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Hoefnagels FA, Patijn ON, Meeusen MJG, Battjes-Fries MCE. The perceptions of food service staff in a nursing home on an upcoming transition towards a healthy and sustainable food environment: a qualitative study. BMC Geriatr 2023; 23:784. [PMID: 38017378 PMCID: PMC10685581 DOI: 10.1186/s12877-023-04493-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 11/20/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Healthy and sustainable food environments are urgently needed, also in nursing and residential care homes. Malnutrition in care homes is becoming an increasing problem as populations worldwide are ageing and many older people do not consume sufficient protein, fibre, fruit, and vegetables. Nursing homes also often experience a lot of food waste. A transition in the food environment like a nursing home, involves the participation of facility management and food service staff members. This study aims to map out their perceived barriers and facilitators for this transition. METHODS A qualitative study using semi-structured interviews was conducted with food service staff members (n = 16), comprising of kitchen staff (n = 4), wait staff (n = 10), and facility management (n = 2) of two nursing homes in the Netherlands. Thematic analysis was used to derive content and meaning from transcribed interviews. RESULTS Four main themes were identified. Theme 1: 'Communication, transparency and accountability in the chain', highlighting the lack of effective communication flows and a fragmented overview of the food service chain as a whole. Theme 2: 'Understanding, knowledge and ability of the concepts healthy and sustainable', revealing the gap in staff's understanding of these abstract concepts, despite perceiving themselves as having sufficient knowledge and ability. Theme 3: 'The pampering service mind-set', highlighting the contradiction in the staff's shared goal of proving the highest quality of life for residents while also pampering them in ways that may not align with promoting healthy and sustainable food choices. Theme 4: 'Transition is important but hard to realize', describing the barriers such as existing routines and a lack of resources as challenges to implementing changes in the food service. CONCLUSIONS Facilitators to transitioning nursing homes towards a healthy and sustainable food environment as perceived by staff members included transparent communication, accountability in the food supply chain, staff's perceived ability and shared goal, while barriers included lack of understanding of the concepts healthy and sustainable, the current pampering mindset, and top-down decision-making. These findings provide valuable insights for nursing homes seeking to transition towards a healthier and more sustainable food environment.
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Affiliation(s)
- Femke A Hoefnagels
- Department of Health and Nutrition, Louis Bolk Institute, Kosterijland 3-5, Bunnik, 3981 AJ, the Netherlands.
| | - Olga N Patijn
- Department IxD, University of Twente, Drienerlolaan 5, Enschede, 7522 NB, The Netherlands
| | - Marieke J G Meeusen
- Wageningen Economic Research, Wageningen University & Research, P.O. Box 29703, The Hague, 2502 LS, The Netherlands
| | - Marieke C E Battjes-Fries
- Department of Health and Nutrition, Louis Bolk Institute, Kosterijland 3-5, Bunnik, 3981 AJ, the Netherlands
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Blondal BS, Geirsdottir OG, Beck AM, Halldorsson TI, Jonsson PV, Sveinsdottir K, Ramel A. HOMEFOOD randomized trial-beneficial effects of 6-month nutrition therapy on body weight and physical function in older adults at risk for malnutrition after hospital discharge. Eur J Clin Nutr 2023; 77:45-54. [PMID: 36028775 PMCID: PMC9876791 DOI: 10.1038/s41430-022-01195-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 07/21/2022] [Accepted: 08/03/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND/OBJECTIVES Malnutrition is common among older adults. Dietary intervention studies in older adults aiming to improve anthropometrics measures and physical function have been inconsistent. We aimed to investigate the effects of nutrition therapy in combination with home delivered meals and oral nutritional supplements (ONS) in community-dwelling older adults discharged from hospital. METHODS A total of 106 participants (>65 years) were randomized into the intervention group (n = 53) and into the control group (n = 53). The intervention group received individual nutrition therapy (five in person visits and three phone calls) and freely delivered energy- and protein- rich foods, while the control group received standard care. Dietary intake, anthropometrics, and short physical performance battery (SPPB) were assessed at baseline and at endpoint. RESULTS Energy intake at baseline was similar in both groups (~1500 kcal at the hospital) but there was a significant increase in energy intake and body weight in the intervention group (+919 kcal/day and 1.7 kg, P < 0.001 in both cases) during the study period, compared to a significant decrease in both measures among controls (-815 kcal/day and -3.5 kg, P < 0.001 in both cases). SPPB score increased significantly in the intervention group while no changes were observed among controls. CONCLUSIONS Most Icelandic older adults experience substantial weight loss after hospital discharge when receiving current standard care. However, a 6-month multi-component nutrition therapy, provided by a clinical nutritionist in combination with freely delivered supplemental energy- and protein-dense foods has beneficial effects on body weight, physical function, and nutritional status. STUDY REGISTRATION This study was registered at ClinicalTrials.gov ( NCT03995303 ).
