The Effects Of Testosterone And A Nutritional Supplement On Hospital Admissions In Under-nourished, Older People.
Funder
National Health and Medical Research Council
Funding Amount
$1,054,231.00
Summary
Weight loss and undernutrition in older people are assocated with poor outcomes including increased rates of hospital admissions and death. In a pilot study of 49 undernourished older, community dwelling people we found that daily treatment for one year with a combination of testosterone tablets and a nutritional supplement produced a significant reduction in hospitalisations. We propose a larger, multicentre study to explore and hopefully confirm this exciting, potentiallly important finding.
MATERNAL UNDERNUTRITION, INFANT REFEEDING, ADIPOSITY AND DIABETES
Funder
National Health and Medical Research Council
Funding Amount
$297,323.00
Summary
Malnutrition is a major health problem throughout the world and one of the priority areas for the WHO. Refeeding program guidelines have been established and implemented when children are assessed as being malnourished. Recent studies on the effect of these important programs throughout the world have suggested they may not have been as successful as wished. Indeed, even though many of the subjects are the urban poor, it has been found that many are developing diabetes in their twenties. This is ....Malnutrition is a major health problem throughout the world and one of the priority areas for the WHO. Refeeding program guidelines have been established and implemented when children are assessed as being malnourished. Recent studies on the effect of these important programs throughout the world have suggested they may not have been as successful as wished. Indeed, even though many of the subjects are the urban poor, it has been found that many are developing diabetes in their twenties. This is associated with an increase in abdominal fatness, out of proportion to the rest of the body's size and shape. The increase in diabetes in this group is most worrying and a major public health problem. It is not known whether the diabetes and abdominal fatness are caused by the refeeding programs or whether they are due to the fact that the body's metabolism was programmed during pregnancy. Perhaps the infants were malnourished whilst they were developing during pregnancy and metabolism was changed so they could store fat easily and not use glucose as readily in the rest of the body. This study is designed to show whether there are metabolic changes which predispose to diabetes and fatness present at birth in those who are malnourished or whether the refeeeding program designed to help them grow is the cause of these later problems.Read moreRead less
The Role Of Sarcopenia And Undernutrition In Disability After Hip Fracture
Funder
National Health and Medical Research Council
Funding Amount
$315,391.00
Summary
Hip fracture is one of the most costly and devastating medical events which can befall an elderly individual, and is expected to affect 40,000 Australians per year by the year 2040. It often results in permanent loss of walking abilities and independence, as well as a severely diminished quality of life. For example, 80% of elderly Australians who fracture their hip will not regain their previous level of walking ability, 20% will have died, and up to 25% will be in permanent nursing home reside ....Hip fracture is one of the most costly and devastating medical events which can befall an elderly individual, and is expected to affect 40,000 Australians per year by the year 2040. It often results in permanent loss of walking abilities and independence, as well as a severely diminished quality of life. For example, 80% of elderly Australians who fracture their hip will not regain their previous level of walking ability, 20% will have died, and up to 25% will be in permanent nursing home residence 12 months later. Although hip fracture has been thought of as a problem primarily related to osteoporosis (age-related loss of bone), it is now increasingly clear that other factors such as muscle wasting and weakness, gait and balance problems and poor dietary intake are also risk factors for this condition. Although surgical techniques have advanced to the point that most operations to repair hip fracture are now successful, the rehabilitation outcomes are disappointingly poor compared to other orthopaedic injuries. We believe that this is because recovery after hip fracture is in fact not primarily related to the bone disease itself, but to inadequate muscle bulk and strength. It is likely that already frail patients with a new hip fracture will experience further muscle wasting over time, because of their very low levels of physical activity, poor nutritional intake, depression, social isolation, and impaired memory in some cases. Their poor diet may be related in part to their difficulty in getting out of the home, preparing meals, reduced appetite and poor morale in the post-fracture period. If our theory is correct, then we will be able to prove that disability after hip fracture is closely related to muscle mass, and many common clinical problems contribute to this underlying mechanism of dysfunction. We will test these ideas by following patients who have had a hip fracture for 12 months with periodic detailed assessmentsRead moreRead less
The Effects Of Maternal Health On Fetal Kidney Development And Its Function
Funder
National Health and Medical Research Council
Funding Amount
$297,338.00
Summary
There is an epidemic of renal disease among Australian aborigines. While much of this could have been prevented by effective control of Group A streptococcal skin infections, there is also evidence that the high susceptibility to end-stage renal disease is related to poor intrauterine development of the kidney as low- birth weight is a predisposing factor. Mothers, whose renal function is impaired, tend to have babies which are low birth weight. There is no knowledge about the effects of materna ....There is an epidemic of renal disease among Australian aborigines. While much of this could have been prevented by effective control of Group A streptococcal skin infections, there is also evidence that the high susceptibility to end-stage renal disease is related to poor intrauterine development of the kidney as low- birth weight is a predisposing factor. Mothers, whose renal function is impaired, tend to have babies which are low birth weight. There is no knowledge about the effects of maternal renal dysfunction on development of the fetal kidney. We have recently developed an animal model in which we can study the effects of maternal renal dysfunction on the development of the kidney of her offspring. Human beings form 60% of the functional units (nephrons) in the kidney in the last trimester. Sheep, like human beings (and unlike rats), completely form all the nephrons that they will ever have, during intrauterine life. While the fetal kidneys play an essential role in the formation of amniotic fluid, regulation of fetal fluid and electrolyte homeostasis depends on maternal renal function via transplacental transfer. If maternal renal function is reduced, it is likely that the fetal kidneys will be exposed to a greater volume and solute load through transplacental equilibration. This may have a profund effect on renal development especially if coupled with an inadequate maternal diet and a high maternal salt intake. Under these conditions we predict that development of the fetal kidney will be impaired and renal capacity after birth, reduced. This means that the kidney will 'age' more rapidly. Thus the affected individual would be predisposed to renal disease in adult life. In our animal model we will study the effects and interactions of maternal renal insufficiency, poor fetal nutrition and a high maternal salt intake on fetal kidney development and function.Read moreRead less