In-hospital dietary intake and the course of mobilization among older patients with hip fracture in the post-surgical period.

BACKGROUND AND PURPOSE: Most older persons who suffer hip-fracture are frail and show comorbidities and functional deterioration, with poor short and long-term prognosis, high morbidity rates, and premature death. The aim of this work was to assess the association between in-hospital dietary intake and the course of mobilization of hip-fractured older patients in the post-surgical period until hospital discharge. METHODS: Prospective, observational, cohort study, n = 90 hip-fracture ≥ 65 years old patients. Pfeiffer questionnaire, Barthel Index, Charlson Comorbidity Index, Mini Nutritional Assessment, mobilization and dietary assessment, body mass index, arm and calf circumferences and blood analytical determinations. The mobilization progress was assessed measuring the ability to sit down and walking, at 2nd and 3rd-4th days post-surgery until discharge, respectively. RESULTS: Charlson Comorbidity Index was associated with ability to sit down, and energy intake was associated with ability to walk. Energy and protein intake is an important factor influencing mobilization success in older patients after surgery. Poor mobilization is related to high Charlson Comorbidity Index. CONCLUSIONS: In hip-fractured older patients, energy-protein intake and comorbidities assessed by Charlson Comorbidity Index are the main factors associated with poor mobilization in the post-surgical period.

Phytoestrogens enhance antioxidant enzymes after swimming exercise and modulate sex hormone plasma levels in female swimmers.

Our aim was to investigate the effects of diet supplementation with phytoestrogens on sex hormone levels, antioxidant adaptive responses and oxidative damage induced by exercise. Ten female swimmers participated for 26 days in a diet intervention with either a functional beverage rich in vitamins C and E or the same beverage but also supplemented with Lippia citriodora extract (PLX) containing 20 mg/100 ml verbascoside. After the intervention all subjects participated in a swimming session for 30 min maintaining the intensity at about 75-80% of their individual best performance time for a 50-m swim. In lymphocytes, the superoxide dismutase activity increased after exercise, with a higher increase in the PLX group. Swimming increased the erythrocyte activity of glutathione peroxidase and glutathione reductase in the PLX group. Purified glutathione reductase activity increased after an in vitro incubation with PLX. No effects were observed on the lymphocyte levels of malondialdehyde and carbonyls, but exercise increased the percentage of high-damaged lymphocytes 2.8 times in the placebo group and 1.5 times in the PLX group. PLX decreased the levels of 17-ß-estradiol and testosterone and increased the levels of the sex hormone binding globulin. In conclusion, supplementation with phytoestrogens enhances the glutathione-dependent enzyme activities in erythrocytes and the superoxide dismutase activity in lymphocytes in response to exercise. PLX also shows direct antioxidant properties, by increasing glutathione reductase enzyme activity in vitro. Supplementation with phytoestrogens also decreases the plasma steroid hormone levels, pointing towards a possible agonistic effect of verbascoside in the hypothalamic regulation of estradiol synthesis.