Impact of restrictive diets on the risk of undernutrition in a free-living elderly population

Abstract

Background & aims: Elderly subjects are at risk for undernutrition. Restrictive diets may increase this risk. The aim was to evaluate the impact of restrictive diets on undernutrition and its risk in free-living elderly.

Methods: Ambulatory patients over age 75 and under a restrictive diet (low salt, low cholesterol, diabetic) were included prospectively, along with age- and gender-matched controls. Weight and height were measured, and the short-form of the Mini Nutritional Assessment was scored. Groups were compared to determine variables associated with a low MNA-SF(®).

Results: 95 patients in the diet group (62 F, 33 M, 80 ± 4 y) and 95 controls (57 F, 38 M, 82 ± 5 y) were included. Restrictive diets (low salt n = 33, diabetic n = 19, low cholesterol n = 15, combination n = 27) had been followed since 11.0 ± 5.9 years. Using the cut-off of 12 for MNA-SF(®), 44 patients in the diet group were at risk vs. 22 among controls (P < 0.001). In multivariate analysis, a restrictive diet increased the probability of having an MNA-SF(®) < 12 (OR = 3.6, (95%)CI = 1.8-7.2, P < .001).

Conclusions: Restrictive diets in patients over 75 increase the risk of undernutrition. On an individual level, these diets may need reassessment. Society guidelines should promote specific recommendations for the elderly.