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Malnutrition is a major health concern among older adults in Pakistan due to cultural, economic, and health barriers that limit proper nutrition. This study aims to develop a culturally appropriate, protein-enriched food multi-mix (FMM) using locally available cereals, legumes, and soybean meal to improve the nutritional status of older adults. The study includes both a cross-sectional survey to assess malnutrition prevalence and a randomized controlled trial to evaluate the impact of the FMM intervention.
Malnutrition, particularly under nutrition poses a significant threat to the health and quality of life of older adults in Pakistan. Age-related changes in body composition, including a decrease in total body protein, lead to complications such as poor wound healing, reduced skin elasticity, and lower resistance to infection. Many older adults in Pakistan are unable to meet their daily protein requirements due to socioeconomic and dietary constraints. This project aims to develop a protein-enriched food multi-mix (FMM) tailored to the cultural preferences and nutritional needs of older adults in Pakistan. The concept of FMM is a novel and scientific approach to food diversification, combining traditional food knowledge with modern food technology. A randomized control trial was conducted to investigate the efficacy of the proposed protein-enriched recipe. The duration of the intervention study was 3 months, and one serving of the product was given to the study participants.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control Group (Group 1) | No Intervention | Participants in this group continued their usual diet without any additional intervention. Their nutritional status was monitored throughout the study as a baseline reference for comparison. | |
| Protein-Enriched Food Multi-Mix (FMM) (Group 2) | Experimental | Participants received a protein-enriched food multi-mix (FMM) developed from locally available cereals, legumes, and soybean meal. The FMM is culturally tailored and designed to enhance the dietary protein intake of older adults. |
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| Fortified Food Multi-Mix (FMM) (Group 3) | Experimental | Participants received a version of the FMM that is fortified with additional micronutrients (e.g., vitamins and minerals) to address both malnutrition and common micronutrient deficiencies among older adults. |
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| Food Multi-Mix (FMM)+ Physical Activity (Group 4) | Experimental | The standard protein-enriched FMM along with a structured daily physical activity regimen tailored for older adults. This group is designed to assess the synergistic effect of nutrition and physical activity on overall health and function. |
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| Fortified Food Multi-Mix (FMM) + Physical Activity (Group 5) |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Protein-Enriched Food Multi-Mix (FMM) | Dietary Supplement | The FMM was developed using locally sourced cereals and legumes and was enhanced with soybean meal. It was tailored to the taste preferences and dietary needs of older adults. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Nutritional Status | Nutritional status was assessed by using the Mini-Nutritional Assessment-Short Form (MNA-SF), a validated screening tool with scores ranging from 0 to 14, where higher scores indicate better nutritional status and lower scores indicate risk of malnutrition or malnutrition. This form consists of six main items and has a scoring of a total of 14 points classified as normal (12-14), at risk of malnutrition (8-11), and malnourished (0-7). The difference in MNA-SF scores before and after the intervention was measured to evaluate the effectiveness of the FMM and physical activity. | Baseline and after 12 weeks of intervention |
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Inclusion Criteria:
People aged 60 years and above
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Community | Lahore | Punjab Province | Pakistan |
Primary reason for not sharing the IPD is to protect participants privacy.
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| ID | Term |
|---|---|
| D044342 | Malnutrition |
| ID | Term |
|---|---|
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| D015444 | Exercise |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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The study involved five parallel groups: 1) a control group consuming their normal diet 2) one receiving the protein-enriched food multi-mix (FMM), 3) one receiving Fortified FMM, 4) one receiving FMM with daily physical activity, 5) one receiving fortified FMM with daily Physical activity
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Open-label study; participants and investigators were aware of the intervention.
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| Experimental |
The fortified version of the FMM was given to the participants combined with a structured daily physical activity plan. This group is intended to evaluate the combined effect of enhanced nutrition and exercise on nutritional status and physical performance. |
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| Fortified Food Multi-Mix (FMM) | Dietary Supplement | This is the fortified version of the standard FMM, with added essential micronutrients to improve nutritional status. |
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| Physical Activity | Other | A structured physical activity regimen appropriate for older adults was implemented daily. The activities were designed to enhance muscle strength, mobility, and overall health. |
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