Evidence Library

Search Plan and Results

Search Plan and Results

Evidence Analysis Question

What is the relationship between diet liberalization (selective diets, non-restrictive diets) and weight gain in adults over age 65?

Date of Literature Review

March 2007

Inclusion Criteria

Age

Adults (65 years and older).

Setting

Rehabilitation settings, long-term care, sub-acute care, transitional care, assisted living, residential care and homebound. May be bed-bound or wheelchair-bound.

Health Status

Any.

Nutrition Related Problem/Condition

Malnutrition, sarcopenia, weight loss, cachexia, starvation and unintentional weight loss in elderly patients consuming oral intake.

Study Design Preferences

RCT or clinical controlled studies

Large non-randomized observational studies

Cohort, case-control studies.

Size of study groups:

The sample size must equal 10 individuals for each study group. For example, this would include 10 patients in the intervention group and 10 patients in the control or comparison group.

Study Drop-out Rate

Less than 20%.

Year Range

2000 to 2007.

Authorship

If an author is included on more than one review article or primary research article that is similar in content, the most recent review or article will be accepted and earlier versions will be rejected.

If an author is included on more than one review article or primary research article and the content is different, then both reviews may be accepted.

Language

Limited to articles in English.

Exclusion Criteria

Age

Adults younger than 65 years of age.

Setting

Hospice.

Health Status

Any.

Nutrition Related Problem/Condition

Non-age-related unintentional weight loss, unintentional weight gain, patients on enteral and parenteral feedings.

Size of study groups

Less than 10 individuals for each study group. For example, this would include 10 patients in the intervention group and 10 patients in the control or comparison group.

Study Drop-out Rate

More than 20%.

Year Range

Prior to 2000.

Authorship

Studies by same author similar in content.

Language

Articles not in English.

Search Terms: Search Vocabulary

Health Condition

Weight loss, malnutrition, sarcopenia, cachexia, starvation, elderly, aged.

Intervention

Diet liberalization, selective diet, non-restrictive diet, cardiac, low sodium, low salt, no concentrated sweets, low simple sugar, low fat, low cholesterol, heart healthy.

Type of Study Design

RCTs, clinical studies, observational studies, cohort and case-control studies.

Electronic Databases

Database

Pubmed.

Search Terms

(Weight loss or weight gain or malnutrition or sarcopenia or cachexia or starvation) and (diet liberalization or selective diet or non-restrictive diet or menu or meal or choice or dietary restriction or diet restriction or cardiac or low sodium or low salt or no concentrated sweets or low simple sugar or low fat or low cholesterol or heart healthy) and (elderly or aged).

Hits

656.

Articles to Review

16.

CENTRAL database not used.

No other databases used.

Total articles identified to review from electronic databases: 19

Articles Identified from other sources:

From the ADA Position Paper

Schatz IJ, Masaki K, Yano K, Chen R, Rodriguez BL, Curb JD. Cholesterol and all-cause mortality in elderly people from the Honolulu Heart Program: A cohort study. Lancet. 2001; 358(9, 279): 351-355.

Simons LA, Simons J, Friedlander Y, McCallum J. Cholesterol an d other lipids predict coronary heart disease and ischaemic stroke in the elderly, but only in those below 70 years. Atherosclerosis. 2001; 159(1): 201-208.

Tariq SH, Karcic E, Thomas DR, Thomson K, Philpot C, Chapel DL, Morley JE. The use of a no-concentrated sweets diet in the management of type 2 diabetes in nursing homes. J Am Diet Assoc. 2001; 101(12): 1, 463-1, 466.

Inclusion List:

List of Included Articles

Kofod J, Birkemose A. Meals in nursing homes. Scand J Caring Sci. 2004; 18(2): 128-134.

Simons LA, Simons J, Friedlander Y, McCallum J. Cholesterol and other lipids predict coronary heart disease and ischaemic stroke in the elderly, but only in those below 70 years. Atherosclerosis. 2001; 159(1): 201-208.

