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Purpose The present work aimed to delineate (i) a revised protocol according to recent methodological developments in evidence generation, to (ii) describe its interpretation, the assessment of the overall certainty of evidence and to (iii) outline an Evidence to Decision framework for deriving an evidence-based guideline on quantitative and qualitative aspects of dietary protein intake. Methods A methodological protocol to systematically investigate the association between dietary protein intake and several health outcomes and for deriving dietary protein intake recommendations for the primary prevention of various non-communicable diseases in the general adult population was developed. Results The developed methodological protocol relies on umbrella reviews including systematic reviews with or without meta-analyses. Systematic literature searches in three databases will be performed for each health-related outcome. The methodological quality of all selected systematic reviews will be evaluated using a modified version of AMSTAR 2, and the outcome-specific certainty of evidence for systematic reviews with or without meta-analysis will be assessed with NutriGrade. The general outline of the Evidence to Decision framework foresees that recommendations in the derived guideline will be given based on the overall certainty of evidence as well as on additional criteria such as sustainability. Conclusion The methodological protocol permits a systematic evaluation of published systematic reviews on dietary protein intake and its association with selected health-related outcomes. An Evidence to Decision framework will be the basis for the overall conclusions and the resulting recommendations for dietary protein intake.

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Multimodale Lebensstilinterventionen, besonders KR+AT+KT+VM, f��hren bei ��lteren Personen mit Adipositas zu einer (signifikanten) Reduktion des KG und der FM., Adipositas-Kongress 2021 ��� 37. Jahrestagung der Deutschen Adipositas-Gesellschaft e.V. /Kn��ttel (im Journal nur Abstract ver��ffentlicht/keg17.12.21)

Bei ��lteren Personen mit Adipositas erhalten multimodale Lebensstilinterventionen die FFM und verbessern die k��rperliche Funktion, was f��r den Erhalt der Selbst��ndigkeit einen besonderen Beitrag leisten kann., Adipositas-Kongress 2021 ��� 37. Jahrestagung der Deutschen Adipositas-Gesellschaft e.V. (im Journal nur Abstract ver��ffentlicht/keg17.12.21)

Nutritional care and nutritional status may differ in older persons receiving informal (IC) or professional (PC) home care and further depend on the living situation, but little is known in this regard. In this analysis of a cross-sectional multicenter study, type of care, living situation, and nutritional care were enquired in 353 older adults (&ge, 65) receiving IC or PC, living either with partner (LP), with others (LO) or alone (LA), and the nutritional status was determined by BMI and MNA&reg, For IC receivers, food shopping (IC-LP 94%, IC-LO 96%, IC-LA 92%) and warm meals (IC-LP 89%, IC-LO 90%, IC-LA 71%) were mainly provided by relatives, whereas 47% of PC-LA prepared warm meals by themselves and 22% received meals on wheels. Thirteen percent were underweight, 13% malnourished, and 57% at risk of malnutrition without differences between the groups. Adjusted odds ratios (OR) of being malnourished were also not different (IC-LP 2.2 [95% CI 0.5&ndash, 9.7], IC-LO 1.4 [0.3&ndash, 6.6], IC-LA 1.4 [0.3&ndash, 6.6]) compared to PC-LA. In conclusion, provision of nutritional care obviously differed according to the type of care and living situation, whereas nutritional status does not seem to be affected by these aspects. More research is clearly needed in this field.

Additional file 4: Table showing the knowledge of national recommendations for nutrition overall and according to the number of TM-levels and best practices for TMD. (DOCX 13 kb)

Additional file 1: Questionnaire that was used for the survey. (DOCX 84 kb)

Supplemental material, DoMAP_Revision_SupplTableS1 for Development of a Model on Determinants of Malnutrition in Aged Persons: A MaNuEL Project by Dorothee Volkert, Eva Kiesswetter, Tommy Cederholm, Lorenzo M. Donini, Doris Eglseer, Kristina Norman, Stéphane M. M. Schneider, Nanette Ströbele-Benschop, Gabriel Torbahn, Rainer Wirth and Marjolein Visser in Gerontology and Geriatric Medicine

Additional file 3: Table containing the availability of the different combinations of best practices for TMD. (DOCX 12 kb)

Additional file 2: Table containing the availability of the different combinations of TM-levels. (DOCX 12 kb)

Background For nursing home (NH) residents with swallowing or chewing problems, appealing texture-modified-diets (TMD) need to be available in order to support adequate nutrition. The aim of this study was to describe the availability of TMD and best practices for TMD in German NHs and to identify related NH characteristics. Methods Information on NH characteristics, available texture-modified (TM)-levels (soft, “minced & moist”, pureed) and implemented best practices for TMD (derived from menu plan, separately visible components, re-shaped components, considering individual capabilities of the resident) was collected in a survey in German NHs. The number of TM-levels as well as the number of best practices for TMD were tested for their association with 4 structural, 16 operational and 3 resident-related NH characteristics. Results The response rate was 7.2% (n = 590) and 563 NHs were included. The vast majority of NHs (95.2%) reported offering “minced & moist” texture and 84.2% preparing separately visible meal components. Several operational characteristics were more frequently (p

Oropharyngeal dysphagia (OD) is a highly prevalent and growing condition in the older population. Although OD may cause very severe complications, it is often not detected, explored, and treated. Older patients are frequently unaware of their swallowing dysfunction which is one of the reasons why the consequences of OD, ie, aspiration, dehydration, and malnutrition, are regularly not attributed to dysphagia. Older patients are particularly vulnerable to dysphagia because multiple age-related changes increase the risk of dysphagia. Physicians in charge of older patients should be aware that malnutrition, dehydration, and pneumonia are frequently caused by (unrecognized) dysphagia. The diagnosis is particularly difficult in the case of silent aspiration. In addition to numerous screening tools, videofluoroscopy was the traditional gold standard of diagnosing OD. Recently, the fiberoptic endoscopic evaluation of swallowing is increasingly utilized because it has several advantages. Besides making a diagnosis, fiberoptic endoscopic evaluation of swallowing is applied to evaluate the effectiveness of therapeutic maneuvers and texture modification of food and liquids. In addition to swallowing training and nutritional interventions, newer rehabilitation approaches of stimulation techniques are showing promise and may significantly impact future treatment strategies.

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