans.  J Nutr Health & Aging. 1997;  1 2
• 63 Health, Department of Dietary reference for food energy and nutrients for the United Kingdom .Report on Health and Social Subjects. London; HMSO 1991 No. 41
• 64 Health, Department of .Reports on Health and Social Subjects. A Nutrition Survey of the Elderly. Report by the Panel on Nutrition of Elderly. London; HMSO 1972 No. 3A
• 65 Health, Department of .Report on Health and Social Subjects. Nutrition and Health in Old Age. London; HMSO 1979 No 16
• 66 Health, Department of .Subjects Nutrition and Bone Health with particular reference to calcium and vitamin D. Report on Health and Social Subjects. London; The Stationary Office 1998 No. 49
• 67 Heini A F, Winsier R L. Divergent Trends in Obesity and Fat Intake Patterns: The American Paradox.  Am J Med. 2000;  102 259-264
• 68 Henry C JK. Mechanisms of change in basal metabolism aging.  Eur J Clin Nutr. 2000;  54 (3) 77-91
• 69 Holick M F. Vitamin D - new horizons for the 21st century. McCollum Award Lecture.  Am J Clin Nutr. 1994;  60 619-630
• 70 Hurley B F, Roth S M. Strength training in the elderly: effects on risk factors for age-related diseases.  Sports Med. 2000;  30 249-268
• 71 Incalzi R A, Gemma A, Capparella O. Energy intake and in-nursinghome starvation. A clinical relevant relationship.  Arch Intern Med. 1996;  156 425-429
• 72 Institute of Medicine Food and Nutrition Board .Dietary Reference Intakes for Calcium Phosphorus, Magnesium, Vitamin D and Fluoride. Washington DC; National Academic Press 1997
• 73 Kalmijn S, Feskens E JM, Launer L J, Kromhout D. Polysaturated fatty acids, antioxidants and cognitive function in very old men.  Am J Epidemiol. 1997;  145 33-41
• 74 Kleiner S M. Water: An essential but overlooked nutrient.  J Am Diet Assoc. 1999;  99 200-206
• 75 Klipstein-Grobusch K, Reilly J J, Potter J, Edwards C A, Roberts M A. Energy intake and expenditure in elderly patients admitted to hospital with acute illness.  Br J Nutr. 1995;  73 323-334
• 76 La Rue A, Koehler K M, Wayne S J, Chiulli S J, Haaland K Y, Garry P J. Nutritional status and cognitive functioning in a normally aging sample: a 6-y reassessment.  Am J Clin Nutr. 1997;  65 20-29
• 77 Launer L J, Kalmijn S. Anti-oxidants and cognitive function: a review of clinical and epidemiologic studies.  J Neural Trans. 1998;  53 (l) 1-8
• 78 Lee I M, Paffenbarger R SJ. Associations of light, moderate, and vigorous intensity physical activity with longevity. The Harvard Alumni Health Study.  Am J Epidemiol. 2000;  151 293-299
• 79 Lemura L M, von Duvillard S P, Mookerjee S. The effects of physical training of functional capacity in adults. Ages 46 - 90: a meta-analysis.  J Sports Med Phys Fitness. 2000;  40 1-10
• 80 Lennard-Jones J E. A positive approach to nutrition and treatment. Report of a working party. London; King's Fund Center 1991
• 81 Madigan S M, Tracey F, McNulty H. Riboflavin and vitamin B₆ intakes and status and biochemical response to riboflavin supplementation in free-living elderly people.  Am J Clin Nutr. 1998;  68 389-395
• 82 Marcus E L, Berry E M. Refusal to eat in the elderly.  Nutr Rev. 1998;  56 163-171
• 83 Masaki K H, Losonczy K G, Izmirlian G, Foley D J, Ross G W, Petrovitch H, Havlik R, White L R. Association of vitamin E and C supplement use with cognitive function and dementia in elderly men.  Neurology. 2000;  28 1265-1272
