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The feasibility of serving liquid yoghurt supplemented with probiotic bacteria, Lactobacillus rhamnosus LB 21, and Lactococcus lactis L1A — A pilot study among old people with dementia in a residential care facility

  • JNHA: Clinical Trials and Aging
  • Published:
JNHA - The Journal of Nutrition, Health and Aging

Abstract

Background

Constipation and body weight loss are prevalent among old people. Treatment with different species of lactic acid bacteria has been suggested for various forms of gastrointestinal disorders.

Objective, participants and intervention

This pilot study was performed to assess the feasibility of administering and consuming a drinkable yoghurt containing Lactobacillus rhamnosus LB 21 and Lactococcus L1A, and to evaluate the influence on bowel movements and body weight in 15 people with dementia, aged 65–95 years in residential care facility.

Design

A drinkable yoghurt (Verum Drickyoghurt©) with added bacteria was served daily for 6 months in conjunction with ordinary food intake. Body weight, bowel movement frequency and consistency, food and fluid intake and time spent in various activities were recorded for two weeks preintervention, and 3 times during the follow-up period.

Result

This study showed that the yoghurt was easy to serve, with few side effects for the participants and that the various recording forms and diaries were easy for the staff to complete. The extra intake of yoghurt did not have any detectable beneficial effect on bowel movements. The overnight fast was almost 15 hours per day. Body weight decreased by 0.65 kg/month (95% confidence interval. 0.27–0.97).

Conclusions

The present study design was feasible in this group of old people with dementia. The absence of any detectable effect of the supplement on constipation, but rather a considerable loss in body weight, indicate that further research is needed in a large randomised controlled trial, if associations between dementia, constipation and energy balance are to be understood.

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References

  1. Mamhidir AG, Ljunggren G, Kihlgren M, Kihlgren A, Wimo A. Underweight, weight loss and related risk factors among older adults in sheltered housing—a Swedish follow-up study. J Nutr Health Aging. Jul–Aug 2006;10(4):255–262.

    CAS  PubMed  Google Scholar 

  2. Suominen M, Muurinen S, Routasalo P, et al. Malnutrition and associated factors among aged residents in all nursing homes in Helsinki. Eur J Clin Nutr. Apr 2005;59(4):578–583.

    Article  CAS  PubMed  Google Scholar 

  3. Niwata S, Yamada Y, Ikegami N. Prevalence of inappropriate medication using Beers criteria in Japanese long-term care facilities. BMC Geriatr. 2006;6:1.

    Article  PubMed  Google Scholar 

  4. Hsieh C. Treatment of constipation in older adults. Am Fam Physician. Dec 1 2005;72(11):2277–2284.

    PubMed  Google Scholar 

  5. Corbi G, Acanfora D, Iannuzzi GL, et al. Hypermagnesemia predicts mortality in elderly with congestive heart disease: relationship with laxative and antacid use. Rejuvenation Res. Feb 2008;11(1):129–138.

    Article  CAS  PubMed  Google Scholar 

  6. Spinzi GC. Bowel care in the elderly. Dig Dis. 2007;25(2):160–165.

    Article  CAS  PubMed  Google Scholar 

  7. De Lillo AR, Rose S. Functional bowel disorders in the geriatric patient: constipation, fecal impaction, and fecal incontinence. Am J Gastroenterol. Apr 2000;95(4):901–905.

    Article  PubMed  Google Scholar 

  8. Lauque S, Arnaud-Battandier F, Mansourian R, et al. Protein-energy oral supplementation in malnourished nursing-home residents. A controlled trial. Age Ageing. Jan 2000;29(1):51–56.

    Article  CAS  PubMed  Google Scholar 

  9. Wouters-Wesseling W, Wouters AE, Kleijer CN, Bindels JG, de Groot CP, van Staveren WA. Study of the effect of a liquid nutrition supplement on the nutritional status of psycho-geriatric nursing home patients. Eur J Clin Nutr. Mar 2002;56(3):245–251.

