M. Martín

Specific bioelectrical impedance vector analysis (BIVA) is more accurate than classic BIVA to detect changes in body composition and in nutritional status in institutionalised elderly with dementia

BACKGROUND A new analytical variation of bioelectrical impedance vector analysis (BIVA), called specific BIVA, has shown to be more accurate in detecting changes in fat mass than classic BIVA. OBJECTIVE To compare classic and specific BIVA in order to identify which is more strongly associated with psycho-functional and nutritional indicators in a group of institutionalised elderly patients with dementia. SUBJECTS AND METHODS Cross-sectional study. Fifty-four patients (34 women, 20 men) with dementia in moderately severe to very severe stages and aged 60-95years underwent geriatric nutritional assessment, including body mass index calculations, the Mini Nutritional Assessment, the Geriatric Nutritional Risk Index, and whole body composition analysis. RESULTS With specific BIVA (unlike with classic BIVA), significant differences were found between women with moderately severe and very severe dementia. In the BIVA conducted for body mass index, the confidence ellipses produced with the classic BIVA approach were highly overlapping; but with specific BIVA, significant differences were observed between the women in different nutritional categories (malnutrition, risk of malnutrition, normal weight and obesity). On the other hand, both approaches distinguished malnourished women from those who were at risk of malnutrition, according to the Mini Nutritional Assessment; and men with a moderate-high risk of malnutrition from men with no risk, on the basis of the Geriatric Nutritional Risk Index. CONCLUSION Overall, the findings of the present study suggest that specific BIVA is more effective than classic BIVA in identifying bioelectrical changes associated with psycho-functional and nutritional indicators in institutionalised elderly with dementia.

Body mass index and waist circumference are not good surrogate indicators of adiposity in psychogeriatric patients

to assess the utility of body mass index (BMI) and waist circumference (WC) as surrogate indicators of adiposity with respect to the total body fat estimated with bioimpedance analysis in psychogeriatric patients.

Estudio de tolerancia y aceptacion de una formula enteral hiperproteica enriquecida en fibra

OBJECTIVES To evaluate the gastrointestinal tolerance and acceptance of the new formulation of Isosource Protein ® Fibre® with a new blend of fibers IS50®. METHODS Opened, non-comparative, nonrandomized, descriptive study in patients requiring full enteral tube feeding for at least 7 days. Gastrointestinal tolerance was assessed by daily record of subjective gastrointestinal symptoms by the patient, and objectives behind the abdominal exploration by the researcher for up to 15 days. RESULTS 18 patients were included with a mean age of 67.32 ± 13.8 years, of whom 66.7% were male. The average actual weight of the sample was 68.7 ± 9.8 kg (range: 51-90 kg) and BMI 24.0 ± 4.0 kg/m2 (range: 16.0 to 32.00 kg/m2). The average volume prescribed Isosource Protein® Fiber® was 1580 ± 282.7 ml / day (range: 1200 to 2000 ml/day). 72.22% of the patients received 1500 ml/day, received 16.67% 1750 ml / day, 5.56% received 2000 ml/day and 5.56% received 2500 ml/day. The analysis of the gastrointestinal tolerance of patients revealed that in the first study visit, reported no significant gastrointestinal problems, only one patient indicated the presence of mild constipation. By contrast, in the last study visit, it was observed that two patients reported constipation (mild to moderate) and two patients reported diarrhea (mild and severe). As for the evaluation of gastrointestinal tolerance by the investigator and depositional habit, the results show that in 100% cases tolerance was normal. Regarding the depositional habit, it was observed than the 66.7% of patients had no bowel movements at baseline, compared to 33.4% at the last visit of the patient (p = 0.035). In this sense, a significant increase (p = 0.035) in the mean number of daily bowel movements at the final visit (0.89 ± 0.90, range: 0-3) was observed, compared to the initial visit (0.44 ± 0.78, range: 0-3). CONCLUSIONS Isosource Protein® Fibre® has proved a formula for enteral nutrition well tolerated, with a very low frequency of gastrointestinal symptoms and an improvement in the number of stools, which encourages compliance with the standard prescribed by the health professional and suggest a positive effect on the regulation of intestinal transit.