• 84 Masaki K H, White L R, Petrovitch H, Ross G W, Curb J D, Ardo E, Grove J. The influence of prior and concurrent use of aspirin and vitamins on cognitive function scores in elderly Japanese-American men.  Neurobiol Aging. 1994;  1 74
• 85 Mathey M FA, de Graaf C, Schimmel W, van Staveren W A. Effect of an evening supplement provided to nursing home elderly on body weight and dietary intake.  J Nutr and Aging. 2001, in press; 
• 86 Mathey M FA. Aging & appetite. Social and physiological approaches in the elderly. Thesis, Wageningen University 2000
• 87 Mayer K U, Baltes P B. Die Berliner Altersstudie. Berlin; Akademie Verlag Berlin 1996
• 88 McGee S, Abernethy W, Simel D L. Is this patient hypovolemic?.  JAMA. 1999;  281 1022-1029
• 89 Morley J E. The role of nutrition in the prevention of age-associated diseases. In: Morley JE, Glick Z, Rubenstein LZ (eds) Geriatric nutrition. A comprehensive review. New York; Raven Press 1990: 89-104
• 90 Morley J E. Anorexia in older persons. Epidemiology and optimal treatment.  Drugs and Aging. 1996;  8 (2) 134-155
• 91 Morley J E. Anorexia of aging: physiologic and pathologic.  Am J Clin Nutr. 1997;  66 760-773
• 92 Morley J E. Protein-energy malnutrition in older subjects.  Proc Nutr Soc. 1998;  57 587-592
• 93 Morley J E, Kraenzle D. Causes of weight loss in a community nursing home.  J Am Geriatr Soc. 1994;  42 583-585
• 94 Morley J E, Solomon D H. Major issues in geriatrics over the last five years.  J Am Geriatr Soc. 1994;  42 218-225
• 95 Morley J E, Thomas D R. Anorexia and aging: pathophysiology.  Nutrition. 1999;  15 499-503
• 96 Moulias R, Meaume S, Raynaud-Simon A. Sarcopenia, hypermetabolism, and aging.  Z Gerontol Geriat. 1999;  32 425-432
• 97 Mowé M, Bohmer T. Nutrition problems among home-living elderly people may lead to disease and hospitalization.  Nutr Rev. 1996;  54 22-24
• 98 Mowé M, Bohmer T, Kindt E. Reduced nutritional status in an elderly population (> 70 y) is probable before disease and possible contributes to the development of disease.  Am J Clin Nutr. 1994;  59 317-324
• 99 NAGE, British Dietetic Association .1994
• 100 National Center for Health Statistics .Plan and operation of the First, Second, Hispanic and Third Health and Nutrition Examination surveys. DHHS publications nos [PHS] 1973 - 1994: 79 - 1310; 81 - 1317; 85 - 1321; 94 - 1308
• 101 Niles R M. Recent advances in the use of vitamin A (retinoids) in the prevention and treatment of cancer.  Nutrition. 2000;  16 1084-1090
• 102 Nilsson-Ehle H, Jagenburg R, Landahl S, Lindstedt S, Svanborg A, Westin J. Serum cobalamins in the elderly: a longitudinal study of a representative population sample from age 70 to 81.  Eur J Haematol. 1991;  47 10-16
• 103 Nordiska Ministerrådet .Nordiska näringsrekommendationer. Köpenhamn; Nordiska Ministerradet 1996
• 104 Oakley G P. Eat right and take a multivitamin.  N Engl J Med. 1998;  338 (15) 1060-1061
• 105 Ortega R M, Requejo A M, Andrés P. Dietary intake and cognitive function in a group of elderly people.  Am J Clin Nutr. 1997;  66 803-809
• 106 Paffenbargar R S. Physical activity, all cause mortality, and longevity of college alumni.  N Engl J Med. 1986;  314 605