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Affiliation(s)
- B S Blondal
- Faculty of Food Science and Nutrition, School of Health Science, University of Iceland, Reykjavik, Iceland.
| | - O G Geirsdottir
- Faculty of Food Science and Nutrition, School of Health Science, University of Iceland, Reykjavik, Iceland
| | - A M Beck
- University College Copenhagen, Institute of Nursing and Nutrition, Sigurdsgade 26, 2200, Copenhagen, Denmark
- The Dietetic and Nutritional Research Unit, EFFECT, Herlev and Gentofte University Hospital, Borgmester Ib Juuls Vej 50, 2730, Herlev, Denmark
| | - T I Halldorsson
- Faculty of Food Science and Nutrition, School of Health Science, University of Iceland, Reykjavik, Iceland
| | - P V Jonsson
- The Icelandic Gerontological Research Institute, Tungata 26, 101, Reykjavik, Iceland
- Faculty of Medicine, School of Health, University of Iceland, Reykjavík, Iceland
- Department of Geriatrics, The National University Hospital of Iceland, Reykjavík, Iceland
| | | | - A Ramel
- Faculty of Food Science and Nutrition, School of Health Science, University of Iceland, Reykjavik, Iceland
- Matís ohf, Vinlandsleið 12, 113, Reykjavik, Iceland
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Due A, Beck AM, Birk CB, Justesen L, Majgaard M, Lei M, Langsted S SK, Jensen TS. Innovative rehabilitating meal service programs for old people living at home: A randomized controlled pilot study. Clin Rehabil 2022; 36:926-939. [PMID: 35521825 DOI: 10.1177/02692155221088777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To test the feasibility of a pilot study for a future definitive trial investigating the effect of different meal service programs for old people living at home. DESIGN An 8-week randomized controlled trial was performed. SETTING Three municipalities in the Nordic country, Denmark. SUBJECTS Danish participants (≥65y) with reduced functionality. INTERVENTION Three different meal service programs 1) 24-h meals service, 2) Protein-rich meal service, and 3) Rehabilitation meal service, were developed and compared to standard care. MAIN MEASURES The main outcome was study feasibility. Dietary intake, anthropometry, physical function, quality of life, readmissions and adverse events were also evaluated. Comparisons between participants receiving a meal service program and standard care were done by one-way ANOVA, chi-square test and Fishers exact test. RESULTS A total of 592 subjects were assessed for eligibility and 13% (76/592) were recruited. Final analysis included 75% (57/76) of participants. The outcome measures seemed acceptable and feasible though eligibility, inclusion, and completion of the intervention were lower than expected. The 24-h meal service program managed to significantly increase the intake of protein (p = 0.049) and energy (p = 0.038) compared to the control group where reductions were seen. No other significant differences were found. CONCLUSIONS The pilot study was feasible and several benefits for completers were seen. However, in a future definitive trial, inclusion criteria should be wider, more effort should be put on the time, training and focus of the personal in close contact to the older subjects and the intervention should be less comprehensive and more flexible.
