Skip to main content
Top
Published in: BMC Geriatrics 1/2018

Open Access 01-12-2018 | Study protocol

A digitally supported home-based exercise training program and dietary protein intervention for community dwelling older adults: protocol of the cluster randomised controlled VITAMIN trial

Authors: Jantine van den Helder, Carliene van Dronkelaar, Michael Tieland, Sumit Mehra, Tessa Dadema, Bart Visser, Ben J. A. Kröse, Raoul H. H. Engelbert, Peter J. M. Weijs

Published in: BMC Geriatrics | Issue 1/2018

Login to get access

Abstract

Background

Increased physical activity and dietary protein intake are promising interventions to prevent or treat the age-related decline in physical performance in older adults. There are well-controlled exercise as well as dietary intervention studies that show beneficial effects on physical performance in older adults. In practice, however, weekly group based exercise or nutritional programs may not be as effective. To optimise these exercise programs for community dwelling older adults, a digitally supported and personalised home-based exercise training program has been designed aiming to improve physical performance in older adults. In addition, a protein intervention in combination with the training program may further improve physical performance in older adults.

Methods

The VITAMIN study will be a cluster randomised controlled trial with three parallel arms. In total, 240 community dwelling older adults (≥ 55 years) participating in weekly group exercise are randomly allocated into: 1) regular weekly exercise program (Control group, n = 80), 2) digitally supported personalised home-based exercise training program group (VITA group, n = 80) and 3) digitally supported personalised home-based exercise training program group plus dietary protein counselling (VITA-Pro group, n = 80). The VITAMIN study aims to evaluate effectiveness of the digitally supported personalised home-based exercise training program as well as the additional value of dietary protein on physical performance after 6 months. In addition, a 12 month follow-up measurement will assess the retaining effect of the interventions. Primary outcome is physical performance measured by the Modified Physical Performance Test (M-PPT) and relevant secondary and observational outcomes include habitual physical activity and dietary intake, body composition, cognitive performance, quality of life, compliance and tablet usage. Data will be analysed by Linear Mixed Models.

Discussion

To our knowledge, the VITAMIN study is the first study that investigates the impact of home-based exercise, protein intake as well as use of persuasive technology in the population of community dwelling older adults.