• 107 Paffenbarger R S, Williams J L. Chronic disease in former college students, V: Early precursors of fatal stroke.  Am J Publ Health. 1967;  57 1290-1299
• 108 Payette H, Gray-Donald K, Cyr R, Boutier V. Predictors of dietary intake in a functionally dependent elderly population in the community.  Am J Pub Health. 1995;  85 677-683
• 109 Payette H, Gray-Donald K, Cyr R. Predictors of dietary intake in a functionally dependent elderly population in the community.  Am J Clin Nutr. 1995;  85 677-683
• 110 Perrig W J, Perrig P, Stahelin H B. The relation between antioxidants and memory performance in the old and very old.  J Amer Geriatr Soc. 1997;  45 718-724
• 111 Phillips P A, Rolls B J, Ledingham J G. Reduced thirst after water deprivation in healthy elderly men.  N Engl J Med. 1984;  311 (12) 753-759
• 112 Poehlman E T. Effect of exercise on daily energy needs in older individuals.  Am J Clin Nutr. 1998;  68 (5) 998
• 113 Poehlman E T. Special Considerations in Design of Trials with Elderly Subjects: Unexplained Weight Loss, Body Composition and Energy Expenditure.  J Nutr. 1999;  129 (1) 260-263
• 114 Position of the American dietetic association . Medical nutrition therapy and pharmacotherapy.  J Am Diet Assoc. 1999;  99 227-230
• 115 Position of the American dietetic association . Nutrition, aging and the continuum of care.  ADA. 2000;  5 580-595
• 116 Report of working groups on energy requirements of older individuals.  Eur J Clin Nutr. 1996;  50 (1) 192
• 117 Riggs K M, Spiro A, Tucker K. Relations of vitamin B₁₂, vitamin B₆, folate and homocysteine to cognitive performance in the Normative Ageing Study.  Am J Clin Nutr. 1996;  63 306-314
• 118 Rimm E B, Willett W C, Hu F B. Folate and vitamin B6 from diet and supplements in relation to risk of coronary heart disease among women.  JAMA. 1998;  279 (5) 359-364
• 119 Ritz P. Physiology of aging with respect to gastrointestinal, circulatory and immune system changes and their significance for energy and protein metabolism.  Eur J Clin Nutr. 2000;  54 (I.3) 21-25
• 120 Riviere S, Birlouex-Aragon I, Nourhashemi F, Vellas B. Low plasma vitamin C in Alzheimer's patients despite an adequate diet.  Int J Geriatr Psychiatry. 1998;  13 749-754
• 121 Robbins L J. Evaluation of weight loss in the elderly.  Geriatrics. 1989;  44 31-37
• 122 Roberts S B, Fuss P, Evans W J, Heyman M B, Young V R. Energy expenditure, aging and body composition.  J Nutr. 1993;  123 (2) 474-480
• 123 Roberts S B, Fuss P, Heyman M B, Evans W J, Tsay R, Rasmussen H, Fiatarone M, Cortiella J, Dallai G E, Young V R. Control of Food intake in older men.  JAMA. 1994;  272 1601-1606
• 124 Rolls B J, Dimeo K A, Shide D J. Age-related impairments in the regulation of food intake.  Am J Clin Nutr. 1995;  62 923-931
• 125 Roubenoff R. Sarcopenia and its implications for the elderly.  Eur J Clin Nutr. 2000;  54 40-47
• 126 Roubenoff R, Hughes V A. Sarcopenia: Current concepts.  J Gerontol. 2000;  55A M716-M724
• 127 Rowe J W, Kahn R L. Human aging: usual and succesful.  Science. 1987;  237 143-149
• 128 Russel R M. Gastrointestinal function and aging. In: Morley JE, Glick Z, Rubenstein LZ (eds) Geriatric nutrition. A comprehensive review. New York; Raven Press 1990: 231-238
• 129 Russell R M. The aging process as a modifier of metabolism.  J Clin Nutr. 2000;  72 529-532