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Affiliation(s)
- Anette Due
- Nutrition and Health Education, 386475University College Copenhagen
| | - Anne Marie Beck
- Research Unit for Nutrition and Dietetics, 53176Herlev and Gentofte Hospital
| | | | - Lise Justesen
- Nutrition and Health Education, 386475University College Copenhagen
| | - Maj Majgaard
- Staff for Health and Care, 114283Municipality of Silkeborg
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Food as medicine? Exploring the impact of providing healthy foods on adherence and clinical and economic outcomes. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 5:100129. [PMID: 35478519 PMCID: PMC9032066 DOI: 10.1016/j.rcsop.2022.100129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/14/2022] [Accepted: 03/14/2022] [Indexed: 11/21/2022] Open
Abstract
Background Methods Results Conclusion
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ABDELBASSET WK, NAMBI G, EL-SAKHAWY MAM, MAHMOUD MZ, ALRAWAILI BS, ELSAYED SH. Study on WSR-based community healthy food distribution design method. FOOD SCIENCE AND TECHNOLOGY 2022. [DOI: 10.1590/fst.70521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
| | - Gopal NAMBI
- Prince Sattam bin Abdulaziz University, Saudi Arabia
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6
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Clark CN, Hart BB, McNeil CK, Duerr JM, Weller GB. Improved Time in Range During 28 Days of Meal Delivery for People With Type 2 Diabetes. Diabetes Spectr 2022; 35:358-366. [PMID: 36072813 PMCID: PMC9396729 DOI: 10.2337/ds21-0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Nutrition therapy is a cornerstone of care for people with type 2 diabetes, yet starting new, healthy eating behaviors and sustaining them can be challenging. This decentralized, single-arm study assessed the impact of 28 days of home-delivered, pre-portioned meals (three meals per day) on continuous glucose monitoring (CGM)-derived glycemic control and quality of life. RESEARCH DESIGN AND METHODS We enrolled 154 people with type 2 diabetes from across the United States. All participants were enrolled in a digital-first type 2 diabetes care center of excellence and had a time in range (TIR) <70% or a glucose management index (GMI) >7%. A total of 102 participants received another set of meals for a household member. Forty-four participants were excluded from CGM-based analysis because of sparse data in the baseline or intervention period. RESULTS From the baseline through the intervention period, average TIR improved by 6.8% (95% CI 4.0-9.7, P <0.001), average GMI improved by 0.21% (95% CI 0.11-0.32, P <0.001), and participants' odds of achieving ≥70% TIR increased (odds ratio 2.55 [95% CI 0.93-7.80, P = 0.051]). Although average TIR increased rapidly upon initiation of meal delivery, it regressed when the delivery period ended. CONCLUSION Home-delivered meals were associated with modest TIR and GMI improvements, but only in the short term. More research is needed to determine whether the effects of nutrition therapy can be extended by providing ongoing meal delivery or additional support such as behavioral intervention.
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Fleury S, Sulmont-Rossé C, Tronchon P, Roux S, Van Wymelbeke-Delannoy V. Le portage de repas à domicile : processus d’installation et d’appropriation de ce service par les personnes âgées en perte d’autonomie. NUTR CLIN METAB 2021. [DOI: 10.1016/j.nupar.2020.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Baic S. Managing malnutrition in older adults in the community during the COVID-19 pandemic. Nurs Older People 2021; 33:14-19. [PMID: 33825366 DOI: 10.7748/nop.2021.e1311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2020] [Indexed: 11/09/2022]
Abstract
The COVID-19 pandemic has resulted in an increase in the number of older adults in the community who are at risk of malnutrition. Vulnerable groups include people recovering at home from mild-to-moderate COVID-19, those discharged from hospital after severe infection and those who have undergone extended periods of social isolation as a result of the public health measures in place to reduce the spread of infection. Various COVID-19-specific malnutrition care pathways and resources are available, and this article details practical interventions that can assist nurses caring for older adults in the community to identify and manage malnutrition risk.
