Estimation of Physical Activity Level in Elderly Nursing Home Residents

Objective: According to the 2010 edition of Dietary Reference Intakes for Japanese (DRIs-J), the estimated energy requirement (EER) is calculated as the basal metabolic rate (BMR) multiplied by the physical activity level (PAL). Nutritional management is expected to be performed on an individual bas...

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Published inEiyōgaku zasshi Vol. 71; no. 5; pp. 235 - 241
Main Authors Tanaka, Kiyoshi, Ohta, Junko, Fujii, Ayano, Kuwabara, Akiko
Format Journal Article
LanguageEnglish
Japanese
Published The Japanese Society of Nutrition and Dietetics 2013
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ISSN0021-5147
1883-7921
DOI10.5264/eiyogakuzashi.71.235

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Abstract Objective: According to the 2010 edition of Dietary Reference Intakes for Japanese (DRIs-J), the estimated energy requirement (EER) is calculated as the basal metabolic rate (BMR) multiplied by the physical activity level (PAL). Nutritional management is expected to be performed on an individual basis for the elderly nursing home residents, and therefore, knowledge regarding the appropriate EER is essential. These subjects are highly problematic in that they have extremely large differences in their BMR and PAL. In this study, we preliminarily analyzed the methods for PAL estimation in these subjects. Subjects and Methods: The study subjects were 28 elderly women who had been nursing home residents for more than three months, and the inclusion criteria were body weight changes of less than 3% and serum albumin level higher than 3.6 g/dl. BMR was estimated using two equations: first, the one by the National Institute of Health and Nutrition (NIHN), and second, the one in the 2010 edition of DRIs-J. The estimated PAL was defined as the total energy intake divided by the BMR. Results: There were no differences in terms of age, height, weight, BMI, or serum albumin levels between the subjects receiving nursing care levels 1-2 and those receiving nursing care levels 3-5. The estimated PAL was lower in the former than in the latter, although these findings were not statistically significant. PAL estimated on the basis of the NIHN equation exceeded 1.8 in 10 of the subjects, which was considered inappropriately high. Conclusions: PAL estimated by various equations have given different results. Further studies are warranted regarding the determination of PAL in nursing home residents.
AbstractList Objective: According to the 2010 edition of Dietary Reference Intakes for Japanese (DRIs-J), the estimated energy requirement (EER) is calculated as the basal metabolic rate (BMR) multiplied by the physical activity level (PAL). Nutritional management is expected to be performed on an individual basis for the elderly nursing home residents, and therefore, knowledge regarding the appropriate EER is essential. These subjects are highly problematic in that they have extremely large differences in their BMR and PAL. In this study, we preliminarily analyzed the methods for PAL estimation in these subjects. Subjects and Methods: The study subjects were 28 elderly women who had been nursing home residents for more than three months, and the inclusion criteria were body weight changes of less than 3% and serum albumin level higher than 3.6 g/dl. BMR was estimated using two equations: first, the one by the National Institute of Health and Nutrition (NIHN), and second, the one in the 2010 edition of DRIs-J. The estimated PAL was defined as the total energy intake divided by the BMR. Results: There were no differences in terms of age, height, weight, BMI, or serum albumin levels between the subjects receiving nursing care levels 1-2 and those receiving nursing care levels 3-5. The estimated PAL was lower in the former than in the latter, although these findings were not statistically significant. PAL estimated on the basis of the NIHN equation exceeded 1.8 in 10 of the subjects, which was considered inappropriately high. Conclusions: PAL estimated by various equations have given different results. Further studies are warranted regarding the determination of PAL in nursing home residents.