• 130 Saltzman J R, Russell R M. The aging gut. Nutritional issues.  Gastroenterol Clin North Am. 1998;  27 309-324
• 131 Sano M, Ernesto R G, Thomas M R, Klauber K, Schafer M, Grundman P, Woodbury J, Growdon C W, Cotmain E, Pfeiffer L S, Schneider L J, Thai A. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer's disease. The Alzheimer's Disease Cooperative Study.  New Eng J Med. 1997;  336 1216-1222
• 132 Savage D G, Lindenbaum J, Stabler S P, Allen R H. Sensitivity of serum methylmalonic acid and total homocysteine determinations for diagnosing cobalamin and folate deficiencies.  Am J Medicine. 1994;  96 239-246
• 133 Scarlett J D, Read H, O'Dea K. Protein-bound cobalamin absorption declines in the elderly.  Am J Haematol. 1992;  39 79-83
• 134 Schlettwein-Gsell D, Barclay D, Osler M. EURONUT-SENECA Nutrition and the Elderly in Europe. Dietary habits and attitudes.  Eur J Clin Nutr. 1991;  45 (3) 83-97
• 135 Schmidt R, Hayn M, Fazekas F, Kapeller P, Esterbaur H. Magnetic Resonance Imaging white matter hyperintensities in clinically normal elderly individuals: correlations with plasma concentrations of naturally occurring antioxidants.  Stoke. 1996;  27 2043-2047
• 136 Schroll K, Carbajal A, Decarli B. SENECA Nutrition and the elderly in Europe. Food patterns of elderly Europeans.  Eur J Clin Nutr. 1996;  50 (2) 86-100
• 137 Security, Department of H. a. S .Reports on Health and Social Subjects No. 3. A Nutrition Survey of the Elderly. Report by the Panel on the Nutrition of the Elderly. London; HMSO 1972
• 138 Security, Department of H. a. S .Report on Health and Social Subjects No. 16. Nutrition and Health in Old Age. The cross-sectional analysis of the findings of a survey made in 1972/73 of elderly people who had been studied in 1967/68. Report by the Committee on Medical Aspects of Food Policy. London; HMSO 1979
• 139 Seidell J C, Visscher T LS. Body weight and weight change and their health implications for the elderly.  Eur J Clin Nutr. 2000;  54 (3) 33-39
• 140 Seiler W O. Nutritional status of ill elderly patients.  Z Gerontol Geriatr. 1999;  32 (1) 7-11
• 141 Selhub J. Homocysteine metabolism.  Ann Rev Nutr. 1999;  19 217-246
• 142 Selhub J, Bagley L C, Miller J, Rosenberg I H. B vitamins, homocysteine and neurocognitive function in the elderly.  Am J Clin Nutr. 2000;  71 614-620
• 143 Selhub J, Jacques P, Rosenberg I, Rogers G, Bowman B, Gunter E, Wright J, Johnson C. Serum total homocysteine concentrations in the third National Health and Nutrition Examination Survey (1991 - 1994): Population reference ranges and contribution of vitamin status to high serum concentrations.  Ann Inter Med. 1999;  131 331-339
• 144 Sesso H D, Paffenbarger R SJ, Lee I M. Physical activity and coronary heart disease in men: The Harvard Alumni Health Study.  Circulation. 2000;  102 975-980
• 145 Shearer M J. The roles of vitamins D and K in bone health and osteoporosis prevention. Proceed.  Nutr Soc. 1997;  56 915-937
• 146 Shearer M J. Role of vitamin K and Gla proteins in the pathophysiology of osteoporosis and vascular calcification.  Current Opinion in Clinical and Metabolic Care. 2000;  3 433-438
• 147 Sheils J F, Rubin R, Stapleton D C. The estimated costs and savings of medical nutrition therapy: the Medicare population.  J Am Diet Assoc. 1999;  99 428-435