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Affiliation(s)
- Sue Baic
- Nutrition Basics, Bristol, England
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9
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Kunvik S, Rautakallio-Järvinen P, Laaksonen M, Valve R, Salonoja M, Fogelholm L, Suominen MH. Effects of Home-Delivered Meals on Older People's Protein Intake, Physical Performance, and Health-Related Quality of Life: The Power Meals Randomized Controlled Trial. J Nutr Gerontol Geriatr 2021; 40:125-149. [PMID: 33684023 DOI: 10.1080/21551197.2021.1892562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This trial examined the effectiveness of an 8-week home meal service on protein and other nutrient intake, physical performance (PP) and health related quality of life (HRQoL) among older people living at home (≥65 years; home care clients, caregivers and care recipients). Participants were randomized into three groups; (1) protein-rich meal, snack, and bread (INT1), (2) regular meal (INT2) and (3) control group. Nutrient intake was assessed with 3-day food diaries, PP with Short Physical Performance Battery (SBBP) and HRQoL with 15 dimensional Health-related quality of life instrument. Total of 67 (59.7% women, mean age 78.2 years) participants (n = 22 INT1, n = 24 INT2, n = 21 CG) completed the trial. At baseline, mean protein intake was 0.92 (SD 0.32) g/kg adjusted body weight (aBW)/d. At 8 weeks, protein-rich home meal service in INT1 increased protein intake (+ 0.11 (95%CI -0.01 to 0.21) g/kg aBW/d, 9.4 (95%CI 1.0 to 17.8) g/d) compared to other groups. It also increased calcium intake (+169.9 (95%CI 26 to 314) mg/d) and improved results in Sit-to-Stand Test (-4.8 (95%CI -6.8 to -2.7) sec) in INT1 compared to CG. Both home meal services increased saturated fat intake (INT1; 4.6 (95%CI 1.0-8.2) g/d, INT2;7.8 (95%CI 1.9 to 13.7)g/d) and decreased salt intake (INT1;-2330.9 (95%CI -2998 to -1664) mg/d, INT2; -2371.9 (95%CI -3399 to -1345) mg/d) compared to CG. There was no effect on overall HRQoL.
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Affiliation(s)
- Susanna Kunvik
- Pori Social and Health Services, Pori, Finland.,Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | | | | | - Raisa Valve
- Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | | | | | - Merja H Suominen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
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Fleury S, Tronchon P, Rota J, Meunier C, Mardiros O, Van Wymelbeke-Delannoy V, Sulmont-Rossé C. The Nutritional Issue of Older People Receiving Home-Delivered Meals: A Systematic Review. Front Nutr 2021; 8:629580. [PMID: 33763442 PMCID: PMC7982843 DOI: 10.3389/fnut.2021.629580] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 01/29/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Setting up a home-delivered meal service often allows older people suffering from physical and/or cognitive disabilities to stay at home. However, older people who delegate their food activities (food purchasing, cooking…) have been reported to have a worse nutritional status than people who take care of their food activities. In this context, we will conduct a systematic review of all studies related to the nutritional issue in home-delivered meal older recipients. Methods: In June 2020, we searched 3 databases (Pubmed, Web of Science, EMBASE) to identify studies from all years on older adults at home and receiving home-delivered meal services (population). The following outcomes were considered: nutritional status (Body Mass Index, weight, undernutrition) and nutritional intake. Any nutritional intervention, comparator, and study design were relevant for inclusion. Results: Forty-eight original studies met the inclusion criteria, most of them being published after the year 2000 (n = 34) and undertaken in the USA (n = 32). The selection includes 30 cross-sectional and 18 longitudinal studies. The main findings of this review are the following: (1) home-delivery meal older recipients are at high risk of undernutrition; (2) providing home-delivery meals may improve the nutritional status and nutrient intake; (3) this improvement is even higher when the home-delivery meal service is improved, for instance by providing dietetic counseling or adding supplementary snacks/meals or enriched food. However, even an improved service does not allow all the older recipients meeting their recommended nutritional allowance. Conclusion: This review reveals a need to further develop strategies allowing home-delivery meal older recipients to fulfill their nutritional needs. From a methodological point of view, there is a need to describe in more detail the home-delivered services provided to studies' participants to better consider meal frequency and meal content in the results.
