Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-26T08:47:14.545Z Has data issue: false hasContentIssue false
  • English
  • Français

Nutrition, ageing and ill health

Published online by Cambridge University Press:  22 August 2007

S. E. Gariballa  and
A. J. Sinclair
S. E. Gariballa*
Affiliation:
Academic Department of Geriatric Medicine, The University of Birmingham, The Hayward Building, Selly Oak Hospital, Raddlebarn Road, Birmingham B29 6JD, UK
A. J. Sinclair
Affiliation:
Academic Department of Geriatric Medicine, The University of Birmingham, The Hayward Building, Selly Oak Hospital, Raddlebarn Road, Birmingham B29 6JD, UK
*
*Corresponding author: Dr S. E. Gariballa, fax +44 (0)121 627 8304, email C.A.Dyer@bham.ac.uk
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

There are physical, mental, social and environmental changes which take place with ageing; for example, decreased physical activity, increase in body fat, decrease in lean body mass and consequently decreased energy intake may be associated with physiological functions that affect metabolism, nutrient intake, physical activity and risk of disease. There are now many studies which have found that undernutrition is prevalent and often unrecognized in patients admitted to hospitals and institutions. There is also evidence which links protein-energy undernutrition or its markers with clinical outcomes in acute and non-acute hospital settings and that nutritional supplements can improve outcomes in some of these settings. However, most clinically-available nutrition screening instruments lack sensitivity and specificity, and abnormal nutritional indicators may simply reflect effects of age, functional disability, or severe underlying disease. Thus, causal relationship cannot be assumed without a sufficiently powerful intervention study which adequately adjusts for the effects of non-nutritional factors, such as the number and severity of co-morbid conditions on clinical outcome.

Keywords

NutritionAgeingIll healthClinical outcome
Type
Review Article
Information
British Journal of Nutrition , Volume 80 , Issue 1 , July 1998 , pp. 7 - 23
Copyright
Copyright © The Nutrition Society 1998

References

Acheson, RM & Williams, DRR (1983) Does consumption of fruit and vegetables protect against stroke. Lancet i, 1191–1193.CrossRefGoogle Scholar
Agarwal, N, Acevedo, F, Leighton, L, Cayten, CG & Pitchumoni, CS (1988) Predictive ability of various nutritional variables for mortality in elderly people. American Journal of Clinical Nutrition 48, 1173–1178.CrossRefGoogle ScholarPubMed
Altura, BT, Burton, M & Altura, M (1984) Interactions of Mg and K on cerebral vessels – aspects in view of stroke. Magnesium 3, 195–211.Google Scholar
Aptaker, RL, Roth, FJ, Reichhardt, G, Querden, ME & Levy, CE (1994) Serum albumin level as a predictor of geriatric stroke rehabilitation outcome. Archives of Physical and Medical Rehabilitation 75, 80–84.CrossRefGoogle ScholarPubMed
Barer, D, Leibowitz, R, Ebrahim, S, Pengally, D & Neale, R (1989) Vitamin C status in patients with stroke and other acute illnesses. Journal of Clinical Epidemiology 42, 625–631.CrossRefGoogle ScholarPubMed
Bassey, EJ & Harries, UJ (1993) Normal values for handgrip strength in 920 men and women aged over 65 years, and longitudinal changes over 4 years in 620 survivors. Clinical Science 84, 331–337.CrossRefGoogle ScholarPubMed
Bassey, EJ & Terry, AM (1988) Blood lactate in relation to oxygen uptake during uphill treadmill walking in young and old women. Journal of Physiology 396, 104p Abstr.Google Scholar
Bassey, EJ & Terry, AM (1986) The oxygen cost of walking in the elderly. Journal of Physiology 373, 42p Abstr.Google Scholar
Bastow, MD, Rawlings, J & Allison, SP (1983) Benefits of supplementary tube feeding after fractured neck of femur. British Medical Journal 287, 1589–1592.CrossRefGoogle ScholarPubMed
Basu, TK, Aksoy, M & Dickerson, JWT (1979) Effects of 5-fluorouracil on thiamin status of adult female rats. Chemotherapy 25, 70–76.CrossRefGoogle ScholarPubMed
Beaumont, D, Lehmann, AB & James, OFW (1989) Protein turnover in malnourished elderly subjects: the effect of refeeding. Age and Ageing 18, 235–240.CrossRefGoogle ScholarPubMed
