Die effek van energie-, proteïen-, vitamien-, en mineraalsupplementering op die voedingstatus van gehospitaliseerde bejaardes

Abstract

At present about 4% of the total population of South Africa is older than 65 years. The combined effect of the decrease in fertility and mortality has resulted in a increase in the percentage of the elderly. Seven percent of the South African population is institutionalized. Studies done in other countries have shown that malnutrition is common in hospitalized elderly. The purpose of this study was to: assess the nutritional status of the hospitalized elderly assess the effect of a high energy, protein, vitamin and mineral supplement on the nutritional status of the hospitalized elderly. The nutritional status of 55 men and 60 women over the age of 54 years was determined by anthropometry, dietary data, biochemical blood analyses and immune status in the Goodwood Aftercare Centre. The body mass index of the majority of the men and women fell within the normal range. According to the triceps skinfold thickness 11, 8% of men and 45; 8% of women showed energy depletion, The mid-arm muscle circumference of 21,4% of men and 20,8% of women indicated protein depletion. The mean energy intake of both men and women was less than the recommended dietary allowances (RDA). The mean dietary intakes of calcium, iron (only in women), magnesium, zinc, copper, thiamine, nicotinic acid, vitamin B6, folic acid and ascorbic acid (only in women) were less than the RDA.

The serum total protein and albumin levels of approximately 31% of men and 42% of women were low. Forty seven percent of men had low serum total iron levels and 41, 5% 1 ow hemoglobin levels. More than 50% of men and women had a biochemical thiamine deficiency while 39% of both men and women a vitamin B6 deficiency. The majority of men and 77% of women had low serum folic acid levels. The leucocyte ascorbic acid levels of 71% of men and women were low. Thirty one percent of men and 40,5% of women were classified as anergic. Twenty men and 20 women received, in addition to their normal diet, a high energy, protein, vitamin and mineral supplement (experimental group). After seven weeks their nutritional status was again assessed. This dietary supplement consisted of food as such (for example full acream milk powder, egg, orange juice, etc), as well as vitamin tablets (vitamin A, B-complex, folic acid and ascorbic acid) and mineral tablets (iron gluconate). During that same period a control group of 20 men and 20 women received only the normal hospital diet. After supplementation, the weight and body mass index of the men in the experimental group were significantly higher than those of the men in the control group. No significant change occurred in the anthropometry of the women in the experimental group compared with the, women in the control group. The dietary supplement significantly increased energy and nutrient intake of both men and women in the experimental groups in comparison with the control groups. The mean biochemical changes in the serum carotene, folic acid and plasma piridoxal phosphate levels in the experimental group were significantly higher

after supplementation in comparision with the control group. After supplementation there was no significant change in the immune status of the experimental groups in comparison with the control groups. This study has shown that the nutritional status of this group of elderly was poor. It also showed that a dietary supplement could improve their nutritional status.