• 148 Shephard R J. Aerobic fitness and health, Champaign, Ill. Human Kinetics 1994
• 149 Silver A J, Morley J E, Strome S, Jones D, Vickers L. Nutritional status in an academic nursing home.  J Am Geriatr Soc. 1988;  36 487-491
• 150 Smith M A, Rottkamp C A, Nunomura A, Raina A K, Perry G. Oxidative stress in Alzheimer's disease.  Biochim Biophys Acta. 2000;  1502 139-144
• 151 Smithers G, Finch S, Doyle W CL, Bates C J, Prentice A, Clarke P C. The National Diet and Nutrition Survey: People Aged 65 Years and Over.  Nutrition and Food Science. 1998;  3 133-137
• 152 Snow C F. Laboratory diagnosis of vitamin B12 and folate deficiency: a guide for the primary care physician.  Arch Intern Med. 1999;  159 1289-1298
• 153 Sorkin J D, Muller D C, Andres R. Longitudinal Change in Height of Men and Women: Implications for Interpretation of the Body Mass Index.  J Epidemiol. 1999;  150 969-977
• 154 Sram R J, Binkova B, Topinka J, Kotesoved F, Fojtikova I, Hanel I, Klaschka J, Kocisova J, Prosek M, Machalek J. Effect of anti-oxidant supplementation in an elderly population.  Basic Life Sci. 1993;  61 459-477
• 155 Stabler S P, Marcell P D, Podell E R, Allen R H, Savage D G, Lindenbaum J. Elevation of total homocysteine in the serum of patients with cobalamin or folate deficiency detected by capillary gas chromatography-mass spectrometry.  J Clin Invest. 1988;  81 466-474
• 156 Steele J G, Sheiham A, Marcenes W, Walls A WG. National Diet and Nutrition Survey: People Aged 65 Years and Over. Report of the Oral Health Survey. London; The Stationery Office 1998 Vol. 2
• 157 Steen B. Preventive Nutrition in old age - A review.  The Journal of Nutrition, Health & Aging. 2000;  4 114-119
• 158 Stehouwer C D, Weijenberg M P, van den Berg M. Serum homocysteine and risk of coronary heart disease and cerebrovascular disease in elderly men: a 10-year follow-up.  Arterioscler Thromb Asc Biol. 1998;  18 1895-1901
• 159 Stevens J. The effect of age on the association between Body-Mass-Index and mortality.  N Engl J Med. 1998;  338 1-7
• 160 Sullivan D H. Impact of nutritional status on health outcomes of nursing home residents.  J Am Geriatr Soc. 1995;  43 195-196
• 161 Sullivan D H. The role of nutrition in increased morbidity and mortality.  Clin Geriatr Med. 1995;  11 661-672
• 162 Sullivan D H, Lipschitz D A. Evaluating and treating nutritional problems in older patients.  Clin Geriatr Med. 1997;  13 753-768
• 163 Sullivan D H, Sun S, Walls R C. Protein-energy Undernutrition Among Elderly Hospitalized Patients.  JAMA. 1999;  281 2013-2019
• 164 Suter P M, Golner B B, Goldin B R, Morrow F D, Russell R M. Reversal of protein-bound vitamin B₁₂-malabsorption with antibiotics in atrophic gastritis.  Gastroenterology. 1991;  101 1039-1045
• 165 Taunton J E, Martin A D, Rhodes E C, Wolski L A, Donelly M, Elliot J. Exercise for older woman: choosing the right prescription.  Br J Sports Med. 1997;  31 5-10
• 166 Tayback M, Kumanyika S, Chee E. Body weight as a risk factor in the elderly.  Arch Intern Med. 1990;  150 1065-1072
• 167 Thomas D R, Ashmen W, Morley J E, Evans W J. Nutritional Management in long-term care: development of a clinical guideline.  J Gerontology Med Sc. 2000;  55A M725-M734