Bogden, JD, Oleske, JM, Lavenhar, MA, Munves, EM, Kemp, FW, Blruening, KS, Holding, KJ, Denny, TN, Guarino, MA, Krieger, LM & Holland, BK (1988) Zinc and immunocompetence in elderly people: Effect of zinc supplementation for 3 months. American Journal of Clinical Nutrition 8, 655–663.CrossRefGoogle Scholar
Brocklehurst, JC, Griffiths, LL, Taylor, GF, Marks, J, Scott, DL & Blackley, J (1968) The clinical features of chronic vitamin deficiency – A therapeutic trial in geriatric hospital patients. Gerontologica Clinica 10, 309–320.CrossRefGoogle ScholarPubMed
Bunker, VW & Clayton, BE (1989) Research Review: Studies in the nutrition of elderly people with particular reference to essential trace elements. Age and Ageing 18, 422–429.CrossRefGoogle ScholarPubMed
Busse, EW (1980) Eating in late life: physiological and psychological factors. American Pharmacology 20, 36–38.CrossRefGoogle Scholar
Buzby, GP, Mullen, J, Mathews, DC, Hobbs, CL & Rosato, EF (1979) Prognostic nutritional index in gastrointestinal surgery. American Journal of Surgery 139, 160–167.CrossRefGoogle Scholar
Campbell, WW, Crim, MC, Dallal, GE, Young, VR & Evans, WJ (1994) Increased protein requirements in elderly people. American Journal of Clinical Nutrition 60, 501–509.CrossRefGoogle ScholarPubMed
Cederholm, T & Hellstrom, K (1992) Nutritional status in recently hospitalised and free-living elderly subjects. Gerontology 38, 105–110.CrossRefGoogle ScholarPubMed
Chandra, RK (1983) Nutrition, immunity and infection. Lancet i, 688–690.CrossRefGoogle Scholar
Chandra, RK (1989) Nutritional regulation of immunocompetence and risk of disease. In Nutrition in the Elderly, pp. 203–218 [Horwitz, A, Macfadyen, DM, Munro, H, Scrimshaw, NS, Steen, B and Williams, TF, editors]. Oxford: Oxford University Press.Google Scholar
Chandra, RK (1992) Effect of vitamin and trace-element supplementation on immune response and infection in elderly people. Lancet 340, 1124–1127.CrossRefGoogle Scholar
Christou, NV, Meakins, JL, Gordon, J, Yee, J, Hassan, ZM, Nohr, CW, Chizgal, HM & McLean, LD (1995) The delayed hypersensitivity response and host resistance in surgical patients: 20 years later. Annals of Surgery 222, 534–548.CrossRefGoogle ScholarPubMed
Chumlea, WC, Baumgartner, RN, Garry, PJ, Rhyne, RL, Nickolson, C & Wayne, S (1992) Fat distribution and blood lipids in a sample of healthy elderly people. International Journal of Obesity 16, 125–133.Google Scholar
Chumlea, WC & Vellas, MD (1994) Anthropometry and body composition in the elderly. In Nutrition in the Elderly, Suppl. 2, pp. 61–70 [Vellas, BJ, Guigoz, Y, Garry, PJ and Albarede, JL, editors]. Paris: Serdi Publishing Company.Google Scholar
Dallosso, HM, Morgan, K, Bassey, EJ, Ebrahim, SB, Fentem, PH & Arie, TH (1988) Levels of customary physical activity among the old and the very old living at home. Journal of Epidemiology and Community Health 42, 121–127.CrossRefGoogle ScholarPubMed
Dawson, D, Hendershot, G & Fulton, J. Ageing in the Eighties: Functional Limitations of Individuals 65 and over. NCHS Advance Data from Vital Health Statistics no. 133, DHHS Publication (PHS) no. 87–1250. Hyattsville, Wyoming: Public Health Service.Google Scholar
Dawson-Hughes, B, Harris, SS, Krall, EA & Dallal, GE (1997) Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age and older. New England Journal of Medicine 337, 670–676.CrossRefGoogle Scholar
de Groot, LCPGM, van Staveren, WA & Hautvast, JGAG (1991) Euronut SENECA Study. European Journal of Clinical Nutrition 45, Suppl. 3, 1–196.Google Scholar
de Keyser, J, De Klippel, N, Merkx, H, Vervaeck, M & Merroelen, L (1992) Serum concentrations of vitamin A and E and early outcome after ischaemic stroke. Lancet 339, 1562–1565.CrossRefGoogle Scholar
Delmi, M, Rapin, C-H, Bengoa, JM, Delmas, PD, Vasey, H & Bonjour, JP (1990) Dietary supplementation in elderly patients with fractured neck of femur. Lancet 335, 1013–1016.CrossRefGoogle Scholar
Dempsey, DT, Mullen, JL & Buzby, GP (1988) The link between nutritional status and clinical outcome. American Journal of Clinical Nutrition 47, 352–356.CrossRefGoogle ScholarPubMed
Department of Health (1991) Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Report on Health and Social Subjects no. 41. London: HM Stationery Office.Google Scholar
