title: Nutritional counselling in disabled people: effects on dietary patterns, body composition and cardiovascular risk factors.
abstract: OBJECTIVE
  Disabled persons are frequently affected by nutritional status impairment, consequent to quantitative and qualitative inadequacy of diet and physical inactivity, resulting in a significant reduction of fat-free mass and bone mineral density (BMD), and an over-expression of fat mass and an increased number of biochemical risk factors for chronic degenerative diseases. The aim of this study was to analyse the applicability and the efficacy of a nutritional counselling intervention in order to improve dietary intake and nutritional status in disabled people.
  
  
  METHODS
  Thirty-seven disabled subjects (24 with physical disability and 13 with both mental retardation and physical disability; age 33.5+/-9.2 years) underwent an assessment of nutritional status, and an intervention with nutritional counselling was proposed to each patient for one year. Anthropometric measurements, indirect calorimetry, dual-energy X-ray absorptiometry, dietary intake, and biochemical analysis at baseline (T0) and after one year (T1) of counselling intervention were performed.
  
  
  RESULTS
  Sixty-five percent of patients dropped out. Overall, no significant improvement in cardiovascular risk factors, body composition and dietary patterns was reported at T1 in completer subjects. Six subjects who were obese or overweight at T0, reported significant weight and fat mass (FM) reduction at T1 (P=0.01 and P=0.00, respectively).
  
  
  CONCLUSIONS
  Nutritional counselling seems to be ineffective and poorly applicable to disabled people. Further studies should be directed towards a treatment program associated with careful screening, motivation analysis, and follow-up in this patient population.
authors.affiliation: International Center for the Assessment of Nutritional Status, University of Milan, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Bertoli
authors.forename: A
authors.initials: A
authors.lastname: Spadafranca
authors.forename: G
authors.initials: G
authors.lastname: Merati
authors.forename: G
authors.initials: G
authors.lastname: Testolin
authors.forename: A
authors.initials: A
authors.lastname: Veicsteinas
authors.forename: A
authors.initials: A
authors.lastname: Battezzati
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000886:Anthropometry; D001823:Body Composition; D002153:Calorimetry, Indirect; D016009:Chi-Square Distribution; D003376:Counseling; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005247:Feeding Behavior; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D015596:Nutrition Assessment; D009752:Nutritional Status; D018529:Nutritional Support; D010101:Oxygen Consumption / Q000502:physiology; D010349:Patient Compliance; D012307:Risk Factors; D018709:Statistics, Nonparametric