Effect of a nutrient-enriched drink on dietary intake and nutritional status in institutionalised elderly

Abstract

Objective: (1) To determine whether nutritional supplementation (energy and micronutrients) in institutionalised elderly has a positive effect on dietary intake and nutritional status. (2) To investigate whether individuals tend to compensate for the energy content of the intervention product by decreasing their habitual food consumption. Methods: A 24-week, randomised, double-blind, placebo-controlled, intervention trial in homes for the elderly (n ¼ 3), in nursing homes (n ¼ 3) and 'mixed' homes (n ¼ 3) in The Netherlands. Institutionalised elderly people (n ¼ 176) older than 60 years of age, with a body mass index p30 kg/m 2 and a Mini-Mental State Examination score of 10 points or higher, randomly received a nutrient-enriched drink or a placebo drink twice a day during 24 weeks in addition to their usual diet. Allocation to treatment took into account of sex, the Mini-Mental State Examination score and the plasma homocysteine level. Body weight and several nutrition-related analyses in fasting blood samples were measured in all participants. Data on dietary intake were collected in a subsample (n ¼ 66). Results: A significantly favourable effect (Po0.001) of the intervention drink was observed on vitamin intake, mineral intake and vitamin status in blood (for example, homocysteine decreased from 14.7 to 9.5 mmol/l in the intervention group as compared with that in the placebo group (17.2-15.9)). The difference in change in total energy intake between the two treatment groups was 0.8 MJ/day (P ¼ 0.166). Energy intake from food decreased in both groups to the same extent (À0.5 MJ/day). Therefore, this decrease cannot be considered as compensation for the energy content of the product. Conclusions: This group of institutionalised elderly people does not compensate for the energy content of a concentrated nutritional supplement. Therefore, this supplement is effective for counteracting the development of malnutrition in this population.

Effectiveness of nutritional interventions in older adults at risk of malnutrition across different health care settings: Pooled analyses of individual participant data from nine randomized controlled trials

“…Four studies were performed in a hospital setting including older adults at discharge from hospital [13,18,25,30], three studies among community-dwelling older adults [19,26,29], and two studies among institutionalized older adults [27,28]. Participants in the intervention group (n ¼ 500, 50.5%) were more often included in an institutionalized setting than participants in the control group (n ¼ 490, 49.5%), which is due to a slight oversampling of participants in the intervention group in one study conducted in an institutionalized setting [27], and oversampling of participants in the control group in one study conducted in a hospital setting [30] (Table 2). Risk of malnutrition was based on NRS2002 [18,25], MNA-sf screening tool [28,30], low BMI or recent weight loss [13,26], SNAQ 65þ [19], the Fried criteria [29], or no malnutrition criterion was applied [27].…”

Dietary assessment in elderly people: experiences gained from studies in the Netherlands

“…In several studies in the institutionalized elderly (Manders et al, 2006;Nijs et al, 2006a, b), including the elderly living in long-term care facilities, trained dietitians used an observation and direct measurement method. We chose this method because older residents in these homes often suffer from cognitive decline, which make FFQs, 24-h recalls or other methods relying on memory, less reliable (van Staveren et al, 1994).…”

Energirike smoothies til pasienter i sykehjem

“…Ifølge informantene kunne dette skyldes alderen, underliggende sykdommer eller nedsatt matlyst. For dem som har underliggende sykdom, eller som har nedsatt matlyst, kan det vaere aktuelt å tilføre naeringsstoffer i smoothies etter individuelle behov (9,31,32). Ut fra funnene i studien vår og tidligere studier (9, 31, 32) er det viktig med individuell tilpasning av smoothien, slik at den enkelte får tilpasset sine behov for energi og naeringsstoffer.…”