• 168 Tricopoulou A, Kouris-Blaza A, Wahlqvist M L. Diet and overall survival in elderly people.  Br Med J. 1995;  311 1457-1460
• 169 Ubbink J B. Should all elderly people receive folate supplements?.  Drugs and Aging. 1998;  13 415-420
• 170 van Asselt D Z, de Groot L CP, van Staveren W A. Role of cobalamin intake and atrophic gastritis in mild cobalamin deficiency in older Dutch subjects.  Am J Clin Nutr. 1998;  68 328-334
• 171 van Asselt D ZB, de Groot C PGM, van Staveren W A. Role of cobalamin intake and atrophic gastritis in mild cobalamin deficiency in older Dutch subjects.  Am J Clin Nutr. 1998;  68 328-334
• 172 van der Wielen R PJ. Vitamin intake and status in elderly Europeans. The Netherlands, Wageningen University, Dep of Human Nutr 1995: 161-167
• 173 van der Wielen R PJ, Wild G, Groot C PG, Hoefnagels W HL, van Staveren W A. Dietary intakes of energy and water soluble vitamins in different categories of aging.  J Gerontol. 1996;  51A (1) B100-B107
• 174 Vellas B, Guigoz Y, Baumgarter M, Garry P J, Lauque S, Albarede J L. Relationships between nutritional markers and the mini-nutritional assessment in 155 older persons.  J Am Geriatr Soc. 2000;  48 1300-1309
• 175 Vellas B J, Albarede J L, Garry P J. Diseases and aging: Patterns of morbidity with age: Relationship between aging and age-associated diseases.  Am J Clin Nutr. 1992;  55 1225-1230
• 176 Vetta F, Ronzoni S, Taglieri G. The impact of malnutrition on the quality of life in the elderly.  Clin Nutr. 1999;  18 259-267
• 177 Vita P J, Tery R B, Hubert H B, Fries J F. Aging, health risks, and cumulative disability.  N Engl J Med. 1998;  338 1035-1041
• 178 Volkert D. Ernährung im Alter. Wiesbaden; Quelle & Meyer 1997
• 179 Wahlqvist M L, Kouris-Blazos A, Savige G S. Older people: Physiological Changes. In: Sadler MJ, Strain JJ, Caballero B (eds) Encyclopedia of human nutrition. London; Academic Press 1999: 1471-1479
• 180 Walmsley C M, Bates C J, Prentice A, Cole T J. Relationship between cigarette smoking and nutrient intakes and blood status indices of older people living in the UK: further analysis of data from the National Diet and Nutrition Survey of people aged 65 years and over, 1994/95.  Public Health Nutrition. 1999;  2 199-208
• 181 WHO expert committee .Physical status: the use and interpretation of anthropometry. Geneva; WHO technical report series 854 1995
• 182 Williams P T. Relationships of heart disease risk factors to exercise quantity and intensity.  Arch Intern Med. 1998;  158 237-245
• 183 Woo J. Relationship among diet, physical activity and other lifestyle factors and debilitating diseases in the elderly.  Eur J Clin Nutr. 2000;  54 (3) 143-147
• 184 World Health Organization .World Atlas of Aging. In: WHO Technical Series 1998 98: 1
• 185 World Health Organization .Nutritional Guidelines for Healthy Aging. in preparation
• 186 World Health Organization .Physical status The use and interpretation of anthropometry. Genf; Report of a WHO Expert Committee 1995
• 187 Wright J D, Bialostosky K, Gunter E W, Carroll M D, Najjar M F, Bowman B A, Johnson C L. Blood folate and vitamin B12: United States, 1988 - 1994.  Vital Health Stat. 1998;  11 1-78
• 188 Young A, Dinan S. Fitness for older people.  BMJ. 1994;  309 331-334
• 189 Young V R. Macronutrient needs in the elderly.  Nutr Rev. 1992;  50 454-462