    Article  CAS  PubMed  Google Scholar 

  10. Marteau PR, de Vrese M, Cellier CJ, Schrezenmeir J. Protection from gastrointestinal diseases with the use of probiotics. Am J Clin Nutr. Feb 2001;73(2 Suppl):430S–436S.

    CAS  PubMed  Google Scholar 

  11. Ahmed M, Prasad J, Gill H, Stevenson L, Gopal P. Impact of consumption of different levels of Bifidobacterium lactis HN019 on the intestinal microflora of elderly human subjects. J Nutr Health Aging. Jan–Feb 2007;11(1):26–31.

    CAS  PubMed  Google Scholar 

  12. Hatakka K, Ahola AJ, Yli-Knuuttila H, et al. Probiotics reduce the prevalence of oral candida in the elderly—a randomized controlled trial. J Dent Res. Feb 2007;86(2):125–130.

    Article  CAS  PubMed  Google Scholar 

  13. Beausoleil M, Fortier N, Guenette S, et al. Effect of a fermented milk combining Lactobacillus acidophilus Cl1285 and Lactobacillus casei in the prevention of antibiotic-associated diarrhea: a randomized, double-blind, placebo-controlled trial. Can J Gastroenterol. Nov 2007;21(11):732–736.

    CAS  PubMed  Google Scholar 

  14. Hickson M, D’souza AL, Muthu N, et al. Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial. Bmj. Jul 14 2007;335(7610):80.

    Article  PubMed  Google Scholar 

  15. Fukushima Y, Miyaguchi S, Yamano T, et al. Improvement of nutritional status and incidence of infection in hospitalised, enterally fed elderly by feeding of fermented milk containing probiotic Lactobacillus johnsonii La1 (NCC533). Br J Nutr. Nov 2007;98(5):969–977.

    Article  CAS  PubMed  Google Scholar 

  16. Gill H, Prasad J. Probiotics, immunomodulation, and health benefits. Adv Exp Med Biol. 2008;606:423–454.

    Article  PubMed  Google Scholar 

  17. Schiffrin EJ, Thomas DR, Kumar VB, et al. Systemic inflammatory markers in older persons: the effect of oral nutritional supplementation with prebiotics. J Nutr Health Aging. Nov–Dec 2007;11(6):475–479.

    CAS  PubMed  Google Scholar 

  18. Bu LN, Chang MH, Ni YH, Chen HL, Cheng CC. Lactobacillus casei rhamnosus Lcr35 in children with chronic constipation. Pediatr Int. Aug 2007;49(4):485–490.

    Article  PubMed  Google Scholar 

  19. Pitkala KH, Strandberg TE, Finne-Soveri UH, Ouwehand AC, Poussa T, Salminen S. Fermented cereal with specific bifidobacteria normalizes bowel movements in elderly nursing home residents. A randomized, controlled trial. Journal of Nutrition Health & Aging. Jul–Aug 2007;11(4):305–311.

    CAS  Google Scholar 

  20. Ouwehand AC, Lagstrom H, Suomalainen T, Salminen S. Effect of probiotics on constipation, fecal azoreductase activity and fecal mucin content in the elderly. Ann Nutr Metab. 2002;46(3–4):159–162.

    Article  CAS  PubMed  Google Scholar 

  21. Drossman DA, Dumitrascu DL. Rome III: New standard for functional gastrointestinal disorders. J Gastrointestin Liver Dis. Sep 2006;15(3):237–241.

    PubMed  Google Scholar 

  22. Chew ML, Mulsant BH, Pollock BG, et al. Anticholinergic activity of 107 medications commonly used by older adults. J Am Geriatr Soc. Jul 2008;56(7):1333–1341.