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Affiliation(s)
- Ségolène Fleury
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, Centre National de la Recherche Scientifique, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Université de Bourgogne Franche-Comté, Dijon, France.,Saveurs et Vie, Orly, France
| | | | - Juliane Rota
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, Centre National de la Recherche Scientifique, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Université de Bourgogne Franche-Comté, Dijon, France
| | - Charlotte Meunier
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, Centre National de la Recherche Scientifique, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Université de Bourgogne Franche-Comté, Dijon, France
| | - Oliver Mardiros
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, Centre National de la Recherche Scientifique, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Université de Bourgogne Franche-Comté, Dijon, France
| | - Virginie Van Wymelbeke-Delannoy
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, Centre National de la Recherche Scientifique, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Université de Bourgogne Franche-Comté, Dijon, France.,Centre Hospitalier Universitaire Dijon Bourgogne, Unité de Recherche Pôle Personnes Âgées, Dijon, France
| | - Claire Sulmont-Rossé
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, Centre National de la Recherche Scientifique, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Université de Bourgogne Franche-Comté, Dijon, France
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Baic S. Managing malnutrition in the community during the COVID-19 pandemic. Nurs Stand 2021; 36:61-66. [PMID: 33615758 DOI: 10.7748/ns.2021.e11667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2020] [Indexed: 10/22/2022]
Abstract
The prevalence of risk factors for malnutrition has increased during the coronavirus disease 2019 (COVID-19) pandemic. These risk factors include various symptoms and effects of COVID-19, such as breathlessness, coughing, inflammation, sarcopenia, anorexia and loss of taste or smell, as well as the side effects of treatment. In addition, public health infection prevention and control measures can inadvertently reduce access to food and increase social isolation, thus adversely affecting people's nutritional status. This article outlines practical interventions for preventing and managing malnutrition in the community, particularly where it is exacerbated by the social restrictions in place to contain the COVID-19 pandemic.
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Affiliation(s)
- Sue Baic
- Nutrition Basics, Bristol, England
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12
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Type of Care and Living Situation Are Associated with Nutritional Care but Not Nutritional Status of Older Persons Receiving Home Care. Healthcare (Basel) 2020; 8:healthcare8030296. [PMID: 32854303 PMCID: PMC7551165 DOI: 10.3390/healthcare8030296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/17/2020] [Accepted: 08/21/2020] [Indexed: 12/03/2022] Open
Abstract
Nutritional care and nutritional status may differ in older persons receiving informal (IC) or professional (PC) home care and further depend on the living situation, but little is known in this regard. In this analysis of a cross-sectional multicenter study, type of care, living situation, and nutritional care were enquired in 353 older adults (≥65) receiving IC or PC, living either with partner (LP), with others (LO) or alone (LA), and the nutritional status was determined by BMI and MNA®. For IC receivers, food shopping (IC-LP 94%, IC-LO 96%, IC-LA 92%) and warm meals (IC-LP 89%, IC-LO 90%, IC-LA 71%) were mainly provided by relatives, whereas 47% of PC-LA prepared warm meals by themselves and 22% received meals on wheels. Thirteen percent were underweight, 13% malnourished, and 57% at risk of malnutrition without differences between the groups. Adjusted odds ratios (OR) of being malnourished were also not different (IC-LP 2.2 [95% CI 0.5–9.7], IC-LO 1.4 [0.3–6.6], IC-LA 1.4 [0.3–6.6]) compared to PC-LA. In conclusion, provision of nutritional care obviously differed according to the type of care and living situation, whereas nutritional status does not seem to be affected by these aspects. More research is clearly needed in this field.
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Borkent JW, Beelen J, Linschooten JO, Roodenburg AJC, de van der Schueren MAE. The ConsuMEER study: a randomised trial towards the effectiveness of protein-rich ready-made meals and protein-rich dairy products in increasing protein intake of community-dwelling older adults after switching from self-prepared meals towards ready-made meals. J Nutr Sci 2019; 8:e30. [PMID: 31523425 PMCID: PMC6728932 DOI: 10.1017/jns.2019.27] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 06/29/2019] [Accepted: 07/22/2019] [Indexed: 12/19/2022] Open
Abstract
The risk of undernutrition in older community-dwelling adults increases when they are no longer able to shop or cook themselves. Home-delivered products could then possibly prevent them from becoming undernourished. This single-blind randomised trial tested the effectiveness of home-delivered protein-rich ready-made meals and dairy products in reaching the recommended intake of 1·2 g protein/kg body weight (BW) per d and ≥25 g of protein per meal. Community-dwelling older adults (n 98; mean age 80·4 (sd 6·8) years) switched from self-prepared to home-delivered hot meals and dairy products for 28 d. The intervention group received ready-made meals and dairy products high in protein; the control group received products lower in protein. Dietary intake was measured at baseline, after 2 weeks (T1), and after 4 weeks (T2). Multilevel analyses (providing one combined outcome for T1 and T2) and logistic regressions were performed. Average baseline protein intake was 1·09 (se 0·05) g protein/kg BW per d in the intervention group and 0·99 (se 0·05) g protein/kg BW per d in the control group. During the trial, protein intake of the intervention group was 1·12 (se 0·05) g protein/kg BW per d compared with 0·87 (se 0·03) g protein/kg BW per d in the control group (between-group differences P < 0·05). More participants of the intervention group reached the threshold of ≥25 g protein at dinner compared with the control group (intervention T1: 84·8 %, T2: 88·4 % v. control T1: 42·9 %, T2: 40·5 %; P < 0·05), but not at breakfast and lunch. Our findings suggest that switching from self-prepared meals to ready-made meals carries the risk of a decreasing protein intake, unless extra attention is given to protein-rich choices.
