title: Impact of restrictive diets on the risk of undernutrition in a free-living elderly population.
abstract: OBJECTIVE
  Elderly subjects are at risk for undernutrition. Restrictive diets may increase this risk. The aim was to evaluate the impact of restrictive diets on undernutrition and its risk in free-living elderly.
  
  
  METHODS
  Ambulatory patients over age 75 and under a restrictive diet (low salt, low cholesterol, diabetic) were included prospectively, along with age- and gender-matched controls. Weight and height were measured, and the short-form of the Mini Nutritional Assessment was scored. Groups were compared to determine variables associated with a low MNA-SF(®).
  
  
  RESULTS
  95 patients in the diet group (62 F, 33 M, 80 ± 4 y) and 95 controls (57 F, 38 M, 82 ± 5 y) were included. Restrictive diets (low salt n = 33, diabetic n = 19, low cholesterol n = 15, combination n = 27) had been followed since 11.0 ± 5.9 years. Using the cut-off of 12 for MNA-SF(®), 44 patients in the diet group were at risk vs. 22 among controls (P < 0.001). In multivariate analysis, a restrictive diet increased the probability of having an MNA-SF(®) < 12 (OR = 3.6, (95%)CI = 1.8-7.2, P < .001).
  
  
  CONCLUSIONS
  Restrictive diets in patients over 75 increase the risk of undernutrition. On an individual level, these diets may need reassessment. Society guidelines should promote specific recommendations for the elderly.
authors.affiliation: Service de Gastroentérologie et Nutrition Clinique, Pôle Digestif, Centre Hospitalier Universitaire de Nice, France.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Zeanandin
authors.forename: Omar
authors.initials: O
authors.lastname: Molato
authors.forename: Franck
authors.initials: F
authors.lastname: Le Duff
authors.forename: Olivier
authors.initials: O
authors.lastname: Guérin
authors.forename: Xavier
authors.initials: X
authors.lastname: Hébuterne
authors.forename: Stéphane M
authors.initials: SM
authors.lastname: Schneider
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003927:Diet, Diabetic; D018752:Diet, Fat-Restricted; D004039:Diet, Sodium-Restricted; D058620:Elder Nutritional Physiological Phenomena; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D011446:Prospective Studies; D012307:Risk Factors