Department of Health (1992) Nutrition in the Elderly. Report on Health and Social Subjects no. 43. London: HM Stationery Office.Google Scholar
Department of Health and Social Security (1972) Nutritional Survey of the Elderly. Report on Public Health and Medical Subjects no 3. London: HM Stationery Office.Google Scholar
Department of Health and Social Security (1979 a) A Nutrition Survey of the Elderly. Report on Health and Social Subjects no. 13. London: HM Stationery Office.Google Scholar
Department of Health and Social Security (1979 b) Nutrition and Health in Old Age. Report on Health and Social Subjects no. 16. London: HM Stationery Office.Google Scholar
De Waart, FG, Portengen, L, Dockes, G, Verwaal, CJ & Kok, FJ (1997) Effect of 3 months vitamin E supplementation on indices of the cellular and humoral immune response in elderly subjects. British Journal of Nutrition 78, 761–774.CrossRefGoogle ScholarPubMed
Dionigi, R, Dominioni, L, Jemos, V, Cremaschi, R & Monico, R (1986) Diagnosing malnutrition. Gut 21, Suppl. 1, 5–8.CrossRefGoogle Scholar
Drinka, PJ & Goodwin, JS (1991) Prevalence and consequence of vitamin deficiency in the nursing homes: A critical review. Journal of the American Geriatric Society 39, 1008–1017.CrossRefGoogle ScholarPubMed
Durnin, JV & Womersley, S (1974) Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. British Journal of Nutrition 32, 77–97.CrossRefGoogle ScholarPubMed
Durnin, JVGA (1961) Food intake and energy expenditure of elderly people. Clinical Gerontology 4, 128–133.CrossRefGoogle Scholar
Durnin, JVGA (1985) Energy intake, energy expenditure and body composition in the elderly. In Nutrition, Immunity and Illness in the Elderly, pp. 19–33 [Chandra, RK, editor]. New York: Pergamon Press.Google Scholar
Durnin, JVGA & Lean, MEJ (1992) Nutrition – consideration for the elderly. In Textbook of Geriatric Medicine and Gerontology, pp. 592–611 [Brocklehurst, JC, Tallis, RC and Fillit, HM, editors]. London: Churchill Livingstone.Google Scholar
Elmstahl, S & Steen, B (1987) Hospital nutrition in geriatric long term care medicine: 11. Effects of dietary supplements. Age and Ageing 16, 73–80.CrossRefGoogle ScholarPubMed
Exton-Smith, AN (1980) Nutritional status: diagnosis and prevention of malnutrition. In Metabolic and Nutritional Disorders in the Elderly, pp. 66–76 [Exton-Smith, AN and Caird, FI, editors]. Bristol: John Wright & Sons.Google Scholar
Ferro-Luzzi, A, Mobarhan, S, Maiani, G, Scaccini, C, Sette, S & Nicastro, A (1988) Habitual alcohol consumption and nutritional status of the elderly. European Journal of Clinical Nutrition 42, 5–13.Google ScholarPubMed
Fiatarone, MA, O'Neil, EF, Ryan, ND, Clements, KM, Solares, GR, Nelson, ME, Roberts, SB, Kehayias, JJ, Lipsitz, LA & Evans, WJ (1994) Exercise training and nutritional supplementation for physical frailty in very elderly people. New England Journal of Medicine 330, 1769–1775.CrossRefGoogle ScholarPubMed
Forbes, GB & Reina, JC (1970) Adult lean body mass declines with age: Some longitudinal observations. Metabolism 19, 653–663.CrossRefGoogle ScholarPubMed
Fotherby, MD & Potter, JF (1992) Potassium supplementation reduces clinic and ambulatory blood pressure in elderly hypertensive patients. Journal of Hypertension 10, 1403–1408.CrossRefGoogle ScholarPubMed
Fuller, NJ, Sawyer, MB, Laskey, MA, Paxton, P & Elia, M (1996) Prediction of body composition in elderly men over 75 years of age. Annals of Human Biology 23, 127–147.CrossRefGoogle ScholarPubMed
Gale, CR, Martyn, CN, Winter, PD & Cooper, C (1995) Vitamin C and risk of death from stroke and coronary heart disease in cohort of elderly people. British Medical Journal 310, 1563–1566.CrossRefGoogle ScholarPubMed
Garrow, J (1994) Starvation in hospital. British Medical Journal 308, 934.CrossRefGoogle ScholarPubMed
Geissler, CA & Bates, JF (1984) The nutritional effects of tooth loss. American Journal of Clinical Nutrition 39, 478–489.Google ScholarPubMed
Gey, KF, Stahelin, HB & Eichholzer, M (1993) Poor plasma status of carotene and vitamin C is associated with higher mortality from ischaemic heart disease and stroke. Clinical Investigation 71, 3–6.Google ScholarPubMed
Gillman, MW, Cupples, LA, Gagnon, D, Posner, BM, Ellison, RC, Castelli, WP & Wolf, PA (1995) Protective effect of fruits and vegetables on development of stroke in men. Journal of the American Medical Association 273, 1113–1117.CrossRefGoogle ScholarPubMed
