Research project
36 | monthsSENIOR

Sustainable eating patterns to limit malnutrition in older adults

Related toSpoke 06

Principal investigators
Hellas Cena,Flavia Magri,Antonio Di Sabatino

Other partecipantsIlaria Di Napoli, Sara Santero, Giulia Viroli, Nagaia Madini, Alice Beretta, Cecilia Ricciardi Rizzo
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Highlights

News
Outputs
InterviewJul 10, 2024

Malnutrition in the elderly: a growing health crisis needing a multidisciplinary approach


FeaturesMay 19, 2023

The Challenge of Malnutrition in Older Adults


Task involved

Task 6.1.1.

Profiling of vulnerable targets (in connection with SPOKE 5) through: a) analyses of existing data in children affected by obesity and ageing population at risk of malnutrition and non-communicable diseases (NCDs) b) screening of socioeconomic factors, lifestyle and dietary habits, environmental factors, food knowledge, nutritional status, body composition, functional status and disability, quality of life, genetic, metagenetic, phenotypic profiles, exposure to endocrine disruptors chemicals (EDCs), immune system functions in children and aging population with malnutrition c) human-derived biological samples analysis (including samples for the gut microbiome structure analysis and function).

Task 6.2.1.

Identification of sustainable tailored multidimensional approach including nutritional strategies aimed at reducing malnutrition in target specific populations by exploiting the interactions between environment, food, genotype and phenotype: a) analysis of the positive and negative interactions between lifestyle, socioeconomic status, clinical condition, psychological distress, medical treatment and diet for the implementation of sustainable dietary patterns; b) malnutrition biomarker validation; c) draft of sustainable nutritional protocols (in connection with Spoke 1 and 4).

Task 6.4.1.

Implementation of sustainable dietary patterns as nutritional treatment for target specific groups with malnutrition. The task includes the prototyping of foods, supplements, ingredients and nutraceuticals aimed at restoring resilience in specific targets with malnutrition (in connection with Spoke 4). In addition, it is implemented a friendly end user personalised web responsive application for remote promoting and monitoring of sustainable dietary patterns target specific.

Task 6.4.2.

Preclinical and clinical evaluation of new prototypes of functional foods, food supplements, ingredients and nutraceuticals for preventing and treating malnutrition (in connection with Spoke 4).

Project deliverables

D6.1.1.1.

Systematic evaluation of existing data on nutritional status and critical issues for target specific groups with malnutrition (M8)

D6.1.1.2.

Identification and mapping of specific target groups with malnutrition (M24)

D6.1.1.3.

Creation of a biobank for biological samples in connection with Spoke 5 (M36)

D6.2.1.1.

Report on lifestyle, socioeconomic status, clinical condition, psychological distress, medical treatment, diet, cultural and environmental determinants of malnutrition in target specific populations (M24)

D6.2.1.2.

Evaluation and harmonisation of existing nutritional protocol, dietary guidelines for specific target groups with malnutrition (M10)

D6.2.1.5.

New sustainable nutrition protocols for specific target groups with malnutrition (M20)

D6.4.1.1.

Development and validation of new sustainable nutritional protocols for specific target groups with malnutrition (M36)

D6.4.2.1.

Proof of concept (M12)

D6.4.2.2.

Scaling up of innovative functional foods, food supplements, ingredients and nutraceuticals useful coadjuvant for malnutrition treatment (M30)

Interaction with other spokes

State of the art

Malnutrition due to disease or aging can be defined as “a state resulting from lack of uptake or intake of nutrition leading to altered body composition and body cell mass leading to diminished physical and mental function and impaired clinical outcome from disease”.
Aging, especially in subjects older than 65 years, is often characterized by different forms of malnutrition. Indeed, the overall prevalence of malnutrition in older patients ranges from 1% to 24.6%. In Europe the prevalence ranges from 0.8% (in the Netherlands and Sweden) to 11.0% (Italy and France). In addition, 50% of the older people in rehabilitation, 20% in residential care, and 40% in hospitals are malnourished. As a result of population aging, the malnutrition prevalence is increasing, and it is expected to reach 29.1% by 2080. 
Due to hospital admission, illness-related loss of appetite and drug-related side-effects, older subjects are at higher risk for malnutrition. Nutrition is an important modulator of health and well-being in older persons. Inadequate nutrition contributes to the progression of many diseases and is also regarded as one important contributing factor in the complex etiology of sarcopenia and frailty. Thus, assessment of nutritional status and adequate nutrition support are key factors for prevention and treatment with important public health impact.

Operation plan

At least 200 older adults (≥65 years) will be enrolled at the Internal Medicine and Rehabilitation units of ICS Fond. Maugeri, Pavia, Italy and Fondazione IRCCS Policlinico San Matteo, Pavia Italy. Exclusion criteria will be: dysphagia, preexisting nutritional medical treatment, terminal illness, past history of gastric bypass, anorexia nervosa, liver and kidney failure, severe dementia/confusion. 
Inclusion criteria will be; age > 65 y and written informed consent. The following parameters will be evaluated in each participant:

  • anthropometric measurements (height, weight, waist circumference, handgrip, bioimpedance);
  • socio-demographic characteristics;
  • nutritional status by GLIM diagnostic scheme for screening, assessment, diagnosis, and classification of malnutrition;
  • lifestyle factors (mediterranean and mind diet adherence, physical activity, sleep habits, smoking, alcohol consumption, independency);
  • healthy status;
  • sarcopenia assessment, diagnosis, and severity grading by EWGSOP2 consensus.

Additionally, blood samples will be collected for a complete nutritional evaluation and biobanking. 
Based on the observed results and on the literature evidence, new sustainable nutrition protocols for preventing and treating malnutrition will be developed. 
Finally, a smaller cohort of malnourished participants will be selected for the second RCT phase, which has the following objetives:

  • evaluation of the new sustainable nutrition protocols developed;
  • clinical evaluation (pilot randomized control trial) of 1 new prototype of functional food or a food supplement for preventing and treating malnutrition, which will be developed by the other partners of Spoke 6.

Expected results

It is expected that the identification through screening of older patients at risk or with malnutrition could provide an overview on older adults’ nutritional status and on potential new risk factors. Furthermore, it is expected to develop new care pathways and care interventions personalized on older adults’ needs.

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InterviewJul 10, 2024
Malnutrition in the elderly: a growing health crisis needing a multidisciplinary approach

An interview with Francesca Coperchini researcher of the SENIOR project


FeaturesMay 19, 2023
The Challenge of Malnutrition in Older Adults

Programmes of Work Packages 6.1, 6.2 and 6.4 of OnFoods and the flagship research project “SENIOR.”