Effect of a nutrition supplement and physical activity program on pneumonia and walking capacity in Chilean older people: a factorial cluster randomized trial.

<h4>Background</h4>Ageing is associated with increased risk of poor health and functional decline. Uncertainties about the health-related benefits of nutrition and physical activity for older people have precluded their widespread implementation. We investigated the effectiveness and cos...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Alan D Dangour, Cecilia Albala, Elizabeth Allen, Emily Grundy, Damian G Walker, Cristian Aedo, Hugo Sanchez, Olivia Fletcher, Diana Elbourne, Ricardo Uauy
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/577479eda7514c5fbd64170536f2c265
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:577479eda7514c5fbd64170536f2c265
record_format	dspace
spelling	oai:doaj.org-article:577479eda7514c5fbd64170536f2c2652021-11-18T05:41:50ZEffect of a nutrition supplement and physical activity program on pneumonia and walking capacity in Chilean older people: a factorial cluster randomized trial.1549-12771549-167610.1371/journal.pmed.1001023https://doaj.org/article/577479eda7514c5fbd64170536f2c2652011-04-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21526229/?tool=EBIhttps://doaj.org/toc/1549-1277https://doaj.org/toc/1549-1676<h4>Background</h4>Ageing is associated with increased risk of poor health and functional decline. Uncertainties about the health-related benefits of nutrition and physical activity for older people have precluded their widespread implementation. We investigated the effectiveness and cost-effectiveness of a national nutritional supplementation program and/or a physical activity intervention among older people in Chile.<h4>Methods and findings</h4>We conducted a cluster randomized factorial trial among low to middle socioeconomic status adults aged 65-67.9 years living in Santiago, Chile. We randomized 28 clusters (health centers) into the study and recruited 2,799 individuals in 2005 (~100 per cluster). The interventions were a daily micronutrient-rich nutritional supplement, or two 1-hour physical activity classes per week, or both interventions, or neither, for 24 months. The primary outcomes, assessed blind to allocation, were incidence of pneumonia over 24 months, and physical function assessed by walking capacity 24 months after enrollment. Adherence was good for the nutritional supplement (~75%), and moderate for the physical activity intervention (~43%). Over 24 months the incidence rate of pneumonia did not differ between intervention and control clusters (32.5 versus 32.6 per 1,000 person years respectively; risk ratio = 1.00; 95% confidence interval 0.61-1.63; p = 0.99). In intention-to-treat analysis, after 24 months there was a significant difference in walking capacity between the intervention and control clusters (mean difference 33.8 meters; 95% confidence interval 13.9-53.8; p = 0.001). The overall cost of the physical activity intervention over 24 months was US$164/participant; equivalent to US$4.84/extra meter walked. The number of falls and fractures was balanced across physical activity intervention arms and no serious adverse events were reported for either intervention.<h4>Conclusions</h4>Chile's nutritional supplementation program for older people is not effective in reducing the incidence of pneumonia. This trial suggests that the provision of locally accessible physical activity classes in a transition economy population can be a cost-effective means of enhancing physical function in later life.<h4>Trial registration</h4>Current Controlled Trials ISRCTN 48153354.Alan D DangourCecilia AlbalaElizabeth AllenEmily GrundyDamian G WalkerCristian AedoHugo SanchezOlivia FletcherDiana ElbourneRicardo UauyPublic Library of Science (PLoS)articleMedicineRENPLoS Medicine, Vol 8, Iss 4, p e1001023 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Alan D Dangour Cecilia Albala Elizabeth Allen Emily Grundy Damian G Walker Cristian Aedo Hugo Sanchez Olivia Fletcher Diana Elbourne Ricardo Uauy Effect of a nutrition supplement and physical activity program on pneumonia and walking capacity in Chilean older people: a factorial cluster randomized trial.
