Malnutrition is associated with an increased risk of falls and impaired activity in elderly patients in Dutch residential long-term care (LTC): a cross-sectional study.

PURPOSE OF THE STUDY: Falls are frequent in LTC, with considerable health consequences. This study explores the relationship between malnutrition, activity, and falls in Dutch LTC residents and the influence of nutritional intervention on this relationship. DESIGN AND METHODS: A secondary data analysis of a cross-sectional, multi-center point prevalence and incidence measurement. SETTING: 81 LTC settings in The Netherlands. PARTICIPANTS: 6.701 LTC residents aged 65 and older; mean age 84; 70% female. Prevalence measurements of nutritional status and activity, and a 30 days incidence measurement of falls. RESULTS: Of all participating residents, 9.8% sustained at least one fall, and 22.8% was malnourished. Malnourished residents were more often a faller (odd ratio (OR) 1.78; p<0.01) and inactive (OR 1.7, p<0.01) than non-malnourished residents. Multivariate analysis confirmed the relation between malnutrition and fallers, without interference of activity. In the malnourished group with nutritional intervention, the percentage of fallers was lower than in the malnourished group without nutritional intervention (OR 0.738; p=0.056). IMPLICATIONS: Malnutrition is associated with an increased risk of being a faller and with impaired activity in Dutch LTC residents. Malnourished residents who receive nutritional intervention have a lower risk of being a faller.

The effect of resistance training combined with timed ingestion of protein on muscle fiber size and muscle strength.

Acute muscle protein metabolism is modulated not only by resistance exercise but also by amino acids. However, less is known about the long-term hypertrophic effect of protein supplementation in combination with resistance training. The present study was designed to compare the effect of 14 weeks of resistance training combined with timed ingestion of isoenergetic protein vs carbohydrate supplementation on muscle fiber hypertrophy and mechanical muscle performance. Supplementation was administered before and immediately after each training bout and, in addition, in the morning on nontraining days. Muscle biopsy specimens were obtained from the vastus lateralis muscle and analyzed for muscle fiber cross-sectional area. Squat jump and countermovement jump were performed on a force platform to determine vertical jump height. Peak torque during slow (30 degrees s-1) and fast (240 degrees s-1) concentric and eccentric contractions of the knee extensor muscle was measured in an isokinetic dynamometer. After 14 weeks of resistance training, the protein group showed hypertrophy of type I (18% +/- 5%; P < .01) and type II (26% +/- 5%; P < .01) muscle fibers, whereas no change above baseline occurred in the carbohydrate group. Squat jump height increased only in the protein group, whereas countermovement jump height and peak torque during slow isokinetic muscle contraction increased similarly in both groups. In conclusion, a minor advantage of protein supplementation over carbohydrate supplementation during resistance training on mechanical muscle function was found. However, the present results may have relevance for individuals who are particularly interested in gaining muscle size.

The effect of bovine colostrum supplementation on exercise performance in elite field hockey players.

In a double-blind, randomized, placebo-controlled study, we investigated the effect of 8 weeks of supplementation with bovine colostrum (Intact) on body composition and exercise performance (5 x 10-m sprint, vertical jump, shuttle-run test, and suicide test). Seventeen female and 18 male elite field hockey players, including players from the Dutch national team, received either 60 g of colostrum or whey protein daily. The 5 x 10-m sprint test performance improved significantly (p =.023) more in the colostrum group [0.64 +/- 0.09 s (mean +/- SEM)] compared to the whey group (0.33 +/- 0.09 s). The vertical jump performance improved more in the colostrum group (2.1 +/- 0.73 cm) compared to the whey group (0.32 +/- 0.82 cm). However, this was not statistically significant (p =.119). There were also no significant differences in changes in body composition and endurance tests between the 2 groups. It is concluded that in elite field hockey players, colostrum supplementation improves sprint performance better than whey. However, there were no differences with regard to body composition or endurance performance.