Effects of nutritional intervention and physical training on energy intake, resting metabolic rate and body composition in frail elderly. a randomised, controlled pilot study.
OBJECTIVE
To analyse the effect of nutritional intervention and physical training on energy intake, resting metabolic rate (RMR) and body composition in the frail elderly.


METHODS
Open, randomised, controlled pilot treatment study.


METHODS
Community-based research centre.


METHODS
Ninety-six community-dwelling frail elderly people aged 75 and older, 40% men.


METHODS
Four treatment arms: i) individual nutritional advice and group sessions on nutrition for the elderly, ii) physical training 2 x 45 minutes per week for 3 months, iii) combined nutritional and physical intervention and iv) control group.


METHODS
The outcomes were energy intake (4-day food diary); resting metabolic rate (indirect calorimetry) and body composition (anthropometry) performed at baseline, after 3 months' intervention (completed by 79 individuals), and as a follow-up at 9 months (completed by 64 individuals).


RESULTS
The training group showed a significantly increased RMR at 3 months. Otherwise, there were no observed differences within or between the four groups. There was no correlation over time between energy intake, RMR and fat free mass. The participants with a low energy intake who managed to increase their energy intake during the study ('responders') had a statistically significantly lower BMI (21 vs. 24) and a lower fat percentage (23 vs. 30) at baseline than the 'non-responders'. The 'non-responders' showed a small but statistically significant decrease in body fat percentage at F1, and in body weight, BMI and FFM at 9 months (F3).


CONCLUSIONS
Individual nutrition counselling and physical exercise had no effect on energy intake, RMR or fat free mass in community-dwelling frail elderly people aged 75 and older. Interventions in frail elderly people should be targeted according to the needs of the individual patients. The issues of randomisation, targeting and responders in are problematised and discussed.
Department of Laboratory Medicine, Division of Clinical Physiology, Karolinska Institutet, Karolinska University Hospital, 141 86 Stockholm, Sweden.
E
E
Lammes
E
E
Rydwik
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G
Akner
D000368:Aged; D000369:Aged, 80 and over; D001481:Basal Metabolism / Q000502:physiology*; D001823:Body Composition / Q000502:physiology*; D002153:Calorimetry, Indirect; D002149:Energy Intake / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D006801:Humans; D008297:Male; D052756:Nutritional Sciences / Q000193:education*; D010865:Pilot Projects; D016896:Treatment Outcome