Golden, MHN & Waterlow, JC (1977) Total protein synthesis in elderly people: A comparison of results with 15N glycine and 14C leucine. Clinical Science and Molecular Medicine 53, 277–288.Google Scholar
Guigoz, Y, Vellas, B & Garry, PJ (1994) Mini nutritional assessment. In Nutrition in the Elderly, Suppl. 2, pp. 15–32 [Vellas, BJ, Guigoz, Y, Garry, PJ and Albarede, JL, editors]. Paris: Serdi Publishing Company.Google Scholar
Gupta, KL, Dworkin, B & Gambert, SR (1988) Common nutritional disorders in the elderly: Atypical manifestations. Geriatrics 43, 87–97.Google ScholarPubMed
Haboubi, NY & Montgomery, RD (1992) Small bowel bacterial overgrowth in elderly people: clinical significance and response to treatment. Age and Ageing 21, 13–19.CrossRefGoogle ScholarPubMed
Halliwell, B (1994) Free radicals, antioxidants, and human disease. Lancet 344, 721–724.CrossRefGoogle ScholarPubMed
Hankey, CR, Summerbell, J & Wynne, HA (1993) The effect of dietary supplementation in continuing care elderly people. Journal of Human Nutrition and Dietetics 6, 317–322.CrossRefGoogle Scholar
Hartz, SC, Roenberg, IH & Russel, RM (1992) Nutrition in the Elderly. The Boston Nutritional Survey. London: Smith Gordon & Co Ltd.Google Scholar
Heaney, RP, Gallagher, JC, Johnston, CC, Neer, R, Parfitt, AM & Whedon, GD (1982) Calcium nutrition and bone health in the elderly. American Journal of Clinical Nutrition 36, 986–1013.CrossRefGoogle ScholarPubMed
Heber, D & Bray, GA (1980) Energy requirements. In Metabolic and Nutritional Disorders in the Elderly, pp. 1–12 [Exton-Smith, AN and Caird, FI, editors]. Bristol: John Wright & Sons Ltd.Google Scholar
Hennekens, CH, Buring, JE, Manson, JE, Stamper, M, Posner, B, Cook, NR, Belanger, C, LaMotte, F, Gaziona, JM, Ridker, PM, Willett, W & Peto, R (1996) Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasm and cardiovascular disease. New England Journal of Medicine 334, 1145–1149.CrossRefGoogle ScholarPubMed
Hodkinson, HM, Cox, M, Lugon, M, Cox, ML & Tomkins, A (1990) Energy cost of chest infection in the elderly. Journal of Clinical and Experimental Gerontology 12, 241–246.Google Scholar
Hoffman, N (1993) Diet in the Elderly: needs and risk. Clinical Nutrition 77, 745–756.Google Scholar
Horan, MA & Pendleton, N (1995) The relationship between ageing and disease. Reviews in Clinical Gerontology 5, 125–141.CrossRefGoogle Scholar
Howard, L, Dillon, B, Saba, TM, Hofmann, S & Cho, E (1984) Decreased plasma fibronectin during starvation in man. Journal of Parenteral and Enteral Nutrition 8, 237–244.CrossRefGoogle ScholarPubMed
Intersalt Cooperative Research Group (1988) Intersalt: An International Study of Electrolyte Excretion and Blood Pressure. Results for 24 hour urinary sodium and potassium excretion. British Medical Journal 297, 319–328.CrossRefGoogle Scholar
Joosten, E, Berg, AVD, Reizler, R, Naurath, HJ & Lindenbaum, J (1993) Metabolic evidence that deficiencies of vitamin B12, folate and vitamin B6 occur commonly in elderly people. American Journal of Clinical Nutrition 58, 468–476.CrossRefGoogle ScholarPubMed
Keller, HH (1995) Weight gain impacts morbidity and mortality in institutionalised older persons. Journal of the American Geriatric Society 43, 165–169.CrossRefGoogle Scholar
Khaw, KT & Barrett-Connor, E (1987) Dietary potassium and stroke associated mortality. A 12-year prospective population study. New England Journal of Medicine 316, 235–239.CrossRefGoogle ScholarPubMed
Klidjian, AM, Archer, TJ & Foster, KJ (1982) Detection of dangerous malnutrition. Journal of Parenteral and Enteral Nutrition 6, 119–123.CrossRefGoogle ScholarPubMed
Klipstein-Grobusch, K, Reilly, JJ, Potter, J, Edwards, CA & Roberts, MA (1995) Energy intake and expenditure in elderly patients admitted to hospital with acute illness. British Journal of Nutrition 73, 323–334.CrossRefGoogle ScholarPubMed
Lake, CR, Ziegler, MG, Coleman, MD & Kopin, IJ (1977) Age-adjusted plasma norepinephrine levels are similar in normotensive and hypertensive subjects. New England Journal of Medicine 296, 208–209.CrossRefGoogle ScholarPubMed
Langford, HG (1983) Dietary potassium and hypertension: epidemiologic data. Annals of Internal Medicine 98, 770–772.CrossRefGoogle ScholarPubMed