Trial registration

NL56094.029.16 / NTR (TC =​ 5888; registered 03–06-2016).
Literature
1.
go back to reference United Nations, Department of Economic and Social Affairs, Population Division. World population prospects: the 2015 revision, key findings and advance tables. 2015, ESA/P/WP.241. United Nations, Department of Economic and Social Affairs, Population Division. World population prospects: the 2015 revision, key findings and advance tables. 2015, ESA/P/WP.241.
2.
go back to reference Stenholm S, Westerlund H, Head J, Hyde M, Kawachi I, Pentti J, Kivimaki M, Vahtera J. Comorbidity and functional trajectories from midlife to old age: the health and retirement study. J Gerontol A Biol Sci Med Sci. 2015;70(3):332–8.CrossRefPubMed Stenholm S, Westerlund H, Head J, Hyde M, Kawachi I, Pentti J, Kivimaki M, Vahtera J. Comorbidity and functional trajectories from midlife to old age: the health and retirement study. J Gerontol A Biol Sci Med Sci. 2015;70(3):332–8.CrossRefPubMed
3.
go back to reference Taekema DG, Gussekloo J, Westendorp RG, de Craen AJ, Maier AB. Predicting survival in oldest old people. Am J Med. 2012;125(12):1194.e1.CrossRef Taekema DG, Gussekloo J, Westendorp RG, de Craen AJ, Maier AB. Predicting survival in oldest old people. Am J Med. 2012;125(12):1194.e1.CrossRef
4.
go back to reference Blair SN. Physical inactivity: the biggest public health problem of the 21st century. Br J Sports Med. 2009;43(1):1.PubMed Blair SN. Physical inactivity: the biggest public health problem of the 21st century. Br J Sports Med. 2009;43(1):1.PubMed
5.
go back to reference Wittink H, Engelbert R, Takken T. The dangers of inactivity; exercise and inactivity physiology for the manual therapist. Man Ther. 2011;16(3):209–16.CrossRefPubMed Wittink H, Engelbert R, Takken T. The dangers of inactivity; exercise and inactivity physiology for the manual therapist. Man Ther. 2011;16(3):209–16.CrossRefPubMed
6.
go back to reference Thorp AA, Healy GN, Owen N, Salmon J, Ball K, Shaw JE, Zimmet PZ, Dunstan DW. Deleterious associations of sitting time and television viewing time with cardiometabolic risk biomarkers: Australian diabetes, obesity and lifestyle (AusDiab) study 2004-2005. Diabetes Care. 2010;33(2):327–34.CrossRefPubMed Thorp AA, Healy GN, Owen N, Salmon J, Ball K, Shaw JE, Zimmet PZ, Dunstan DW. Deleterious associations of sitting time and television viewing time with cardiometabolic risk biomarkers: Australian diabetes, obesity and lifestyle (AusDiab) study 2004-2005. Diabetes Care. 2010;33(2):327–34.CrossRefPubMed
7.
go back to reference Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JC. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc. 2008;56(12):2234–43.CrossRefPubMed Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JC. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc. 2008;56(12):2234–43.CrossRefPubMed
8.
go back to reference de Vries NM, van Ravensberg CD, Hobbelen JS, Olde Rikkert MG, Staal JB, Nijhuis-van der Sanden MW. Effects of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in community-dwelling older adults with impaired mobility, physical disability and/or multi-morbidity: a meta-analysis. Ageing Res Rev. 2012;11(1):136–49.CrossRefPubMed de Vries NM, van Ravensberg CD, Hobbelen JS, Olde Rikkert MG, Staal JB, Nijhuis-van der Sanden MW. Effects of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in community-dwelling older adults with impaired mobility, physical disability and/or multi-morbidity: a meta-analysis. Ageing Res Rev. 2012;11(1):136–49.CrossRefPubMed
9.
go back to reference Pedersen BK, Saltin B. Evidence for prescribing exercise as therapy in chronic disease. Scand J Med Sci Sports. 2006;16(S1):3–63.CrossRefPubMed Pedersen BK, Saltin B. Evidence for prescribing exercise as therapy in chronic disease. Scand J Med Sci Sports. 2006;16(S1):3–63.CrossRefPubMed
11.
go back to reference Stiggelbout M, Popkema DY, Hopman-Rock M, de Greef M, van Mechelen W. Once a week is not enough: effects of a widely implemented group based exercise Programme for older adults; a randomised controlled trial. J Epidemiol Community Health. 2004;58(2):83–8.CrossRefPubMedPubMedCentral Stiggelbout M, Popkema DY, Hopman-Rock M, de Greef M, van Mechelen W. Once a week is not enough: effects of a widely implemented group based exercise Programme for older adults; a randomised controlled trial. J Epidemiol Community Health. 2004;58(2):83–8.CrossRefPubMedPubMedCentral