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Key Words
- BW, body weight
- DNFCSOA, Dutch National Food Consumption Survey Older Adults
- LAPAQ, Longitudinal Ageing Study Amsterdam Physical Activity Questionnaire
- LASA, Longitudinal Ageing Study Amsterdam
- MMSE, Mini Mental State Examination
- SCREEN II, Seniors in the Community: Risk evaluation for eating and nutrition, version II
- SNAQ65+, Short Nutritional Assessment Questionnaire 65+
- T1, 2 weeks after start of intervention
- T2, 4 weeks after start of intervention
- Community-dwelling older adults
- Home-delivered meals
- Meals-on-wheels
- Nutritional status
- Protein-rich products
- Ready-made meals
- Undernutrition
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Affiliation(s)
- Jos W. Borkent
- Department of Nutrition and Health, HAN University of Applied Sciences, Faculty of Health and Social Studies, Nijmegen, the Netherlands
| | - Janne Beelen
- Department of Nutrition and Health, HAN University of Applied Sciences, Faculty of Health and Social Studies, Nijmegen, the Netherlands
| | - Joost O. Linschooten
- Department of Food Science & Technology, HAS University of Applied Sciences, ‘s-Hertogenbosch, The Netherlands
| | - Annet J. C. Roodenburg
- Department of Food Science & Technology, HAS University of Applied Sciences, ‘s-Hertogenbosch, The Netherlands
| | - Marian A. E. de van der Schueren
- Department of Nutrition and Health, HAN University of Applied Sciences, Faculty of Health and Social Studies, Nijmegen, the Netherlands
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Walton K, do Rosario VA, Pettingill H, Cassimatis E, Charlton K. The impact of home-delivered meal services on the nutritional intake of community living older adults: a systematic literature review. J Hum Nutr Diet 2019; 33:38-47. [PMID: 31266095 DOI: 10.1111/jhn.12690] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND There is a global increase in populations aged over 65 years. Physiological changes that occur during ageing may increase the nutritional risk for older adults. To avoid malnutrition and address some of the barriers to obtain an adequate food supply, home-delivered meals services provide meals in the home or in congregate settings for older adults who require nutritional support. METHODS This systematic literature review explored whether nutritional intake is improved in community-living older adults when receiving meal services compared to when meal services are not received. Four electronic databases were searched up to 31 January 2019. In total, 13 original studies were included in this analysis with the components: intervention of home-delivered meal or congregate meal services to older adults; comparison with groups not receiving meal services or days not receiving the meal service; and nutritional intake as an outcome measured by food history, dietary recall and/or food frequency questionnaire. RESULTS The results supported a beneficial effect of home-delivered meals on dietary intake of energy, protein and/or certain micronutrients in older adults. CONCLUSIONS The increased total energy intake is a positive influence on malnutrition risk in frail older adults and the increased protein intake supports good health, promotes recovery from illness and assists in maintaining functionality in older adults. Additionally, there was a particular increase in calcium intake, which is relevant in ageing, especially for bone health.