Larsson, J, Unosson, M, Ek, AC, Nilsson, L, Thorslund, S & Bjurulf, P (1990) Effect of dietary supplement on nutritional status and clinical outcome in 501 geriatric patients. Clinical Nutrition 9, 179–184.CrossRefGoogle ScholarPubMed
Lehmann, AB, Johnston, C & James, OFW (1989) The effects of old age and immobility on protein turnover in human subjects with some observations on possible role of hormones. Age and Ageing 18, 148–157.CrossRefGoogle ScholarPubMed
Levi, S, Cox, M, Lugon, M, Hodkinson, M & Tomkins, A (1990) Increased energy expenditure in Parkinson's disease. British Medical Journal 301, 1256–1257.CrossRefGoogle ScholarPubMed
Lipski, PS, Kelly, PJ & James, OFW (1992) Bacterial contamination of the small bowel in elderly people: Is it necessarily pathological? Age and Ageing 21, 5–12.CrossRefGoogle ScholarPubMed
Lipski, PS, Torrance, A, Kelly, PJ & James, OFW (1993) A study of nutritional deficits of long-stay geriatric patients. Age and Ageing 22, 244–255.CrossRefGoogle ScholarPubMed
Loenen, HMJA, Eshuis, H, Lowik, MRH, Schouten, EG, Hulshof, KF, Odink, J & Kok, FJ (1990) Serum uric acid correlates in elderly men and women with special reference to body composition and dietary intake. Journal of Clinical Epidemiology 43, 1297–1303.CrossRefGoogle ScholarPubMed
Lundgren, BK, Steen, B & Isaksson, B (1987) Dietary habits in 70 and 75-year old males and females. Longitudinal and cohort data from a population study. Naringforskning 31, 53–56.Google Scholar
McEvoy, A, Dutton, J & James, OFW (1983) Bacterial contamination of the small intestine is an important cause of occult malabsorption in the elderly. British Medical Journal 287, 789–793.CrossRefGoogle ScholarPubMed
McGandy, RB, Barows, CH, Spanias, CH, Meredith, A, Stone, JL & Norris, AH (1966) Nutrient intake and energy expenditure in men of different ages. Journal of Gerontology 21, 581–587.CrossRefGoogle Scholar
MacGregor, GA (1983) Sodium and potassium intake and the blood pressure. Hypertension, 5, III79–III84.CrossRefGoogle Scholar
McWhirter, JP & Pennington, CR (1994) Incidence and recognition of malnutrition in hospital. British Medical Journal 308, 945–948.CrossRefGoogle ScholarPubMed
Manson, JE, Willett, WC, Stampfer, MJ, Colditz, GA, Hunter, DJ & Hankinson, SE (1995) Body weight and mortality among women. New England Journal of Medicine 333, 677–685.CrossRefGoogle ScholarPubMed
Marx, JJM (1979) Normal iron absorption and decreased red-cell iron uptake in the aged. Blood 53, 204–211.CrossRefGoogle ScholarPubMed
Metz, J, Bell, AH, Flicker, L, Bottiglieri, T, Ibrahim, J, Seal, E, Schultz, D, Savoia, H & McGrath, KM (1996) The significance of subnormal serum vitamin B12 concentration in older people. Journal of the American Geriatric Society 44, 1355–1361.CrossRefGoogle ScholarPubMed
Meydani, SN, Meydani, M, Blumberg, JB, Leka, LS, Siber, G, Loszewski, R, Thompson, C, Pedrosa, MC, Diamond, RD & Stollar, BD (1997) Vitamin E supplementation and in vivo immune response in healthy elderly subjects. A randomised controlled trial. Journal of the American Medical Association 277, 1380–1386.CrossRefGoogle Scholar
Miall, WE, Ashcroft, MT, Lovell, HG & Moore, F (1967) A longitudinal study of the decline of adult height with age in two Welsh communities. Human Biology 39, 445–454.Google ScholarPubMed
Ministry of Agriculture, Fisheries and Food (1995) Manual of Nutrition. Reference Book no. 342, 10th ed. London: HM Stationery Office.Google Scholar
Mitchell, CO & Lipschitz, DA (1982) The effect of age and sex on routinely used measurements to assess the nutritional status of hospitalised patients. American Journal of Clinical Nutrition 36, 340–349.CrossRefGoogle Scholar
Morgan, BD, Newton, HMV, Schorah, CJ, Jewitt, MA, Hancock, MR & Hullin, RP (1986) Abnormal indices of nutrition in the elderly. Age and Ageing 15, 65–76.CrossRefGoogle ScholarPubMed
Morley, JE (1986) Nutritional status of the elderly. American Journal of Medicine 81, 679–695.CrossRefGoogle ScholarPubMed
Morley, JE (1993) Why do physicians fail to recognise and treat malnutrition in older persons? Journal of the American Geriatric Society 39, 1139–1140.CrossRefGoogle Scholar
Muhlethaler, R, Stuck, AE, Minder, CE & Frey, BM (1995) The prognostic significance of protein-energy malnutrition in geriatric patients. Age and Ageing 24, 193–197.CrossRefGoogle ScholarPubMed