12.
go back to reference Chiung-ju L, Deepika MS, Leah YJ, Daniel OC. Systematic review of functional training on muscle strength, physical functioning, and activities of daily living in older adults. Eur Rev Aging Phys Act. 2014;11(2):95–106.CrossRef Chiung-ju L, Deepika MS, Leah YJ, Daniel OC. Systematic review of functional training on muscle strength, physical functioning, and activities of daily living in older adults. Eur Rev Aging Phys Act. 2014;11(2):95–106.CrossRef
13.
go back to reference Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King AC, Macera C, Castaneda-Sceppa C. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39(8):45.CrossRef Nelson ME, Rejeski WJ, Blair SN, Duncan PW, Judge JO, King AC, Macera C, Castaneda-Sceppa C. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39(8):45.CrossRef
14.
go back to reference Middelweerd A, Mollee JS, van der Wal CN, Brug J, Te Velde SJ. Apps to promote physical activity among adults: a review and content analysis. Int J Behav Nutr Phys Act. 2014;11:9.CrossRef Middelweerd A, Mollee JS, van der Wal CN, Brug J, Te Velde SJ. Apps to promote physical activity among adults: a review and content analysis. Int J Behav Nutr Phys Act. 2014;11:9.CrossRef
15.
go back to reference Geraedts HA, Zijlstra W, Zhang W, Bulstra S, Stevens M. Adherence to and effectiveness of an individually tailored home-based exercise program for frail older adults, driven by mobility monitoring: design of a prospective cohort study. BMC Public Health. 2014;14:570.CrossRefPubMedPubMedCentral Geraedts HA, Zijlstra W, Zhang W, Bulstra S, Stevens M. Adherence to and effectiveness of an individually tailored home-based exercise program for frail older adults, driven by mobility monitoring: design of a prospective cohort study. BMC Public Health. 2014;14:570.CrossRefPubMedPubMedCentral
16.
go back to reference Dasgupta D, Chaudhry B, Koh E, Chawla NV. A survey of tablet applications for promoting successful aging in older adults. Access. 2016;4:9005–17.CrossRef Dasgupta D, Chaudhry B, Koh E, Chawla NV. A survey of tablet applications for promoting successful aging in older adults. Access. 2016;4:9005–17.CrossRef
17.
go back to reference Culos-Reed SN, Rejeski WJ, McAuley E, Ockene JK, Roter DL. Predictors of adherence to behavior change interventions in the elderly. Control Clin Trials. 2000;21(Suppl):5S. Culos-Reed SN, Rejeski WJ, McAuley E, Ockene JK, Roter DL. Predictors of adherence to behavior change interventions in the elderly. Control Clin Trials. 2000;21(Suppl):5S.
18.
go back to reference Tieland CAB, Dirks ML, van der Zwaluw N, Verdijk L, van de Rest O, de Groot LC, C.P.G.M, van Loon LJ. Protein supplementation increases muscle mass gain during prolonged resistance-type exercise training in frail elderly people: a randomized double-blind, placebo-controlled trial. J Am Med Dir Assoc. 2012;13(8):713–9.CrossRefPubMed Tieland CAB, Dirks ML, van der Zwaluw N, Verdijk L, van de Rest O, de Groot LC, C.P.G.M, van Loon LJ. Protein supplementation increases muscle mass gain during prolonged resistance-type exercise training in frail elderly people: a randomized double-blind, placebo-controlled trial. J Am Med Dir Assoc. 2012;13(8):713–9.CrossRefPubMed
19.
go back to reference Deutz NE, Bauer JM, Barazzoni R, Biolo G, Boirie Y, Bosy-Westphal A, Cederholm T, Cruz-Jentoft A, Krznaric Z, Nair KS, Singer P, Teta D, Tipton K, Calder PC. Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN expert group. Clin Nutr. 2014;33(6):929–36.CrossRefPubMedPubMedCentral Deutz NE, Bauer JM, Barazzoni R, Biolo G, Boirie Y, Bosy-Westphal A, Cederholm T, Cruz-Jentoft A, Krznaric Z, Nair KS, Singer P, Teta D, Tipton K, Calder PC. Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN expert group. Clin Nutr. 2014;33(6):929–36.CrossRefPubMedPubMedCentral
20.
