title: Modelling nutritional services in relation to the health status of older individuals living on Mediterranean islands.
abstract: BACKGROUND
  The world's population is ageing and it has been suggested that improvements to health, wellbeing and lifespan can be attributed to improved standards of living, especially regarding diet and nutritional status. The impact of nutritional services provided by a dietician on an older population's health status has not been well evaluated or documented. This study sought to determine whether an association exists between available nutritional services and older people's health status in selected Greek islands and the Cyprus Republic.
  
  
  METHODS
  During 2010, information on nutritional services provided in 9 Greek Islands and the Cyprus Republic was retrieved through interviews of almost all dieticians (n=88) working on these islands. The health status (ie prevalence of hypertension, diabetes, hypercholesterolemia, obesity) of the older population studied (aged >65 years) was retrieved from the Mediterranean Islands Study (MEDIS).
  
  
  RESULTS
  The main reasons for an older person's visit to a dietician was for the treatment of diabetes (79%), hypercholesterolemia (75%) and obesity (70%); 90% of older individuals visited the dietician on a physician's recommendation and 45% of them completed their consultations. The longer the presence of a dietician on an island, the lower the likelihood of observing the prevalence of hypertension (OR=0.59, 95% CI=0.36-0.94), hypercholesterolemia (OR=0.66, 95%CI=0.46-0.95), diabetes (OR=0.77, 95%CI=0.61-0.96) and obesity (OR=0.66, 95%CI=0.45-0.95) above the median rate of the population studied. Financial concerns and a long distance from home to the dieticians' office were the major reasons for ceasing visits to the dietician.
  
  
  CONCLUSIONS
  Enhancing nutritional services within the healthcare system may contribute to reducing the burden of disease among older adults and, consequently, improve their quality of life.
authors.affiliation: Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Tyrovolas
authors.forename: E
authors.initials: E
authors.lastname: Polychronopoulos
authors.forename: Y
authors.initials: Y
authors.lastname: Tountas
authors.forename: D B
authors.initials: DB
authors.lastname: Panagiotakos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003535:Cyprus; D058620:Elder Nutritional Physiological Phenomena; D005260:Female; D006296:Health Services; D006304:Health Status; D006801:Humans; D006937:Hypercholesterolemia / Q000178:diet therapy*; D006973:Hypertension / Q000178:diet therapy*; D008297:Male; D008521:Mediterranean Islands; D009752:Nutritional Status; D009765:Obesity / Q000178:diet therapy*