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Affiliation(s)
- K Walton
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health & Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - V A do Rosario
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health & Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - H Pettingill
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - E Cassimatis
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - K Charlton
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health & Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
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15
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Cho J, Thorud JL, Marishak-Simon S, Hammack L, Stevens AB. Frequency of Hospital Use Before and After Home-Delivery Meal by Meals On Wheels, of Tarrant County, Texas. J Nutr Health Aging 2018; 22:519-525. [PMID: 29582892 DOI: 10.1007/s12603-017-0973-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Patients recently discharged from the hospital are vulnerable and are at high risk for readmission. Home-delivered meals may be beneficial in improving their health and facilitating independent living in the community. The purpose of this study was to identify the association between home-delivered meals and use of hospital services. METHODS This study includes 120 clients recently discharged from an inpatient hospital stay or from an emergency department (ED) visit who received meal services from Meals On Wheels, Inc., of Tarrant County. Healthcare utilization data was extracted from the Dallas-Fort Worth Hospital Council Foundation, a regional all claims database used by over 90% of hospitals in Dallas-Fort Worth area. Signed tests and generalized linear models (GLM) were performed. RESULTS A total of 16,959 meals were delivered from March 2013 through March 2014. Each client received an average of 6.19 meals per week. The average number of ED visits decreased from 5.03 before receipt of meals to 1.45 after receipt of meals, z = -5.23, p < .001. The average number of hospitalizations decreased from 1.33 to .83, z = -7.29, p < .001. The average length of stay per hospitalization decreased from 5.47 days to 2.34 days, z = -5.84, p < .001. Clients who received more meals were less likely to experience ED visits and hospitalizations after controlling for demographic characteristics and levels of physical functioning. CONCLUSION The findings of this study indicate that home-delivered meals services may contribute to a reduction in hospital based care services among frail and vulnerable adults. Additional studies should consider the short and long-term effects of home-delivered meals services on healthcare utilization and the potential to decrease healthcare costs.
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Affiliation(s)
- J Cho
- Jinmyoung Cho, Ph.D. Baylor Scott and White Health, MS-01-501, 2401 S 31st St., Temple, TX 76508, Tel: 254-724-5155,
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16
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Santiago S, Zazpe I, Gea A, Nuñez-Córdoba JM, Carlos S, Bes-Rastrollo M, Martínez-González MA. Fat Quality Index and Risk of Cardiovascular Disease in the Sun Project. J Nutr Health Aging 2018; 22:526-533. [PMID: 29582893 DOI: 10.1007/s12603-018-1003-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To examine the association between a dietary fat quality index (FQI), and the risk of incident cardiovascular events or deaths in the Seguimiento Universidad de Navarra (SUN) cohort. DESIGN Longitudinal analysis during 10.1 years of median follow-up. Cox models were used to estimate adjusted hazard ratios (HR) of incident cardiovascular diseases (CVD) according to tertiles of FQI and of different fat subtypes. SETTING University of Navarra, Spain. PARTICIPANTS 19,341 middle-aged adults. MEASUREMENTS Fat intake was measured with a validated food-frequency questionnaire. The FQI was calculated according to the ratio: (monounsaturated+polyunsaturated) / (saturated+trans fatty acids). RESULTS We observed 140 incident cases of CVD. No association was found for FQI (HR=0.94, 95 %CI 0.61-1.47 for the highest vs the lowest tertile, p for trend=0.884). No significant associations were found for different dietary fat subtypes on CVD risk. The results suggest no clear association between a higher FQI and a higher amount of energy from fat and incidence of CVD (p for interaction: 0.259 and p for trend only among participants with a percentage of energy from fat ≥35% of total energy: 0.272). CONCLUSION In this Mediterranean cohort, the FQI was not associated with cardiovascular events. A "heart-healthy diet" should focus its attention on dietary fat sources and should use an overall dietary pattern approach, rather than limiting the focus on fat subtypes. More research is needed to validate dietary advice on specific fatty acids intake or saturated fatty acids replacements for reducing CVD risk.
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Affiliation(s)
- S Santiago
- Dr. Itziar Zazpe. University of Navarra, Department of Nutrition and Food Sciences and Physiology. Irunlarrea 1, 31080 Pamplona, Navarra, Spain. E-mail: . Tel: +34 948 42 56 00 Ext: 6560. Fax: + 34 948 42 56 49
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