go back to reference Bauer J, Biolo G, Cederholm T, Cesari M, Cruz-Jentoft AJ, Morley JE, Phillips S, Sieber C, Stehle P, Teta D, Visvanathan R, Volpi E, Boirie Y. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE study group. J Am Med Dir Assoc. 2013;14(8):542–59.CrossRefPubMed Bauer J, Biolo G, Cederholm T, Cesari M, Cruz-Jentoft AJ, Morley JE, Phillips S, Sieber C, Stehle P, Teta D, Visvanathan R, Volpi E, Boirie Y. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE study group. J Am Med Dir Assoc. 2013;14(8):542–59.CrossRefPubMed
21.
go back to reference Cardinal BJ, Esters J, Cardinal MK. Evaluation of the revised physical activity readiness questionnaire in older adults. Med Sci Sports Exerc. 1996;28(4):468–72.CrossRefPubMed Cardinal BJ, Esters J, Cardinal MK. Evaluation of the revised physical activity readiness questionnaire in older adults. Med Sci Sports Exerc. 1996;28(4):468–72.CrossRefPubMed
22.
go back to reference Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.CrossRefPubMed Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.CrossRefPubMed
23.
go back to reference Mehra S, Dadema T, Kröse BJA, Visser B, Engelbert RHH, Van Den Helder J, Weijs PJM. Attitudes of older adults in a group-based exercise program toward a blended intervention; a focus-group study. Front Psychol. 2016;7:1827.CrossRefPubMedPubMedCentral Mehra S, Dadema T, Kröse BJA, Visser B, Engelbert RHH, Van Den Helder J, Weijs PJM. Attitudes of older adults in a group-based exercise program toward a blended intervention; a focus-group study. Front Psychol. 2016;7:1827.CrossRefPubMedPubMedCentral
24.
go back to reference Chodzko-Zajko WJ. Exercise and physical activity for older adults. Kinesiolo Rev. 2014;3(1):101–6.CrossRef Chodzko-Zajko WJ. Exercise and physical activity for older adults. Kinesiolo Rev. 2014;3(1):101–6.CrossRef
25.
go back to reference Cermak NM, Res PT, de Groot LC, Saris WH, van Loon LJ. Protein supplementation augments the adaptive response of skeletal muscle to resistance-type exercise training: a meta-analysis. Am J Clin Nutr. 2012;96(6):1454–64.CrossRefPubMed Cermak NM, Res PT, de Groot LC, Saris WH, van Loon LJ. Protein supplementation augments the adaptive response of skeletal muscle to resistance-type exercise training: a meta-analysis. Am J Clin Nutr. 2012;96(6):1454–64.CrossRefPubMed
27.
go back to reference Tieland CAB, Borgonjen-van den Berg KJ, van Loon LJ, de Groot LC, C.P.G.M. Dietary protein intake in community-dwelling, frail, and institutionalized elderly people: scope for improvement. Eur J Nutr. 2012;51(2):173–9.CrossRefPubMed Tieland CAB, Borgonjen-van den Berg KJ, van Loon LJ, de Groot LC, C.P.G.M. Dietary protein intake in community-dwelling, frail, and institutionalized elderly people: scope for improvement. Eur J Nutr. 2012;51(2):173–9.CrossRefPubMed
28.
go back to reference Brown M, Sinacore DR, Binder EF, Kohrt WM. Physical and performance measures for the identification of mild to moderate frailty. J Gerontol A Biol Sci Med Sci. 2000;55(6):350.CrossRef Brown M, Sinacore DR, Binder EF, Kohrt WM. Physical and performance measures for the identification of mild to moderate frailty. J Gerontol A Biol Sci Med Sci. 2000;55(6):350.CrossRef
29.
go back to reference Villareal DT, Chode S, Parimi N, Sinacore DR, Hilton T, Armamento-Villareal R, Napoli N, Qualls C, Shah K. Weight loss, exercise, or both and physical function in obese older adults. N Engl J Med. 2011;364(13):1218–29.CrossRefPubMedPubMedCentral Villareal DT, Chode S, Parimi N, Sinacore DR, Hilton T, Armamento-Villareal R, Napoli N, Qualls C, Shah K. Weight loss, exercise, or both and physical function in obese older adults. N Engl J Med. 2011;364(13):1218–29.CrossRefPubMedPubMedCentral
30.
go back to reference Mangione KK, Craik RL, Palombaro KM, Tomlinson SS, Hofmann MT. Home-based leg-strengthening exercise improves function 1 year after hip fracture: a randomized controlled study. J Am Geriatr Soc. 2010;58(10):1911–7.CrossRefPubMedPubMedCentral Mangione KK, Craik RL, Palombaro KM, Tomlinson SS, Hofmann MT. Home-based leg-strengthening exercise improves function 1 year after hip fracture: a randomized controlled study. J Am Geriatr Soc. 2010;58(10):1911–7.CrossRefPubMedPubMedCentral
31.