Author Kuwabara, Akiko
Ohta, Junko
Fujii, Ayano
Tanaka, Kiyoshi
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  organization: Department of Food and Nutrition, Kyoto Women's University
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  fullname: Ohta, Junko
  organization: Department of Food and Nutrition, Kyoto Women's University
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  fullname: Fujii, Ayano
  organization: Department of Food and Nutrition, Kyoto Women's University
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  fullname: Kuwabara, Akiko
  organization: Department of Health and Nutrition, Osaka Shoin Women's University
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References 11) 厚生労働省:「日本人の食事摂取基準」策定検討委員会報告書 日本人の食事摂取基準[2010年版],p. 17 (2009) 第一出版,東京
3) 食事摂取基準の実践・運用を考える会編:日本人の食事摂取基準[2010年版]の実践・運用 特定給食施設等における栄養・食事管理,pp. 13-14 (2011) 第一出版,東京
4) Miyake, R., Tanaka, S., Ohkawara, K., et al.: Validity of predictive equations for basal metabolic rate in japanese adults, J. Nutr. Sci. Vitaminol, 57, 224-232 (2011
6) 食事摂取基準の実践・運用を考える会編:日本人の食事摂取基準[2010年版]の実践・運用 特定給食施設等における栄養・食事管理,pp. 61-67 (2011) 第一出版,東京
7) 日本栄養システム学会:介護保険施設における栄養ケア・マネジメントの実務のために,pp. 95-96 (2005) 日本健康・栄養システム学会,東京
9) 厚生労働省:要介護度認定に係る制度の概要,http://www.mhlw.go.jp/topics/kaigo/nintei/gaiyo1.html, (2012年9月20日
2) Ganpule, A.A., Tanaka, S., Ishikawa-Takata, K., et al.: Interindividual variability in sleeping metabolic rate in Japanese subjects, Eur. J. Clin. Nutr., 61, 1256-1261 (2007
12) 三橋扶佐子:安静時エネルギー代謝,これからの高齢者の栄養管理サービス栄養ケアとマネジメント,(細谷憲政,松田 朗監),pp. 90-97 (1998) 第一出版,東京
8) 宮澤 靖,東口高志:モニタリングテクニック─栄養管理法の評価と再プランニング,コメディカルのための静脈・経腸栄養手技マニュアル,(日本静脈経腸学会編),pp. 221-227 (2005) 南江堂,東京
1) 厚生労働省:「日本人の食事摂取基準」策定検討委員会報告書:日本人の食事摂取基準[2010年版],pp. 43-61 (2009) 第一出版,東京
5) 食事摂取基準の実践・運用を考える会編:日本人の食事摂取基準[2010年版]の実践・運用 特定給食施設等における栄養・食事管理,pp. 58-60 (2011) 第一出版,東京
10) 厚生労働省:介護保険制度における要介護認定の仕組み,http://www.mhlw.go.jp/topics/kaigo/kentou/15kourei/sankou3.html, (2012年9月20日
11
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12
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4
5
6
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References_xml – reference: 1) 厚生労働省:「日本人の食事摂取基準」策定検討委員会報告書:日本人の食事摂取基準[2010年版],pp. 43-61 (2009) 第一出版,東京
– reference: 12) 三橋扶佐子:安静時エネルギー代謝,これからの高齢者の栄養管理サービス栄養ケアとマネジメント,(細谷憲政,松田 朗監),pp. 90-97 (1998) 第一出版,東京
– reference: 4) Miyake, R., Tanaka, S., Ohkawara, K., et al.: Validity of predictive equations for basal metabolic rate in japanese adults, J. Nutr. Sci. Vitaminol, 57, 224-232 (2011)
– reference: 7) 日本栄養システム学会:介護保険施設における栄養ケア・マネジメントの実務のために,pp. 95-96 (2005) 日本健康・栄養システム学会,東京
– reference: 3) 食事摂取基準の実践・運用を考える会編:日本人の食事摂取基準[2010年版]の実践・運用 特定給食施設等における栄養・食事管理,pp. 13-14 (2011) 第一出版,東京
– reference: 2) Ganpule, A.A., Tanaka, S., Ishikawa-Takata, K., et al.: Interindividual variability in sleeping metabolic rate in Japanese subjects, Eur. J. Clin. Nutr., 61, 1256-1261 (2007)
– reference: 10) 厚生労働省:介護保険制度における要介護認定の仕組み,http://www.mhlw.go.jp/topics/kaigo/kentou/15kourei/sankou3.html, (2012年9月20日)
– reference: 11) 厚生労働省:「日本人の食事摂取基準」策定検討委員会報告書 日本人の食事摂取基準[2010年版],p. 17 (2009) 第一出版,東京
– reference: 5) 食事摂取基準の実践・運用を考える会編:日本人の食事摂取基準[2010年版]の実践・運用 特定給食施設等における栄養・食事管理,pp. 58-60 (2011) 第一出版,東京
– reference: 9) 厚生労働省:要介護度認定に係る制度の概要,http://www.mhlw.go.jp/topics/kaigo/nintei/gaiyo1.html, (2012年9月20日)
– reference: 6) 食事摂取基準の実践・運用を考える会編:日本人の食事摂取基準[2010年版]の実践・運用 特定給食施設等における栄養・食事管理,pp. 61-67 (2011) 第一出版,東京
– reference: 8) 宮澤 靖,東口高志:モニタリングテクニック─栄養管理法の評価と再プランニング,コメディカルのための静脈・経腸栄養手技マニュアル,(日本静脈経腸学会編),pp. 221-227 (2005) 南江堂,東京
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SubjectTerms dietary reference intakes for Japanese 2010 (DRIs 2010)
elderly nursing home
energy intake
nursing care level
physical activity level (PAL)
Title Estimation of Physical Activity Level in Elderly Nursing Home Residents
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