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B. Sturtzel, G. Ohrenberger, I. Elmadfa

J Aging Res Clin Practice 2013;2(1):99-103

Background: Little is known about the protein needs of diseased elderly. Geriatric patients often eat less and are therefore not adequately nourished. Objective: The PRINT (PRotein INTervention)-Study evaluated, in a 36 weeks intervention, if it is possible to increase the protein-energy-intake of institutionalized geriatric patients through protein-energy-optimized meals and if these arrangements could help to improve the nutritional status. Design: A controlled parallel intervention trial. It compares the protein-energy- intake of geriatric patients from protein-energy-optimized meals (intervention group) with common meals (control croup) served from the catering- service-system of a geriatric hospital. Setting: Geriatric hospital in Vienna. Participants: Included: Patients with oral food intake. Excluded: Patients with enteral or parenteral nutrition or taking supplements. 144 geriatric patients with a mean age of 84.9 (± 9.3) years gave their consent to take part in the study.16.6% were men and 83.4% were woman. 82 patients with a mean age of 84.2 (±9.5) years completed the intervention-protocol. Intervention: The intervention was realized with two arrangements. Arrangement 1 (week 1 to 36): Protein optimization of the daily served soups, purees or desserts by adding additional eggs, whipping cream or soured cream (≈ 4g protein/person/d). Arrangement 2 (week 23 to 36): Protein optimization through an additionally daily served cup of milk (200ml) (≈ 8g protein/person/d). With both arrangements together, according the calculation-plan, a mean protein optimization of ≈12g protein/d was reached. Measurements: Protein-energy- intakes were assessed by means of 3-day-weighing records at week 1, week 20 and week 36 of intervention-time. Albumin, serum total protein and bodyweight were taken from the medical report at week 1, week 20 and week 36 of intervention-time. The non-parametric Friedman test for repeated measurements was used to establish the differences within the groups (sig. p<0.05). Results: In the intervention group protein/energy intake increased significantly (p<0.001/p<0.001), serum total protein concentrations increased significantly (p=<0.01) and bodyweight was kept constant (p= 0.993). In the control group protein/energy intake (p<0.001/p<0.001) and bodyweight (p< 0.05) decreased significantly. During intervention- time 12% of the intervention and 20% of the control participants died. Discussion: For geriatric patients a low-dose, long-term protein-energy-addition to the daily meals provision of the catering-system-service could help to improve their protein-energy-intake and nutritional status

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