    Article  PubMed  Google Scholar 

  23. Bray GA. Obesity—a disease of nutrient or energy balance? Nutr Rev. Feb 1987;45(2):33–43.

    CAS  PubMed  Google Scholar 

  24. Persson M, Elmstahl S, Westerterp KR. Validation of a dietary record routine in geriatric patients using doubly labelled water. Eur J Clin Nutr. Oct 2000;54(10):789–796.

    Article  CAS  PubMed  Google Scholar 

  25. Fransson P, Lofroth PO, Franzen L, Henriksson R, Bergstrom P, Widmark A. Acute side effects after dose-escalation treatment of prostate cancer using the new urethral catheter BeamCath technique. Acta Oncol. 2001;40(6):756–765.

    Article  CAS  PubMed  Google Scholar 

  26. Chumlea WC, Roche AF, Steinbaugh ML. Estimating stature from knee height for persons 60 to 90 years of age. J Am Geriatr Soc. Feb 1985;33(2):116–120.

    CAS  PubMed  Google Scholar 

  27. Integrating Nutrition and Physical Activity. Nordic Nutrition Recommendations 2004, 4th ed. Nord 2004:13. Copenhagen: Nordic Council of Ministers, 2004.

    Google Scholar 

  28. Campbell WW, Evans WJ. Protein requirements of elderly people. Eur J Clin Nutr. Feb 1996;50 Suppl 1:S180–183; discussion S183–185.

    Google Scholar 

  29. Copinschi G, Van Reeth O, Van Cauter E. [Biologic rhythms. Effect of aging on the desynchronization of endogenous rhythmicity and environmental conditions]. Presse Med. May 1–8 1999;28(17):942–946.

    CAS  PubMed  Google Scholar 

  30. Ainsworth BE, Haskell WL, Leon AS, et al. Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc. Jan 1993;25(1):71–80.

    Article  CAS  PubMed  Google Scholar 

  31. Frankenfield DC, Muth ER, Rowe WA. The Harris-Benedict studies of human basal metabolism: history and limitations. J Am Diet Assoc. Apr 1998;98(4):439–445.

    Article  CAS  PubMed  Google Scholar 

  32. Goldberg GR, Black AE, Jebb SA, et al. Critical evaluation of energy intake data using fundamental principles of energy physiology: 1. Derivation of cut-off limits to identify under-recording. Eur J Clin Nutr. Dec 1991;45(12):569–581.

    CAS  PubMed  Google Scholar 

  33. Black AE, Coward WA, Cole TJ, Prentice AM. Human energy expenditure in affluent societies: an analysis of 574 doubly-labelled water measurements. Eur J Clin Nutr. Feb 1996;50(2):72–92.

    CAS  PubMed  Google Scholar 

  34. Pinheiro J, Bornkamp B, Bretz F. Design and analysis of dose-finding studies combining multiple comparisons and modeling procedures. J Biopharm Stat. 2006;16(5):639–656.

    Article  PubMed  Google Scholar 

  35. Morley JE. Anorexia of aging: physiologic and pathologic. Am J Clin Nutr. Oct 1997;66(4):760–773.

    CAS  PubMed  Google Scholar 

  36. Wilson MM, Purushothaman R, Morley JE. Effect of liquid dietary supplements on energy intake in the elderly. Am J Clin Nutr. May 2002;75(5):944–947.

    CAS  PubMed  Google Scholar 

  37. Wang PN, Yang CL, Lin KN, Chen WT, Chwang LC, Liu HC. Weight loss, nutritional status and physical activity in patients with Alzheimer’s disease. A controlled study. J Neurol. Mar 2004;251(3):314–320.

    Article  PubMed  Google Scholar 

  38. Niskanen L, Piirainen M, Koljonen M, Uusitupa M. Resting energy expenditure in relation to energy intake in patients with Alzheimer’s disease, multi-infarct dementia and in control women. Age Ageing. Mar 1993;22(2):132–137.

    Article  CAS  PubMed  Google Scholar 

  39. Grundman M, Corey-Bloom J, Jernigan T, Archibald S, Thal LJ. Low body weight in Alzheimer’s disease is associated with mesial temporal cortex atrophy. Neurology. Jun 1996;46(6):1585–1591.