go back to reference Waters DL, Vawter R, Qualls C, Chode S, Armamento-Villareal R, Villareal DT. Long-term maintenance of weight loss after lifestyle intervention in frail, obese older adults. J Nutr Health Aging. 2013;17(1):3–7.CrossRefPubMedPubMedCentral Waters DL, Vawter R, Qualls C, Chode S, Armamento-Villareal R, Villareal DT. Long-term maintenance of weight loss after lifestyle intervention in frail, obese older adults. J Nutr Health Aging. 2013;17(1):3–7.CrossRefPubMedPubMedCentral
32.
go back to reference Reuben DB, Siu AL. An objective measure of physical function of elderly outpatients. The physical performance test. J Am Geriatr Soc. 1990;38(10):1105–12.CrossRefPubMed Reuben DB, Siu AL. An objective measure of physical function of elderly outpatients. The physical performance test. J Am Geriatr Soc. 1990;38(10):1105–12.CrossRefPubMed
33.
go back to reference Troosters T, Gosselink R, Decramer M. Six minute walking distance in healthy elderly subjects. Eur Respir J. 1999;14(2):270–4.CrossRefPubMed Troosters T, Gosselink R, Decramer M. Six minute walking distance in healthy elderly subjects. Eur Respir J. 1999;14(2):270–4.CrossRefPubMed
34.
go back to reference Podsiadlo D, Richardson S. The timed “up & go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142–8.CrossRefPubMed Podsiadlo D, Richardson S. The timed “up & go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142–8.CrossRefPubMed
35.
go back to reference Bohannon RW. Reference values for the timed up and go test: a descriptive meta-analysis. J Geriatr Phys Ther. 2006;29(2):64–8.CrossRefPubMed Bohannon RW. Reference values for the timed up and go test: a descriptive meta-analysis. J Geriatr Phys Ther. 2006;29(2):64–8.CrossRefPubMed
36.
go back to reference Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):85.CrossRef Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, Berkman LF, Blazer DG, Scherr PA, Wallace RB. A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol. 1994;49(2):85.CrossRef
37.
go back to reference Bassey EJ, Harries UJ. Normal values for handgrip strength in 920 men and women aged over 65 years, and longitudinal changes over 4 years in 620 survivors. Clin Sci (Lond). 1993;84(3):331–7.CrossRef Bassey EJ, Harries UJ. Normal values for handgrip strength in 920 men and women aged over 65 years, and longitudinal changes over 4 years in 620 survivors. Clin Sci (Lond). 1993;84(3):331–7.CrossRef
38.
go back to reference Delis DC, Kramer JH, Kaplan E, Holdnack J. Reliability and validity of the delis-Kaplan executive function system: an update. J Int Neuropsychol Soc. 2004;10(2):301–3.CrossRefPubMed Delis DC, Kramer JH, Kaplan E, Holdnack J. Reliability and validity of the delis-Kaplan executive function system: an update. J Int Neuropsychol Soc. 2004;10(2):301–3.CrossRefPubMed
39.
go back to reference Luhrmann PM, Herbert BM, Gaster C, Neuhauser-Berthold M. Validation of a self-administered 3-day estimated dietary record for use in the elderly. Eur J Nutr. 1999;38(5):235–40.CrossRefPubMed Luhrmann PM, Herbert BM, Gaster C, Neuhauser-Berthold M. Validation of a self-administered 3-day estimated dietary record for use in the elderly. Eur J Nutr. 1999;38(5):235–40.CrossRefPubMed
40.
go back to reference Hays RD, Morales LS. The RAND-36 measure of health-related quality of life. Ann Med. 2001;33(5):350–7.CrossRefPubMed Hays RD, Morales LS. The RAND-36 measure of health-related quality of life. Ann Med. 2001;33(5):350–7.CrossRefPubMed
41.
go back to reference Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982;17(1):37–49.CrossRefPubMed Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982;17(1):37–49.CrossRefPubMed
42.
go back to reference Markland D, Tobin V. A modification to the Behavioural regulation in exercise questionnaire to include an assessment of Amotivation. J Sport Exerc Psychol. 2004;26(2):191–6.CrossRef Markland D, Tobin V. A modification to the Behavioural regulation in exercise questionnaire to include an assessment of Amotivation. J Sport Exerc Psychol. 2004;26(2):191–6.CrossRef
43.
go back to reference Noreen EE, Lemon PW. Reliability of air displacement plethysmography in a large, heterogeneous sample. Med Sci Sports Exerc. 2006;38(8):1505–9.CrossRefPubMed Noreen EE, Lemon PW. Reliability of air displacement plethysmography in a large, heterogeneous sample. Med Sci Sports Exerc. 2006;38(8):1505–9.CrossRefPubMed