Taylor KA, Barr SI. Provision of small, frequent meals does not improve energy intake of elderly residents with dysphagia who live in an extended care facility. J Am Diet Assoc. 2006; 106(7): 1, 115-1, 118.

Young KW, Greenwood CE. Shift in diurnal feeding patterns in nursing home residents with Alzheimer's disease. J Gerontol A Biol Sci Med Sci. 2001; 56(11): M700-M706.

Young KW, Greenwood CE, van Reekum R, Binns MA. A randomized, crossover trial of high-carbohydrate foods in nursing home residents with Alzheimer's disease: Associations among intervention response, body mass index, and behavioral and cognitive function. J Gerontol A Biol Sci Med Sci. 2005; 60(8): 1, 039-1, 045.

Articles Considered, but Excluded

List of Excluded Articles with Reason

Excluded Articles Reason for Exclusion

Christensson L, Ek AC, Unosson M. Individually adjusted meals for older people with protein-energy malnutrition: A single-case study. J Clin Nurs. 2001; 10(4): 491-502.
Moved to MNT.

Crogan NL, Evans B, Severtsen B, Shultz JA. Improving nursing home food service: Uncovering the meaning of food through residents' stories. J Gerontol Nurs. 2004; 30(2): 29-36. Only nine subjects.

Grylls WK, McKenzie JE, Horwath CC, Mann JI. Lifestyle factors associated with glycemic control and body mass index in older adults with diabetes. Eur J Clin Nutr. 2003; 57(11): 1, 386-1, 393. Dropout rate more than 20%.

Hays NP, Starling RD, Liu X, Sullivan DH, Trappe TA, Fluckey JD, Evans WJ. Effects of an ad libitum low-fat, high-carbohydrate diet on body weight, body composition, and fat distribution in older men and women: A randomized controlled trial. Arch Intern Med. 2004; 164(2): 210-217. Free-living seniors.

Hsieh CJ, Wang PW. Effectiveness of weight loss in the elderly with type 2 diabetes mellitus. J Endocrinol Invest. 2005; 28(11): 973-977.
Free-living seniors.

Keller HH, Gibbs AJ, Boudreau LD, Goy RE, Pattillo MS, Brown HM. Prevention of weight loss in dementia with comprehensive nutritional treatment. J Am Geriatr Soc. 2003; 51(7): 945-952.
Moved to MNT.

Keller HH, Hedley MR. Nutritional risk needs assessment of community-living seniors: Prevalence of nutrition problems and priorities for action. J Community Health. 2002; 27(2): 121-132. Community-living seniors.

Niedert KC, American Dietetic Association. Position of the American Dietetic Association: Liberalization of the diet prescription improves quality of life for older adults in long-term care. J Am Diet Assoc. 2005; 105(12): 1, 955-1, 965.
Position paper.

Olde-Rikkert MG, Rigaud AS. Malnutrition research: High time to change the menu. Age Aging. 2003; 32(3): 241-243. Editorial.

Paquet C, St-Arnaud -McKenzie D, Kergoat MJ, Ferland G, Dube L. Direct and indirect effects of everyday emotions on food intake of elderly patients in institutions. J Gerontol A Biol Sci Med Sci. 2003; 58(2): 153-158.
Moved to MNT.

Rasmussen HH, Kondrup J, Staun M, Ladefoged K, Lindorff K, Jorgensen LM, Jakobsen J, Kristensen H, Wengler A. A method for implementation of nutritional therapy in hospitals. Clin Nutr. 2006; 25(3): 515-523.
Not all subjects were over age 65.

Van Wymelbeke V, Guedon A, Maniere D, Manckoundia P, Pfitzenmeyer P. A 6-month follow-up of nutritional status in institutionalized patients with Alzheimer's disease. J Nutr Health Aging. 2004; 8(6): 505-508.
Intervention not typical.

Summary of Articles Identified to Review

Number of Included Primary Research Articles Identified from all sources: 7

Number of Included Review Articles Identified from all sources: 0

Total Number of Included Articles: 7

Number of Articles Considered but Excluded: 12

Total Number of Articles Considered: 19