Munro, HN, Suter, NM & Russell, RM (1987) Nutritional requirement of the elderly. Annual Review of Nutrition 7, 23–49.CrossRefGoogle ScholarPubMed
Munro, HN & Young, VR (1980) Protein metabolism and requirements. In Metabolic and Nutritional Disorders in the Elderly, pp. 13–25 [Exton-Smith, AN and Caird, FI, editors]. Bristol: John Wright & Sons Ltd.Google Scholar
National Research Council (1989) Recommended Dietary Allowances, 10th ed. Washington, DC: National Academy Press.Google Scholar
Naurath, HJ, Joosten, E, Reizler, R, Stabler, SP, Allen, RH & Lindenbaum, J (1995) Effects of vitamin B12, folate and vitamin B6 supplements in elderly people with normal serum vitamin concentrations. Lancet 346, 85–89.CrossRefGoogle ScholarPubMed
Norton, B, Homer-Ward, M, Donnelly, DM, Long, RG & Holmes, GK (1996) A randomised prospective comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding after acute dysphasic stroke. British Medical Journal 312, 13–16.CrossRefGoogle Scholar
Nyyssonen, K, Parviainen, MT, Salonen, R, Tuomilehto, J & Salonen, JT (1997) Vitamin C deficiency and risk of myocardial infarction: prospective study of men from eastern Finland. British Medical Journal 314, 634–638.CrossRefGoogle ScholarPubMed
Office of Population, Censuses and Surveys (1989) General Household Survey 1986. London: HM Stationery Office.Google Scholar
Omenn, GS, Goodman, GE, Thorquist, MD, Balmes, J, Cullen, MR, Glass, A, Keogh, JP, Meyskens, FL, Valanis, B, Williams, JH, Barnhart, S & Hammar, S (1996) Effects of a combination of β-carotene and vitamin A on lung cancer and cardiovascular disease. New England Journal of Medicine 334, 1150–1155.CrossRefGoogle ScholarPubMed
Peto, R, Doll, R, Buckley, JD & Sporn, MB (1981) Can dietary β-carotene materially reduce human cancer rates? Nature 290, 201–208.CrossRefGoogle ScholarPubMed
Poehlman, ET (1993) Regulation of energy expenditure in ageing humans. Journal of the American Geriatric Society 41, 552–559.CrossRefGoogle Scholar
Potter, J, Klipstein, K, Reilly, JJ & Roberts, M (1995) The nutritional status and clinical course of acute admissions to a geriatric unit. Age and Ageing 24, 131–136.CrossRefGoogle ScholarPubMed
Prentice, AM, Leavesley, K, Murgatroyd, PR, Coward, WA, Schorah, CJ, Bladon, T & Hullin, RP (1989) Is severe wasting in elderly mental patients caused by an excessive energy requirement? Age and Ageing 18, 158–167.CrossRefGoogle ScholarPubMed
Prince, RL, Smith, M, Dick, IM, Price, RI, Webb, PG, Henderson, NK & Harris, MM (1991) Prevention of postmenopausal osteoporosis: A comparative study of exercise, calcium supplementation and hormone replacement therapy. New England Journal of Medicine 325, 1189–1195.CrossRefGoogle ScholarPubMed
Reeds, PJ & James, WPT (1983) Protein turnover. Lancet i, 571–574.CrossRefGoogle Scholar
Reinhardt, GF, Myscofski, JW, Wilkens, DB, Dobin, PG, Dobrin, PB, Mangan, JE & Stannard, RT (1980) Incidence and mortality of hypoalbuminemic patients in hospitalised veterans. Journal of Parenteral and Enteral Nutrition 4, 357–359.CrossRefGoogle ScholarPubMed
Reinhart, RA (1988) Magnesium metabolism. Archives of Internal Medicine 148, 2415–2420.CrossRefGoogle ScholarPubMed
Rennie, M & Harrison, R (1984) Effect of injury, disease and malnutrition on protein metabolism in man. Unanswered questions. Lancet i, 323–325.CrossRefGoogle Scholar
Rich, MW, Keller, AJ, Schechtman, KB, Marshall, WG Jr & Kouchoukos, NT (1989) Increased complications and prolonged hospital stay in elderly cardiac surgical patients with low serum albumin. American Journal of Cardiology 63, 714–718.CrossRefGoogle ScholarPubMed
Riemersma, RA, Wood, DA, Macintyre, CCA, Elton, RA, Gey, KF & Oliver, MF (1991) Risk of angina pectoris and plasma concentrations of vitamin A, C, E and carotene. Lancet 337, 1–5.CrossRefGoogle Scholar
Roberts, SH, James, O & Jarvis, EH (1977) Bacterial overgrowth syndrome without 'blind loop' a cause for malnutrition in the elderly. Lancet ii, 1193–1195.CrossRefGoogle Scholar
Rothschild, MA, Horatz, M & Schriber, SS (1972 a) Albumin synthesis (first of two parts). New England Journal of Medicine 286, 748–757.CrossRefGoogle Scholar
