Digitally supported dietary counselling may be helpful in increasing the protein intake in combined exercise and nutritional interventions in community-dwelling older adults. To study the effect of this approach, 212 older adults (72.2 ± 6.3 years) were randomised in three groups: control, exercise, or exercise plus dietary counselling. The dietary counselling during the 6-month intervention was a blended approach of face-to-face contacts and videoconferencing, and it was discontinued for a 6-month follow-up. Dietary protein intake, sources, product groups, resulting amino acid intake, and intake per eating occasion were assessed by a 3-day dietary record. The dietary counselling group was able to increase the protein intake by 32% at 6 months, and the intake remained 16% increased at 12 months. Protein intake mainly consisted of animal protein sources: dairy products, followed by fish and meat. This resulted in significantly more intake of essential amino acids, including leucine. The protein intake was distributed evenly over the day, resulting in more meals that reached the protein and leucine targets. Digitally supported dietary counselling was effective in increasing protein intake both per meal and per day in a lifestyle intervention in community-dwelling older adults. This was predominantly achieved by consuming more animal protein sources, particularly dairy products, and especially during breakfast and lunch.
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IntroductionTo stimulate early recognition and treatment of malnutrition, the Dutch Healthcare Inspectorate obliged all hospitals from 2008–2019 to report the number of malnourished patients with an adequate protein intake on the fourth day of hospital admission. In this article we present results over the past 11 years and discuss success factors and barriers for adequate treatment of malnourished patients in hospitals.MethodsThe annual reports of hospitals on the numbers of patients with a screening result ‘malnourished’ and an adequate protein intake on the fourth day of admission were analysed. Hospitals were categorized based on the percentage of malnourished patients with an adequate protein intake on the fourth day of admission as ‘poor’ (<40% of patients in a hospital achieve an adequate protein intake), ‘moderate’ 40–60% of patients in a hospital achieve an adequate protein intake), and ‘good’ (>60% of patients in a hospital achieve an adequate protein intake). To identify success factors and barriers for adequate treatment and registration of malnourished patients in hospitals, three focus groups were held in June and July 2020. Participants were dietitians and quality employees or nurses who were involved in data collection for malnutrition indicators in their hospitals.ResultsBetween 2008–2019, data were reported of 339,720 malnourished patients. The relative number of patients with adequate intake of protein on the fourth day in hospital ranges from 44%-53% between 2011 and 2019. Before 2013, the number of hospitals that reported data was too small to draw conclusions about results of treatment of malnutrition. Data from 2013 to 2019, show a decline in the number of hospitals with a ‘poor’ score. The number of hospitals with a moderate score increased between 2015 and 2019 and the number of hospitals with a good score remained more or less stable, except for 2018 where more hospitals reached a ‘good’ score. Sixteen professionals from ten different hospitals participated in the focus groups and revealed several determinants of adequate treatment of malnourished patients in hospitals such as awareness, feeling responsible and the need of clear instructions and good collaboration.ConclusionThis inventory of the protein intake of 339,720 hospital malnourished patients over 11 years shows that in one out of five Dutch hospitals >60% of malnourished patients had an adequate protein intake on the fourth day of admission. This shows that meeting protein requirements remains a difficult challenge. Early recognition of malnutrition, optimal multidisciplinary treatment and continuous evaluation is necessary to provide optimal nutritional care in the hospital and beyond.
Cell-based production processes in bioreactors and fermenters need to be carefully monitored due to the complexity of the biological systems and the growth processes of the cells. Critical parameters are identified and monitored over time to guarantee product quality and consistency and to minimize over-processing and batch rejections. Sensors are already available for monitoring parameters such as temperature, glucose, pH, and CO2, but not yet for low-concentration substances like proteins and nucleic acids (DNA). An interesting critical parameter to monitor is host cell DNA (HCD), as it is considered an impurity in the final product (downstream process) and its concentration indicates the cell status (upstream process). The Molecular Biosensing group at the Eindhoven University of Technology and Helia Biomonitoring are developing a sensor for continuous biomarker monitoring, based on Biosensing by Particle Motion. With this consortium, we want to explore whether the sensor is suitable for the continuous measurement of HCD. Therefore, we need to set-up a joint laboratory infrastructure to develop HCD assays. Knowledge of how cells respond to environmental changes and how this is reflected in the DNA concentration profile in the cell medium needs to be explored. This KIEM study will enable us to set the first steps towards continuous HCD sensing from cell culture conditions controlling cell production processes. It eventually generates input for machine learning to be able to automate processes in bioreactors and fermenters e.g. for the production of biopharmaceuticals. The project entails collaboration with new partners and will set a strong basis for subsequent research projects leading to scientific and economic growth, and will also contribute to the human capital agenda.
