title: Intensive dietary intervention by a dietitian as a case manager among community dwelling older adults: the EDIT study.
abstract: BACKGROUND
  Clinical trials that have assessed the best approach for treating under-nutrition in old age are scarce.
  
  
  OBJECTIVE
  To determine the impact of an intensive nutritional intervention program led by a dietitian on the health and nutritional status of malnourished community dwelling older adults.
  
  
  METHODS
  Sixty-eight eligible participants (age<75) were randomly assigned to a Dietetic Intervention Treatment (DIT), an intensive nutritional intervention led by a dietitian, or a Medical Treatment (MT), a physician-led standard care group, with an educational booklet regarding dietary requirements and recommendations for older adults. An additional 59 eligible participants who were unable to participate in the randomization were included as a non-randomized "untreated nutrition" group (UNG).
  
  
  RESULTS
  Over the 6-month follow-up, the DIT group showed significant improvement in cognitive function (from 25.8±4.5 to 26.8±4, p=0.04), and depression score (from 7.3±3.9 to 5.4±3.9, p=0.04) compared with the change in the other 2 groups. The DIT group showed a significant improvement in intake of carbohydrates (+15% vs. +1% in the MT and +3% in the UNG), protein (+8% vs. +2% in the MT and -3% in the UNG), vitamin B6 (+20% vs. +7% in the MT and +8% in the UNG), and vitamin B1 (+22% vs. +11% in the MT and 0% in the UNG). The DIT group had a significantly lower cost of physician visits than the other 2 groups ($172.1±232.0 vs. $417.2±368.0 in the MT and $428.1±382.3 in the UNG, p=0.005).
  
  
  CONCLUSIONS
  Intensive dietary intervention was moderately effective in lowering cost of services used and improving medical and nutritional status among community dwelling older adults.
authors.affiliation: Department of Public Health, University of Haifa, Haifa, Israel. rendevelt@univ.haifa.ac.il
authors.forename: R
authors.initials: R
authors.lastname: Endevelt
authors.forename: J
authors.initials: J
authors.lastname: Lemberger
authors.forename: J
authors.initials: J
authors.lastname: Bregman
authors.forename: G
authors.initials: G
authors.lastname: Kowen
authors.forename: I
authors.initials: I
authors.lastname: Berger-Fecht
authors.forename: H
authors.initials: H
authors.lastname: Lander
authors.forename: T
authors.initials: T
authors.lastname: Karpati
authors.forename: D R
authors.initials: DR
authors.lastname: Shahar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019090:Case Management; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000191:economics / Q000517:prevention & control*; D003863:Depression / Q000178:diet therapy* / Q000191:economics; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D004046:Dietetics / Q000379:methods; D002149:Energy Intake; D005260:Female; D006266:Health Education / Q000191:economics / Q000379:methods*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000178:diet therapy* / Q000191:economics; D009752:Nutritional Status; D009819:Office Visits / Q000191:economics; D059039:Standard of Care / Q000191:economics; D013831:Thiamine / Q000008:administration & dosage; D025101:Vitamin B 6 / Q000008:administration & dosage
chemical_list: D004040:Dietary Carbohydrates; D004044:Dietary Proteins; D025101:Vitamin B 6; D013831:Thiamine