Body Mass Index assessment of institutionalized aged people without cognitive impairment using clinical and nutritional factors

Authors

  • María del Mar Ruperto López Departamento de Nutrición Humana y Dietética, Facultad de Ciencias de la Salud, Universidad Alfonso X el Sabio
  • María Gómez-Martín Departamento de Nutrición Humana y Dietética, Facultad de Ciencias de la Salud, Universidad Alfonso X el Sabio
  • Carlos Iglesias Rosado Departamento de Nutrición Humana y Dietética, Facultad de Ciencias de la Salud, Universidad Alfonso X el Sabio

DOI:

https://doi.org/10.14306/renhyd.20.4.245

Keywords:

Body Mass Index, Institutionalized elders, Malnutrition, Obesity

Abstract

Introduction: Overweight and obesity are recognized mortality risk factors in the general population. The aim of the study was to analyse the phenotypic distribution of body mass index (BMI), and to identify the prevalence of malnutrition and clinical and nutritional factors related to BMI in autonomous institutionalized elders.

Material and Methods: Cross-sectional and descriptive study in 104 institutionalized aged people (73% female, mean of age 86.4 [±6.2] years and time on institutionalization 25.7 [±21.7] months). Mini-Nutritional Assessment (MNA), anthropometric measures and laboratory parameters were used for nutritional assessment. Bioimpedance analysis (BIA-101; RJL-System) was used for body composition analysis. The sample was classified into BMI tertiles (Tn): T1=<26.2kg/m2; T2=26.3-29.7kg/m2; and T3=≥29.8kg/m2.

Results: The phenotypic distribution of BMI was: overweight 51% and, prevalence of obesity 29.8%. Mean of BMI: 28.3 (±4.6) kg/m2. Nutritional risk or malnutrition were 60.6% and 11.5%, respectively in the sample. The tertiles of BMI showed significant differences with: mid-arm muscle circumference, triceps-skinfold thickness, total body water (TBW) (all, p<0.001). Subjects into T1 had significantly higher nutritional risk or malnutrition compared with T2 and T3 counterparts (p=0.015). Waist-circumference, calf-circumference (at least, p<0.01), and TBW (p<0.001) were independent predictors of BMI in the linear regression analysis (R2=0.52).

Conclusions: Overweight and obesity measured by BMI is not an exclusion criterion of malnutrition in the geriatric population. Nutritional screening by MNA and the conjoint use of clinical-nutritional parameters are useful for identifying at nutritional risk or malnutrition. Further studies are needed to define the potential nutritional risk factors associated with BMI in autonomous institutionalized aged.

Author Biographies

María del Mar Ruperto López, Departamento de Nutrición Humana y Dietética, Facultad de Ciencias de la Salud, Universidad Alfonso X el Sabio

Profesor  de Grado en Nutricion Humana y Dietética. Facultad de ciencias de la salud. Departamento de Nutricion Humana y Dietética

María Gómez-Martín, Departamento de Nutrición Humana y Dietética, Facultad de Ciencias de la Salud, Universidad Alfonso X el Sabio

Departamento de Nutricion Humana y Dietética

Carlos Iglesias Rosado, Departamento de Nutrición Humana y Dietética, Facultad de Ciencias de la Salud, Universidad Alfonso X el Sabio

Departamento de Nutrición Humana y Dietética

Coordinador del Grado en  Nutrición Humana y Dietética

References

(1) De Luis DA, López R, Gonzalez M, Lopez JA, Mora PF, Castrodeza J, et al. Nutritional status in a multicenter study among institutionalized patients in Spain. Eur Rev Med Pharmacol Sci. 2011; 15(3): 259-65.

(2) Unanue-Urquijo S, Badia-Capdevila H, Rodríguez-Requejo S, Sánchez-Pérez I, Coderch-Lassaletta J. Factores asociados al estado nutricional de pacientes geriátricos institucionalizados y atendidos en su domicilio. Rev Esp Geriatr Gerontol. 2009; 44(1): 38-41.

(3) Jiménez M, Sola JM, Pérez C, Turienzo MJ, Larrañaga G, Mancebo MA, et al. Estudio del estado nutricional de los ancianos de Cantabria. Nutr Hosp. 2011; 26(2): 345-54.

(4) Jürschik P, Nunin C, Botigué T, Escobar MA, Lavedán A, Viladrosa M. Prevalence of frailty and factors associated with frailty in the elderly population of Lleida, Spain: the FRALLE survey. Arch Gerontol Geriatr. 2012; 55(3): 625-31.

(5) Serra M, Fernández X, Ribó L, Palomera E, Papiol M, Serra P. Pérdida de apetito en ancianos no institucionalizados y su relación con la capacidad funcional. Med Clin. 2008; 130(14): 531-3.

(6) Payette H, Hanusaik N, Boutier V, Morais JA, Gray-Donald K. Muscle strength and functional mobility in relation to lean body mass in free-living frail elderly women. Eur J Clin Nutr. 1998; 52(1): 45-53.

(7) Cederholm T, Bosaeus I, Barazzoni R, Bauer J, Van Gossum A, Klek S, et al. Diagnostic criteria for malnutrition - An ESPEN Consensus Statement. Clin Nutr. 2015; 34(3): 335-40.