Rothschild, MA, Horatz, M & Schriber, SS (1972 b) Albumin synthesis (second of two parts). New England Journal of Medicine 286, 816–820.CrossRefGoogle ScholarPubMed
Rothwell, NJ & Stock, MJ (1983) Effect of age on diet-induced thermogensis and brown adipose tissue metabolism in the rat. International Journal of Obesity 7, 583–589.Google Scholar
Royal College of Physicians (1991) Medical Aspects of Exercise: Benefits and Risks. London: Royal College of Physicians of London.Google Scholar
Rudman, D, Feller, AG, Nagraj, HS, Jackson, DL, Rudman, IW & Mattson, DE (1987) Relation of serum albumin concentration to death rate in nursing home men. Journal of Parenteral and Enteral Nutrition 11, 360–363.CrossRefGoogle ScholarPubMed
Russel, RM (1986) Implication of gastric atrophy for vitamin and mineral nutriture. In Nutrition and Ageing, p. 59 [Hutchinson, ML and Munro, HN, editors]. San Diego, CA: Harcourt Brace Jovanovich.CrossRefGoogle Scholar
Russel, RM (1988) Malabsorption and ageing. In Ageing in Liver and Gastrointestinal Tract. 47th Falk Symposium, pp. 297–307 [Bianchi, I, Holt, P and James, OF, editors]. Lancaster: Kluwer Academic.Google Scholar
Russel, RM & Suter, PM (1993) Vitamin requirements of elderly people: an update. American Journal of Clinical Nutrition 58, 4–14.CrossRefGoogle Scholar
Sahyoun, NR, Jacques, PF, Dallal, G & Russel, RM (1996) Use of albumin as a predictor of mortality in community dwelling and institutionalised elderly subjects. Journal of Clinical Epidemiology 49, 981–988.CrossRefGoogle Scholar
Sahyoun, NR, Otradovec, CL, Hartz, SC, Jacob, RA, Peters, H, Russel, RM & McGandy, RB (1988) Dietary intakes and biochemical indicators of nutritional status in an elderly, institutionalised population. American Journal of Clinical Nutrition 47, 524–533.CrossRefGoogle Scholar
Salem, M, Kasinski, N, Andrei, AM, Brussel, T, Gold, MR, Conn, A & Chernow, B (1991) Hypomagnesemia is a frequent finding in the emergency department in patients with chest pain. Archives of Internal Medicine 151, 2185–2190.CrossRefGoogle ScholarPubMed
Sandman, PO, Adofsson, R, Nygren, C, Hallmans, G & Winbald, B (1987) Nutritional status and dietary intake in institutionalised patients with Alzeimer's disease and multiinfarct dementia. Journal of the American Geriatric Society 35, 31–38.CrossRefGoogle Scholar
Sandstrom, B, Alhaug, J, Einarsdottir, K, Simpura, EM & Isaksson, B (1985) Nutritional status, energy and protein intake in general medical patients in three Nordic hospitals. Human Nutrition: Applied Nutrition 39 A, 87–94.Google Scholar
Sano, M, Ernesto, C, Thomas, RG, Klauber, MR, Schafer, K, Grundman, M, Woodbury, P, Growdon, J, Cotman, CW, Pfeiffer, E, Schneider, LS & Thal, LJ (1997) A controlled trial of selegiline, alpha-tocopherol, or both as a treatment for Alzheimer's disease. New England Journal of Medicine 336, 1216–1222.CrossRefGoogle ScholarPubMed
Schiffman, SS (1978) Changes in taste and smell in old persons. In Advances in Research, vol. 2. Durham, NC: Duke University Centre for the Study of Ageing and Human Development.Google Scholar
Schofield, WN, Schofield, C & James, WPT (1985) Basal metabolic rate-review and prediction. Human Nutrition: Clinical Nutrition 39 C, Suppl.1–96.Google Scholar
Schorah, CJ, Tormey, WP, Brooks, GH, Robertshaw, AM, Young, AM, Talukden, R & Kelly, JF (1981) The effect of vitamin C supplements on body weight, serum protein, and general health of an elderly population. American Journal of Clinical Nutrition 34, 871–876.CrossRefGoogle ScholarPubMed
Seltzer, MH, Bashidas, JA & Cooper, DM (1979) Instant nutritional assessment. Journal of Parenteral and Enteral Nutrition 3, 157–159.CrossRefGoogle ScholarPubMed
Senapati, A, Jenner, G & Thompson, RPH (1989) Zinc in the elderly. Quarterly Journal of Medicine 70, 81–87.Google ScholarPubMed
Souba, WW (1997) Nutritional support. New England Journal of Medicine 336, 41–47.CrossRefGoogle ScholarPubMed
Southgate, DAT & Durnin, JVGA (1970) Calorie conversion factors. An experimental reassessment of the factors used in the calculation of the energy value of human diets. British Journal of Nutrition 24, 517–535.CrossRefGoogle ScholarPubMed
Spitzer, ME (1988) Taste acuity in institutionalised and non-institutionalised elderly men. Journal of Gerontology 43, 71–74.CrossRefGoogle Scholar
