Delivery of Nutritious Meals to Elderly Receiving Home Care: Feasibility and Effectiveness.

BACKGROUND/OBJECTIVES: Elderly with functional disabilities are at increased risk of inadequate dietary intake. Little is known about the effectiveness of interventions aimed at improving their dietary intake and nutritional status, nor about the determinants of successful implementation. We performed a feasibility study to evaluate the implementation and effectiveness of a home delivery service providing nutritious meals. DESIGN: Quasi-experimental, with participants allocated to treatment group based on municipality of residence. SETTING AND PARTICIPANTS: Functionally disabled home-dwelling elderly receiving home care. INTERVENTION: Three-month daily meal service consisting of dinner and snacks (intervention). The control group sustained habitual food intake. MEASUREMENTS: Data on satisfaction and problems regarding the meal service were collected by structured interviews. Dietary intake (2-day estimated food diary), nutritional status (anthropometry), handgrip strength, and quality of life (questionnaire-based) was measured at baseline, three months (end of intervention), and six months (follow-up). RESULTS: Forty-four elderly were included (intervention group: 25, control group: 19). For most aspects of the meal service, approximately 90% of participants indicated being satisfied, and the large majority (70%) was interested in receiving a similar meal service in the future. At the end of the 3-month intervention, the intervention group showed a greater increase than the control group in body weight (P< 0.005), body mass index (P< 0.005), upper leg circumference (P< 0.01) and fat free mass (FFM, P< 0.03). Three months post-intervention, only the increase in FFM remained statistically significant (P< 0.05). Except for calcium intake, no positive intervention effect was observed for any of the other outcomes. CONCLUSION: Our study stresses the feasibility as well as the potential of healthy and tasteful meals to support home-dwelling elderly, by showing that a high-quality meal service was highly appreciated and had a rapid effect on FFM.

Effect of a nutritional supplement containing vitamin E, selenium, vitamin c and coenzyme Q10 on serum PSA in patients with hormonally untreated carcinoma of the prostate: a randomised placebo-controlled study.

OBJECTIVE: To assess the effect of a nutritional supplement containing vitamin E, selenium, vitamin C and coenzyme Q10 on changes in serum levels of PSA in patients with hormonally untreated carcinoma of the prostate and rising serum PSA levels. METHODS: Eighty patients were randomised to receive a daily supplement with either vitamin E, selenium, vitamin C, coenzyme Q10 (intervention group) or placebo over 21 weeks. Serum levels of PSA were assessed at baseline (-2, -1, 0 weeks) and after 6, 13, 19, 20 and 21 weeks. Mean changes in log serum level of PSA, testosterone, dihydrotestosterone, luteinizing hormone and sex hormone binding globulin over 21 weeks between the verum and the placebo group were compared by analysis of covariance. RESULTS: Seventy patients completed the study (36 verum; 34 placebo). Compliance was >90% in all patients. In the intervention group, plasma levels of vitamin E, selenium and coenzyme Q10 increased significantly over the 21 weeks study period. No significant differences in serum levels of PSA, testosterone, dihydrotestosterone, luteinizing hormone or sex hormone binding globulin (p>0.2) were observed between the intervention and control group. CONCLUSION: Our results indicate that supplementation of a combination of vitamin E, selenium, vitamin C and coenzyme-Q10 does not affect serum level of PSA or hormone levels in patients with hormonally untreated carcinoma of the prostate.