(8) World Health Organization. Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 1995; 854.

(9) Heiat A, Vaccarino V, Krumholz HM. An evidence-based assessment of federal guidelines for overweight and obesity as they apply to elderly persons. Arch Intern Med. 2001; 161(9): 1194-203.

(10) Al Snih S, Ottenbacher KJ, Markides KS, Kuo Y-F, Eschbach K, Goodwin JS. The effect of obesity on disability vs mortality in older Americans. Arch Intern Med. 2007; 167(8): 774-80.

(11) Winter JE, MacInnis RJ, Wattanapenpaiboon N, Nowson CA. BMI and all-cause mortality in older adults: a meta-analysis. Am J Clin Nutr. 2014; 99(4): 875-90.

(12) Hsu W-C, Tsai AC, Wang J-Y. Calf circumference is more effective than body mass index in predicting emerging careneed of older adults - Results of a national cohort study. Clin Nutr. 2016; 35(3): 735-40.

(13) Kyle UG, Bosaeus I, De Lorenzo AD, Deurenberg P, Elia M, Manuel Gómez J, et al. Bioelectrical impedance analysis-part II: utilization in clinical practice. Clin Nutr. 2004; 23(6): 1430-53.

(14) Kyle UG, Bosaeus I, De Lorenzo AD, Deurenberg P, Elia M, Gómez JM, et al. Bioelectrical impedance analysis-part I: review of principles and methods. Clin Nutr. 2004; 23(5): 1226-43.

(15) Roubenoff R, Baumgartner RN, Harris TB, Dallal GE, Hannan MT, Economos CD, et al. Application of bioelectrical impedance analysis to elderly populations. J Gerontol A Biol Sci Med Sci. 1997; 52(3): M129-136.

(16) Haapala I, Hirvonen A, Niskanen L, Uusitupa M, Kröger H, Alhava E, et al. Anthropometry, bioelectrical impedance and dual-energy X-ray absorptiometry in the assessment of body composition in elderly Finnish women. Clin Physiol Funct Imaging. 2002; 22(6): 383-91.

(17) Guigoz Y, Lauque S, Vellas BJ. Identifying the elderly at risk for malnutrition. The Mini Nutritional Assessment. Clin Geriatr Med. 2002; 18(4): 737-57.

(18) Oreopoulos A, Kalantar-Zadeh K, Sharma AM, Fonarow GC. The obesity paradox in the elderly: potential mechanisms and clinical implications. Clin Geriatr Med. 2009; 25(4): 643-59.

(19) Aranceta J, Pérez C, Serra L, Ribas L, Quiles J, Vioque J, et al. [Prevalence of obesity in Spain: results of the SEEDO 2000

study]. Med Clin. 2003; 120(16): 608-12.

(20) Kvamme J-M, Olsen JA, Florholmen J, Jacobsen BK. Risk of malnutrition and health-related quality of life in communityliving elderly men and women: the Tromsø study. Qual Life Res. 2011; 20(4): 575-82.

(21) Flegal KM, Graubard BI. Estimates of excess deaths associated with body mass index and other anthropometric variables. Am

J Clin Nutr. 2009; 89(4): 1213-9.

(22) Méndez E, Romero J, Fernández MJ, Troitiño P, García S, Jardón M, et al. ¿Tienen nuestros ancianos un adecuado estado nutricional? ¿Influye su institucionalización? Nutr Hosp. 2013; 28(3): 903-13.

(23) Abajo del Alamo C, García S, Calabozo B, Ausín L, Casado J, Catalá MA. Protocolo de valoración, seguimiento y actuación nutricional en un centro residencial para personas mayores. Nutr Hosp. 2008; 23(2): 100-4.

(24) Ramon JM, Subirà C. Prevalencia de malnutrición en la población anciana española. Med Clin. 2001; 117(20): 766-70.

(25) Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010; 39(4): 412-23.

(26) Batsis JA, Germain CM, Vásquez E, Lopez-Jimenez F, Bartels SJ. Waist Circumference, Physical Activity, and Functional Impairments in Older U.S. Adults: Results from the NHANES 2005-2010. J Aging Phys Act. 2015; 23(3): 369-76.

(27) Kim TN, Choi KM. The implications of sarcopenia and sarcopenic obesity on cardiometabolic disease. J Cell Biochem. 2015; 116(7): 1171-8.

(28) Kim TN, Park MS, Yang SJ, Yoo HJ, Kang HJ, Song W, et al. Prevalence and determinant factors of sarcopenia in patients with type 2 diabetes: the Korean Sarcopenic Obesity Study (KSOS). Diabetes Care. 2010; 33(7): 1497-9.

(29) Stephen WC, Janssen I. Sarcopenic-obesity and cardiovascular disease risk in the elderly. J Nutr Health Aging. 2009; 13(5): 460-6.

Published

2016-12-31

How to Cite

Ruperto López, M. del M., Gómez-Martín, M., & Iglesias Rosado, C. (2016). Body Mass Index assessment of institutionalized aged people without cognitive impairment using clinical and nutritional factors. Spanish Journal of Human Nutrition and Dietetics, 20(4), 298–306. https://doi.org/10.14306/renhyd.20.4.245