News Round-up

£1.2 million National Lottery Boost to Help Older Scots ‘Eat Well, Age Well’

A new Scotland wide initiative aiming to tackle the rising tide of malnutrition amongst older people has received £1.2 million of National Lottery funding from the Big Lottery Fund. Led by award winning charity Food Train, the Eat Well, Age Well project will bring together voluntary groups, local and national government, private sector and health professionals to work together nationally to address malnutrition, which affects 1 in 10 older people across Scotland.

As an experienced charity working in this field, Food Train’s army of volunteers make hundreds of vital food deliveries to older people each week in seven local authority areas in Scotland.

Welcoming the funding, Food Train Chief Executive Michelle Carruthers MBE, said: “This funding award is the culmination of many dedicated people coming together, listening and learning from older people about their food needs. Through the Eat Well, Age Well project, we will work towards a sustainable approach to reduce malnutrition among older people living at home and create a long lasting and engaged network across the country committed to this issue. We are absolutely delighted with this Big Lottery Fund award, which will allow us to carry on the legacy of our founders in partnership with others.”

Big Lottery Fund Scotland Chair, Maureen McGinn, said: “This award, made possible by National Lottery players, will bring together partners in the public, third and private sectors to help tackle malnutrition amongst older people in our communities. With its expertise, knowledge and skills, the Food Train is well placed to lead this initiative while working with others to ensure a nation-wide approach. I look forward to following the progress of the Eat Well, Age Well Project as it begins to create a much needed strategy to address this across Scotland.”

Recognising the need for a coordinated approach to food and older people, the Scottish Government and Food Train co-hosted a national Malnutrition Summit in 2015.¹ Aileen Campbell MSP, Minister for Public Health, said: “I welcome the Big Lottery Fund in Scotland continuing their support for projects that deliver community benefits. Food Train has great experience of working with food, health and older people, and is well placed to take this forward. I look forward to hearing how this work progresses. No matter where you are from, everyone has an interest in food. It is important for health, and also plays a big part in social occasions, bringing people together for meals. The Scottish Government will consult on a new Diet and Obesity Strategy in the autumn. We will be considering how we can support everyone to access enough food, access the right food, and support everyone to make healthy choices at every step.”

In developing the proposal, Food Train heard stories from their older members,² who talked fondly of the meals and foods they used to love and share, but how age, frailty and an increasingly inaccessible care system affected their ability to eat as they wished. The Eat Well, Age Well project will test new ways of helping older people eat well across Scotland, while sharing the learning across the UK working alongside the London based Malnutrition Task Force.³

^{References: 1. www.communityfoodandhealth.org.uk/wp-content/uploads/2015/11/malnutrition-summit-report.pdf; 2. www.thefoodtrain.co.uk/images/21_Years_of_conversation_with_Older_People_in_Scotland.pdf; 3. www.malnutritiontaskforce.org.uk.}

Major Changes in Balance of Gut Bacteria Occur Soon after Serious Injury/Trauma

Changes might be used to help doctors stave off critical illness, say researchers.

Major changes in the balance and make-up of gut bacteria occur within 72 hours of serious injury/trauma, reveals a small study, published in the online journal Trauma Surgery & Acute Care Open.

These changes may influence the chances of recovery or death, and might enable doctors to stave off critical illness, suggest the study authors.

The gut has a key role in responding to injury, and the composition of gut bacteria (the microbiome) has been linked to various aspects of human health. But it’s not clear what changes occur in the guts of people who have been seriously injured.

The authors therefore assessed the numbers and types of bacteria in the stool samples of 12 critically injured patients. They had all been admitted to intensive care at one major trauma centre after sustaining serious and/or multiple injuries.

The samples were collected on admission, and then again 24 and 72 hours later. These were compared with stool samples taken from 10 patients treated at the same trauma centre, but who had not been seriously injured and who didn’t require intensive care.

All but one of the patients was male; the average age was 49, but ranged from 20 to 85.

The first of the samples taken showed comparable numbers and types of gut bacteria in the two groups of patients, but substantial differences began to emerge by the time the second sample was taken.

After 72 hours, the samples showed that bacteroidetes, fusobacteria, and verruccomicrobiaceae bacteria were all depleted, whereas clostridia and enterococci species had all increased.

“The short time course in which such alterations occur is also notable – such relatively rapid alterations in intestinal microbiota represent a critical and previously unrecognised phenomenon that may influence clinical course and outcomes after severe trauma,” write the authors.

They acknowledge that the sample size is small, and studies involving many more patients would be required before any firm conclusions could be drawn about the possible impact of these microbial changes.