    CAS  PubMed  Google Scholar 

  40. O’Donovan D, Hausken T, Lei Y, et al. Effect of aging on transpyloric flow, gastric emptying, and intragastric distribution in healthy humans—impact on glycemia. Dig Dis Sci. Apr 2005;50(4):671–676.

    Article  PubMed  Google Scholar 

  41. Westerterp KR, Goris AH. Validity of the assessment of dietary intake: problems of misreporting. Curr Opin Clin Nutr Metab Care. Sep 2002;5(5):489–493.

    Article  PubMed  Google Scholar 

  42. Morais JA, Chevalier S, Gougeon R. Protein turnover and requirements in the healthy and frail elderly. J Nutr Health Aging. Jul–Aug 2006;10(4):272–283.

    CAS  PubMed  Google Scholar 

  43. Houston DK, Nicklas BJ, Ding J, et al. Dietary protein intake is associated with lean mass change in older, community-dwelling adults: the Health, Aging, and Body Composition (Health ABC) Study. Am J Clin Nutr. Jan 2008;87(1):150–155.

    CAS  PubMed  Google Scholar 

  44. Morley JE. Constipation and irritable bowel syndrome in the elderly. Clin Geriatr Med. Nov 2007;23(4):823–832, vi–vii.

    Article  PubMed  Google Scholar 

  45. Petticrew M, Watt I, Sheldon T. Systematic review of the effectiveness of laxatives in the elderly. Health Technol Assess. 1997;1(13):i–iv, 1–52.

    CAS  PubMed  Google Scholar 

  46. Arnaud MJ. Mild dehydration: a risk factor of constipation? Eur J Clin Nutr. Dec 2003;57Suppl 2:S88–95.

    Article  PubMed  Google Scholar 

  47. Merkel IS, Locher J, Burgio K, Towers A, Wald A. Physiologic and psychologic characteristics of an elderly population with chronic constipation. Am J Gastroenterol. Nov 1993;88(11):1854–1859.

    CAS  PubMed  Google Scholar 

  48. Bhutto A, Morley JE. The clinical significance of gastrointestinal changes with aging. Curr Opin Clin Nutr Metab Care. Sep 2008;11(5):651–660.

    Article  CAS  PubMed  Google Scholar 

  49. Bitar KN, Patil SB. Aging and gastrointestinal smooth muscle. Mech Ageing Dev. Dec 2004;125(12):907–910.

    Article  CAS  PubMed  Google Scholar 

  50. Saffrey MJ. Ageing of the enteric nervous system. Mech Ageing Dev. Dec 2004;125(12):899–906.

    Article  CAS  PubMed  Google Scholar 

  51. Everhart JE, Go VL, Johannes RS, Fitzsimmons SC, Roth HP, White LR. A longitudinal survey of self-reported bowel habits in the United States. Dig Dis Sci. Aug 1989;34(8):1153–1162.

    Article  CAS  PubMed  Google Scholar 

  52. Winter TA, O’Keefe SJ, Callanan M, Marks T. Effect of severe undernutrition and subsequent refeeding on gut mucosal protein fractional synthesis in human subjects. Nutrition. Jan 2007;23(1):29–35.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, SE-901 86, Umeå, Sweden

    Maine Carlsson, Y. Gustafson & S. Eriksson

  2. Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden

    L. Haglin

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  1. Maine Carlsson
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Correspondence to Maine Carlsson.

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Carlsson, M., Gustafson, Y., Haglin, L. et al. The feasibility of serving liquid yoghurt supplemented with probiotic bacteria, Lactobacillus rhamnosus LB 21, and Lactococcus lactis L1A — A pilot study among old people with dementia in a residential care facility. J Nutr Health Aging 13, 813–819 (2009). https://doi.org/10.1007/s12603-009-0218-3

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