description	<h4>Background</h4>Ageing is associated with increased risk of poor health and functional decline. Uncertainties about the health-related benefits of nutrition and physical activity for older people have precluded their widespread implementation. We investigated the effectiveness and cost-effectiveness of a national nutritional supplementation program and/or a physical activity intervention among older people in Chile.<h4>Methods and findings</h4>We conducted a cluster randomized factorial trial among low to middle socioeconomic status adults aged 65-67.9 years living in Santiago, Chile. We randomized 28 clusters (health centers) into the study and recruited 2,799 individuals in 2005 (~100 per cluster). The interventions were a daily micronutrient-rich nutritional supplement, or two 1-hour physical activity classes per week, or both interventions, or neither, for 24 months. The primary outcomes, assessed blind to allocation, were incidence of pneumonia over 24 months, and physical function assessed by walking capacity 24 months after enrollment. Adherence was good for the nutritional supplement (~75%), and moderate for the physical activity intervention (~43%). Over 24 months the incidence rate of pneumonia did not differ between intervention and control clusters (32.5 versus 32.6 per 1,000 person years respectively; risk ratio = 1.00; 95% confidence interval 0.61-1.63; p = 0.99). In intention-to-treat analysis, after 24 months there was a significant difference in walking capacity between the intervention and control clusters (mean difference 33.8 meters; 95% confidence interval 13.9-53.8; p = 0.001). The overall cost of the physical activity intervention over 24 months was US$164/participant; equivalent to US$4.84/extra meter walked. The number of falls and fractures was balanced across physical activity intervention arms and no serious adverse events were reported for either intervention.<h4>Conclusions</h4>Chile's nutritional supplementation program for older people is not effective in reducing the incidence of pneumonia. This trial suggests that the provision of locally accessible physical activity classes in a transition economy population can be a cost-effective means of enhancing physical function in later life.<h4>Trial registration</h4>Current Controlled Trials ISRCTN 48153354.
format	article
author	Alan D Dangour Cecilia Albala Elizabeth Allen Emily Grundy Damian G Walker Cristian Aedo Hugo Sanchez Olivia Fletcher Diana Elbourne Ricardo Uauy
author_facet	Alan D Dangour Cecilia Albala Elizabeth Allen Emily Grundy Damian G Walker Cristian Aedo Hugo Sanchez Olivia Fletcher Diana Elbourne Ricardo Uauy
author_sort	Alan D Dangour
title	Effect of a nutrition supplement and physical activity program on pneumonia and walking capacity in Chilean older people: a factorial cluster randomized trial.
title_short	Effect of a nutrition supplement and physical activity program on pneumonia and walking capacity in Chilean older people: a factorial cluster randomized trial.
title_full	Effect of a nutrition supplement and physical activity program on pneumonia and walking capacity in Chilean older people: a factorial cluster randomized trial.
title_fullStr	Effect of a nutrition supplement and physical activity program on pneumonia and walking capacity in Chilean older people: a factorial cluster randomized trial.
title_full_unstemmed	Effect of a nutrition supplement and physical activity program on pneumonia and walking capacity in Chilean older people: a factorial cluster randomized trial.
title_sort	effect of a nutrition supplement and physical activity program on pneumonia and walking capacity in chilean older people: a factorial cluster randomized trial.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/577479eda7514c5fbd64170536f2c265
work_keys_str_mv	AT alanddangour effectofanutritionsupplementandphysicalactivityprogramonpneumoniaandwalkingcapacityinchileanolderpeopleafactorialclusterrandomizedtrial AT ceciliaalbala effectofanutritionsupplementandphysicalactivityprogramonpneumoniaandwalkingcapacityinchileanolderpeopleafactorialclusterrandomizedtrial AT elizabethallen effectofanutritionsupplementandphysicalactivityprogramonpneumoniaandwalkingcapacityinchileanolderpeopleafactorialclusterrandomizedtrial AT emilygrundy effectofanutritionsupplementandphysicalactivityprogramonpneumoniaandwalkingcapacityinchileanolderpeopleafactorialclusterrandomizedtrial AT damiangwalker effectofanutritionsupplementandphysicalactivityprogramonpneumoniaandwalkingcapacityinchileanolderpeopleafactorialclusterrandomizedtrial AT cristianaedo effectofanutritionsupplementandphysicalactivityprogramonpneumoniaandwalkingcapacityinchileanolderpeopleafactorialclusterrandomizedtrial AT hugosanchez effectofanutritionsupplementandphysicalactivityprogramonpneumoniaandwalkingcapacityinchileanolderpeopleafactorialclusterrandomizedtrial AT oliviafletcher effectofanutritionsupplementandphysicalactivityprogramonpneumoniaandwalkingcapacityinchileanolderpeopleafactorialclusterrandomizedtrial AT dianaelbourne effectofanutritionsupplementandphysicalactivityprogramonpneumoniaandwalkingcapacityinchileanolderpeopleafactorialclusterrandomizedtrial AT ricardouauy effectofanutritionsupplementandphysicalactivityprogramonpneumoniaandwalkingcapacityinchileanolderpeopleafactorialclusterrandomizedtrial
_version_	1718424848057761792

Effect of a nutrition supplement and physical activity program on pneumonia and walking capacity in Chilean older people: a factorial cluster randomized trial.

Ejemplares similares