44.
go back to reference McCrory MA, Gomez TD, Bernauer EM, Mole PA. Evaluation of a new air displacement plethysmograph for measuring human body composition. Med Sci Sports Exerc. 1995;27(12):1686–91.CrossRefPubMed McCrory MA, Gomez TD, Bernauer EM, Mole PA. Evaluation of a new air displacement plethysmograph for measuring human body composition. Med Sci Sports Exerc. 1995;27(12):1686–91.CrossRefPubMed
45.
go back to reference Visser M, Fuerst T, Lang T, Salamone L, Harris TB. Validity of fan-beam dual-energy X-ray absorptiometry for measuring fat-free mass and leg muscle mass. Health, aging, and body composition study--dual-energy X-ray absorptiometry and body composition working group. J Appl Physiol (1985). 1999;87(4):1513.CrossRef Visser M, Fuerst T, Lang T, Salamone L, Harris TB. Validity of fan-beam dual-energy X-ray absorptiometry for measuring fat-free mass and leg muscle mass. Health, aging, and body composition study--dual-energy X-ray absorptiometry and body composition working group. J Appl Physiol (1985). 1999;87(4):1513.CrossRef
46.
go back to reference Njeh CF, Fuerst T, Hans D, Blake GM, Genant HK. Radiation exposure in bone mineral density assessment. Appl Radiat Isot. 1999;50(1):215–36.CrossRefPubMed Njeh CF, Fuerst T, Hans D, Blake GM, Genant HK. Radiation exposure in bone mineral density assessment. Appl Radiat Isot. 1999;50(1):215–36.CrossRefPubMed
47.
go back to reference Burkhart TA, Arthurs KL, Andrews DM. Manual segmentation of DXA scan images results in reliable upper and lower extremity soft and rigid tissue mass estimates. J Biomech. 2009;42(8):1138–42.CrossRefPubMed Burkhart TA, Arthurs KL, Andrews DM. Manual segmentation of DXA scan images results in reliable upper and lower extremity soft and rigid tissue mass estimates. J Biomech. 2009;42(8):1138–42.CrossRefPubMed
48.
go back to reference Kushner RF, Schoeller DA. Estimation of total body water by bioelectrical impedance analysis. Am J Clin Nutr. 1986;44(3):417–24.CrossRefPubMed Kushner RF, Schoeller DA. Estimation of total body water by bioelectrical impedance analysis. Am J Clin Nutr. 1986;44(3):417–24.CrossRefPubMed
49.
go back to reference World Health Organization. Waist circumference and waist-hip ratio: report of a WHO expert consultation. Geneva; 2011. World Health Organization. Waist circumference and waist-hip ratio: report of a WHO expert consultation. Geneva; 2011.
50.
go back to reference Mizrahi-Lehrer E, Cepeda-Valery B, Romero-Corral A. Anthropometry of body fat: how anthropometric measures predict mortality and especially cardiovascular mortality. In: Handbook of anthropometry. New York: Springer New York; 2012. p. 385–95.CrossRef Mizrahi-Lehrer E, Cepeda-Valery B, Romero-Corral A. Anthropometry of body fat: how anthropometric measures predict mortality and especially cardiovascular mortality. In: Handbook of anthropometry. New York: Springer New York; 2012. p. 385–95.CrossRef
51.
go back to reference Marfell-Jones M. Handbook: international standards for anthropometric assessment: International Society for the Advancement of Kinanthropometry; 2014. Marfell-Jones M. Handbook: international standards for anthropometric assessment: International Society for the Advancement of Kinanthropometry; 2014.
52.
go back to reference Falciglia G, O'Connor J, Gedling E. Upper arm anthropometric norms in elderly white subjects. J Am Diet Assoc. 1988;88(5):569–74.PubMed Falciglia G, O'Connor J, Gedling E. Upper arm anthropometric norms in elderly white subjects. J Am Diet Assoc. 1988;88(5):569–74.PubMed
Metadata
Title
A digitally supported home-based exercise training program and dietary protein intervention for community dwelling older adults: protocol of the cluster randomised controlled VITAMIN trial
Authors
Jantine van den Helder
Carliene van Dronkelaar
Michael Tieland
Sumit Mehra
Tessa Dadema
Bart Visser
Ben J. A. Kröse
Raoul H. H. Engelbert
Peter J. M. Weijs
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2018
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-018-0863-7

Other articles of this Issue 1/2018

BMC Geriatrics 1/2018 Go to the issue