Stableforth, PG (1986) Supplement feeds and nitrogen and calorie balance following femoral neck fracture. British Journal of Surgery 73, 651–655.CrossRefGoogle ScholarPubMed
Sullivan, DH & Walls, RC (1994) Impact of nutritional status on morbidity in a population of geriatric rehabilitation patients. Journal of the American Geriatric Society 42, 471–477.CrossRefGoogle Scholar
Tayback, M, Kumanyika, S & Chee, E (1990) Body weight as a risk factor in the elderly. Archives of Internal Medicine 150, 1065–1072.CrossRefGoogle ScholarPubMed
The Alpha-Tocopherol, β-Carotene Cancer Prevention Study Group (1994) The effect of vitamin E and β-carotene on the incidence of lung cancer and other cancers in male smokers. New England Journal of Medicine 330, 1029–1035.CrossRefGoogle Scholar
Thomas, AJ, Bunker, VW, Hinks, LJ, Sodha, M, Mullee, MA & Clayton, BE (1988) Energy, protein, zinc and copper status of twenty one elderly inpatients: analysed dietary intake and biochemical indices. British Journal of Nutrition 59, 181–191.CrossRefGoogle ScholarPubMed
Thomas, AJ, Bunker, VW, Stansfield, MF, Sodha, NK & Clayton, BE (1989) Iron status of hospitalised and house bound elderly people. Quarterly Journal of Medicine 70, 175–184.Google Scholar
Tobian, L, Lange, J, Ulm, K, Wold, L & Iwai, J (1985) Potassium reduces cerebral haemorrhage and death rate in hypertensive rats, even when blood pressure is not lowered. Hypertension 7, Suppl. 1, 1110–1114.CrossRefGoogle Scholar
Todd, JE & Walker, AM (1980) Adult Dental Health, vol. 1, England and Wales, 1968–1978. London: HM Stationery Office.Google Scholar
Treasure, J & Ploth, D (1983) Role of dietary potassium in the treatment of hypertension. Hypertension 5, 864–872.CrossRefGoogle ScholarPubMed
Uauy, R, Scrimshaw, NS & Young, VR (1978 a) Human protein requirement: Nitrogen balance response to graded levels of egg protein in elderly men and women. American Journal of Clinical Nutrition 31, 779–785.CrossRefGoogle ScholarPubMed
Uauy, R, Winterer, JC, Bilmazes, C, Haverberg, LN, Scrimshaw, NS & Munro, HN (1978 b) The changing pattern of whole body protein metabolism in ageing humans. Journal of Gerontology 33, 663–671.CrossRefGoogle Scholar
Vir, SC & Love, AHG (1979) Nutritional status of institutionalised and non-institutionalised aged in Belfast, Northern Ireland. American Journal of Clinical Nutrition 32, 1934–1947.CrossRefGoogle Scholar
Viteri, FE & Alvarado, J (1970) The creatinine height index: its use in the estimation of the degree of protein depletion and repletion in protein calorie malnourished children. Paediatrics 46, 696–706.CrossRefGoogle ScholarPubMed
Wagner, PA, Jernigan, JA, Bailey, LB, Nickens, C & Brazzi, GA (1983) Zinc nutriture and cell mediated immunity in the aged. International Journal of Vitamin and Nutrition Research 53, 94–101.Google ScholarPubMed
Weinberg, AD, Minaker, KLand the Council on Scientific Affairs, American Medical Association (1995) Dehydration: evaluation and management in older adult. Journal of the American Medical Association 274, 1552–1556.CrossRefGoogle Scholar
Williams, CM, Driver, LT, Older, J & Dickerson, JW (1989) A controlled trial of sip-feed supplements in elderly orthopaedic patients. European Journal of Clinical Nutrition 43, 267–274.Google ScholarPubMed
Woo, J, Ho, SC, Mak, YT, Law, LK & Cheung, A (1994) Nutritional status of elderly patients during recovery from chest infection and the role of nutritional supplements. Age and Ageing 23, 40–48.CrossRefGoogle Scholar
World Health Organization (1985) Energy and Protein Requirements. Report of a Joint FAO/WHO/UNU Expert Consultation. WHO Technical Report Series no. 724. Geneva: WHO.Google Scholar
World Health Organization (1989) The WHO MONICA Project. World Health Statistics Quarterly 42, 27–149.Google Scholar
Yamori, Y (1993) Hypertensive cerebrovascular disease: importance of nutrition in pathogenesis and prevention. Annals of New York Academy of Sciences 676, 92–103.CrossRefGoogle Scholar
Yamori, Y, Nara, Y, Mizushima, S, Sawamura, M & Hori, R (1994) Nutritional factors for stroke and major cerebrovascular disease. Health Reports (Statistics Canada) 6, 22–27.Google Scholar
Yui, Y, Itokawa, Y & Kawai, C (1980) Furosemide-induced thiamin deficiency. Cardiovascular Research 14, 537–540.CrossRefGoogle Scholar