But they point to other relevant research, including laboratory studies suggesting that critical illness may be linked to clinically significant changes in the microbiome, and recent research of burn injury patients, showing major changes in the composition and number of gut bacteria that may be associated with a heightened risk of sepsis.

“The gut bacterial community is known to modulate inflammation, and is related to a range of clinical outcomes in the patient who is critically ill,” they write.

They go on to say: “Implementing a probiotic regimen or guiding the microbial composition changes after trauma might prove a powerful tool in the critical care arsenal...Though causal relationships remain to be determined, a better understanding of the nature of these post injury changes may lead to the ability to intervene in otherwise pathological clinical trajectories.”

^{Research: Characterising the gut microbiome in trauma: significant changes in microbial diversity occur early after severe injury. Trauma Surgery & Acute Care Open: http://tsaco.bmj.com/lookup/doi/10.1136/tsaco-2017-000108}

 

 

E.U. Funded Research Consortium ‘LipiDiDiet’ Finds a Way to Impact Alzheimer’s Disease Before it’s too Late

Full results from the European LipiDiDiet clinical trial were published online in The Lancet Neurology.¹ The trial showed that in people with prodromal Alzheimer’s (the pre-dementia stage of this disease), consumption of a once-daily medical nutrition drink, whilst not improving a specific neuropsychological test battery (NTB)*, did result in a significant stabilisation of everyday cognitive and functional performance, as well as reduced brain shrinkage. The drink contains ‘Fortasyn Connect’, a specific combination of essential fatty acids, vitamins and other nutrients**.

The pioneering clinical trial is part of a large European Union funded project and involved 311 patients across 11 sites in four countries (Finland, Germany, the Netherlands and Sweden). The trial involved patients with prodromal Alzheimer’s (often referred to as Mild Cognitive Impairment or MCI). Patients were randomised to receive either the nutritional intervention or an iso-caloric control drink for 24 months.

The study’s primary endpoint, impact on NTB, was not met. The decline in the NTB of the control group was less than anticipated rendering this analysis statistically underpowered. However, key secondary endpoints showed significant advantages for nutrient-treated patients, with 45% less worsening in the Clinical Dementia Rating-Sum of Boxes (CDR-SB). This measure is especially important because it tracks the patient’s disease progression based on performance in managing everyday life, such as handling household emergencies, handling financial transactions or forgetting a major event. Furthermore, there was less brain atrophy in the active group, with 26% difference for the hippocampus and 16% for the ventricular volume. Progressive brain degeneration is typical for Alzheimer’s, with hippocampal damage being responsible for many of the associated memory deficits. Over the 24-month period the incidence of any adverse events were similar between the active and control groups.

Professor Hilkka Soininen, Professor in Neurology MD, PhD from the University of Eastern Finland, who headed the clinical trial as part of the LipiDiDiet project, said: "The results, published in The Lancet Neurology, are extremely valuable as they bring us closer to understanding the impact of nutritional interventions on prodromal Alzheimer’s, which we are now better at diagnosing but unable to treat due to a lack of approved pharmaceutical options. The LipiDiDiet study illustrates that this nutritional intervention can help to conserve brain tissue and also memory and patients' ability to perform everyday tasks – possibly the most troubling aspects of the disease.”

The LipiDiDiet trial is now the third clinical trial on this nutritional intervention to show favourable effects on memory performance. The two previous clinical trials involved patients with mild Alzheimer’s dementia and reported that daily intake of the nutritional intervention improved memory performance and increased measures of synaptic and functional connectivity in the brain.

Professor Tobias Hartmann, the project’s coordinator, said: “While this nutritional intervention is not a cure for Alzheimer’s, it effectively shows that the earlier in the disease process we intervene, the greater the advantage for the patient. Importantly, reduced atrophy in the patient’s brain shows that the benefit extends beyond symptomatic effects, something never before achieved."

For further information on the European LipiDiDiet study and consortium, visit: www.lipididiet.eu.

^{References: * The neuropsychological test battery (NTB) is a composite of different tests. In this case it included learning, recalling and recognising 10 high-frequency, high-imagery nouns, to recollect as many words that belong to the animals category and a letter digit substitution test.; ** Fortasyn Connect contains a combination of nutrients including omega-3 fatty acids, choline, uridine monophosphate, phospholipids, antioxidants and B vitamins. It is a Food for Special Medical Purpose (FSMP), clinically proven for the dietary management of early Alzheimer’s disease.; 1. Soininen H, Solomon A, Visser PJ, Hendrix SB, Blennow K, Kivipelto M, and Hartmann T on behalf of the LipiDiDiet clinical study group (2017). 24-month intervention with a specific multinutrient in patients with prodromal Alzheimer’s disease (LipiDiDiet): a randomised, double-blind, controlled trial. The Lancet Neurology.}

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