OBJECTIVES. The Nutrition Screening Initiative is a national collaborative effort committed to the identification and treatment of nutritional problems in older persons. METHODS. A 14-item checklist of characteristics associated with nutritional status was administered to a random sample of Medicare beneficiaries, aged 70 years and older, in New England. Regression analysis was used to derive item weights that would predict poor nutrient intakes and low perceived health status. Sensitivity and specificity values were reviewed to define low, moderate, and high nutritional risk scores. RESULTS. A revised checklist containing 10 yes/no items was adopted. Scores of 6 or more points defined persons at high nutritional risk. Twenty-four percent of the Medicare population was estimated to be at high nutritional risk according to the checklist. Among those in the high-risk group, 56% perceived their health to be "fair" or "poor" and 38% had dietary intakes below 75% of the recommended dietary allowances for three or more nutrients. CONCLUSIONS. The Nutrition Screening Initiative Checklist is a brief, easily scored instrument that can accurately identify noninstitutionalized older persons at risk for low nutrient intake and health problems.
Objectives Community-based services, such as Meals on Wheels (MOW), allow older adults to remain in their homes for as long as possible. Many MOW recipients experience decreased appetite that limits intake at mealtimes. This pilot study aimed to determine the feasibility of providing high protein high energy snacks to improve nutrient intakes of MOW clients in a regional centre of New South Wales, Australia.Participants A convenience sample of 12 MOW clients.Intervention Participants received snacks five times a week, in addition to their usual MOW order, for four weeks.Measurements Nutritional status was assessed using the Mini Nutritional Assessment tool. Pre-post changes in dietary intake were assessed using a diet history and food frequency questionnaire. Qualitative interviews conducted in clients' homes were digitally recorded, transcribed verbatim, and themes identified.Results Post-intervention, there was a trend for an increased energy (mean = +415kJ (SD=1477)/day) and protein (+7.2 (±14.06) g/day) intake. MNA scores significantly increased (P= 0.036) and proportion of respondents categorised as 'malnourished' or 'at risk of malnutrition' decreased from 17% to 8%, and 67% to 25%, respectively (P Conclusion Provision of an additional daily mid-meal snack may be a useful addition to existing MOW services, for improved energy and protein intakes. However, not all MOW clients at risk of malnutrition perceived the snacks to be beneficial to them. Keywordsprobably, help, someone, wheels, else, but, not, me, programme, clients, offered, could, meals, feasibility, study, snack
Objectives Community-based services, such as Meals on Wheels (MOW), allow older adults to remain in their homes for as long as possible. Many MOW recipients experience decreased appetite that limits intake at mealtimes. This pilot study aimed to determine the feasibility of providing high protein high energy snacks to improve nutrient intakes of MOW clients in a regional centre of New South Wales, Australia.Participants A convenience sample of 12 MOW clients.Intervention Participants received snacks five times a week, in addition to their usual MOW order, for four weeks.Measurements Nutritional status was assessed using the Mini Nutritional Assessment tool. Pre-post changes in dietary intake were assessed using a diet history and food frequency questionnaire. Qualitative interviews conducted in clients' homes were digitally recorded, transcribed verbatim, and themes identified.Results Post-intervention, there was a trend for an increased energy (mean = +415kJ (SD=1477)/day) and protein (+7.2 (±14.06) g/day) intake. MNA scores significantly increased (P= 0.036) and proportion of respondents categorised as 'malnourished' or 'at risk of malnutrition' decreased from 17% to 8%, and 67% to 25%, respectively (P Conclusion Provision of an additional daily mid-meal snack may be a useful addition to existing MOW services, for improved energy and protein intakes. However, not all MOW clients at risk of malnutrition perceived the snacks to be beneficial to them. Keywordsprobably, help, someone, wheels, else, but, not, me, programme, clients, offered, could, meals, feasibility, study, snack
Aim: Technology is being used increasingly for dietary assessment, to streamline and improve the efficiency. These technologies allow for the inclusion of visual food portion images within the assessments rather than in addition to them as previously required. This paper describes the methodology for creating these food portion images using an online dietary assessment website (DietAdvice) as an example technology. The images include country-specific Australian food items, not previously available.Methods: Foods contained in the DietAdvice website were assessed to determine the number requiring food portion images. Preparation methods, recipes and portion sizes were determined for the foods, which varied from single foods through to cooked dishes and beverages. Foods were photographed by a professional photographer against a white background on a standard dinner plate or bowl with a standard of reference in each frame.Results: Approximately 200 food items required images, with varying portion sizes ranging from two to eight images per food item. Six hundred and thirty-one photographs were taken. Food such as ice-cream, burritos and fruit needed to be photographed quickly to prevent deterioration and ensure a quality real-to-life photographs.Conclusion: The art of photographing food portions itself is a difficult task. Inappropriate angles or lighting can make the food appear larger or smaller than it actually is. Timing is critical as the food can melt, wilt, collapse or discolour if the photo is not taken promptly. Clear labelling and a standard of reference for all photographs was necessary. The developed food portion images will allow users of the DietAdvice website to estimate portion sizes more accurately than text-based sizes alone, although validation is required. This paper describes the methodology for creating these food portion images using an online dietary assessment website (DietAdvice) as an example technology. The images include country specific Australian food items, not previously available.Methods: Foods contained in the DietAdvice website were assessed to determine the number requiring food portion images. Preparation methods, recipes and portion sizes were determined for the foods which varied from single foods through to cooked dishes and beverages. Foods were photographed by a professional photographer against a white background on a standard dinner plate or bowl with a standard of reference in each frame.
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