Effectiveness of mealtime interventions on nutritional outcomes for the elderly living in residential care: A systematic review and meta-analysis

Abbott, Rebecca; Whear, Rebecca; Thompson-Coon, Jo; Ukoumunne, Obioha C; Rogers, Morwenna; Bethel, Alison; Hemsley, Anthony; Stein, Ken

doi:10.1016/j.arr.2013.06.002

Cited by 130 publications

(159 citation statements)

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“…These findings suggest that improvements in taste only impact on intakes at the time of the improved taste. Secondly, these findings suggest that for sustained increased protein intakes, either improvements in taste need to be made at more than one meal, or that other strategies may be more beneficial (4) . Investigations into alternative strategies to increase protein intakes in older adults are required.…”

mentioning

confidence: 99%

“…This under-nutrition is considered to result, at least in part, from low protein intakes (1,3) . Strategies for increasing protein intakes include the use of protein supplements, the development of usual foods through protein fortification or improvements in appeal or use, and the improvement of usual dining experiences (3,4) . Our studies demonstrate increased protein intakes in older adults following the addition of sauce to a lunch meal (5,6) .…”

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Increased protein intakes following the addition of sauce to an older persons' lunch meal are not sustained

Appleton

2015

Proc. Nutr. Soc.

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Protein-specific under-nutrition is considered to affect 10-20% of UK older adults (1) , with potential detriments to health and wellbeing (1,2) . This under-nutrition is considered to result, at least in part, from low protein intakes (1,3) . Strategies for increasing protein intakes include the use of protein supplements, the development of usual foods through protein fortification or improvements in appeal or use, and the improvement of usual dining experiences (3,4) . Our studies demonstrate increased protein intakes in older adults following the addition of sauce to a lunch meal (5,6) . While effects were demonstrated in the one meal however, any benefits may be easily reduced by compensation or adjustment at the next meal. This study investigated the impact of the addition of sauce to an older persons' lunch meal on intake at that and at the following meal.Using a repeated measures design, 56 community-dwelling older adults consumed a lunch meal with sauce and a lunch meal without sauce on two separate occasions, and intake at lunch and at the following evening meal were measured. Lunch meals in both conditions (chicken, sweetcorn, carrots, mashed potatoes) were identical, excepting the addition of sauce in the sauce condition. Evening meals were a buffet meal (bread, cheese, ham, salad, crisps, condiments, cakes, biscuits, fruit). Participants were free to consume as much or as little as they wished from all meals, and amount consumed was determined by weighing.Analyses were conducted for fifty participants using only the foods consumed in the core lunch meal (i.e. not including the gravy). At the lunch meal, significantly more protein was consumed with sauce compared to without sauce (means: 35 ± 15 g vs. 31 ± 15 g, (t(49) = 2·20, p = 0·03). Effect sizes however are small, no effects were found in any of the other measures of the meal (largest energy: (t(49) = 1·62, p = 0·11), and effects were not sustained when intake at the next meal was included in analyses (means: 59 ± 19 g vs 56 ± 20 g, t(49) = 1·69, p = 0·10).These findings suggest that the addition of sauce to an older persons' lunch meal can increase protein intakes at that meal, but that this effect is not large enough to be sustained to include intakes at the next meal. The increased intakes at the lunch meal replicate those of previous studies (5,6) , and have previously been attributed to improvements in taste (6) . These effects however were compensated for by intake at the next meal. These findings suggest that improvements in taste only impact on intakes at the time of the improved taste. Secondly, these findings suggest that for sustained increased protein intakes, either improvements in taste need to be made at more than one meal, or that other strategies may be more beneficial (4) . Investigations into alternative strategies to increase protein intakes in older adults are required.

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confidence: 99%

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Increased protein intakes following the addition of sauce to an older persons' lunch meal are not sustained

Appleton

2015

Proc. Nutr. Soc.

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“…large handles on cutlery, coloured glasses for visually impaired patients) to help increase independence. Where there are specific problems such as difficulty swallowing or poor dentition, other professionals should be involved as physicians, speech therapists and dentists to address the problem [22].…”

Section: Evidence-based Interventions To Prevent and To Treat Malnutrmentioning

confidence: 99%

Nutrition and Hydration

Roigk

2018

Perspectives in Nursing Management and Care for Older Adults

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Malnutrition and dehydration are important aspects of the care of older people, particularly those in hospitals or in long-term care facilities. Many older people do not eat and drink adequately during hospital stays and, following hip fracture, many patients achieve only a half of their recommended daily energy, protein and other nutritional requirements [1]. This leads to poor recovery and diminished health status and functional ability and results in a higher risk of other complications (Chap. 6).Nurses are the coordinators of the care process, so it is essential that they bring other health-care specialists together as a team to collaboratively provide highquality care that reflects patients' needs for assessment, intervention and health promotion. When an interdisciplinary team (orthogeriatric collaboration) work together care is more successful, improves patient outcomes and reduces the risk of the inhospital and long-term mortality.The aim of this chapter is to increase awareness of nurses' responsibility, within a multidisciplinary team, for assessment and intervention of nutrition and hydration, examine the issues pertaining to nutrition and fluid balance in older people and outline the nature, assessment and interventions relating to malnutrition and dehydration. Learning OutcomesAt the end of the chapter, and following further study, the nurse will be able to:

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“…In a recent poll conducted by the International Association of Gerontology and Geriatrics, RAC experts from eight countries identified "improving nutrition" as one of the top five international research priorities in this setting (13). To the best of our knowledge, previously published reviews in the RAC setting have summarised evidence regarding malnutrition prevalence (14), associated risk factors (15), and effective nutritional interventions (16)(17)(18). The purpose of this paper is to review and summarise existing evidence on these aspects of malnutrition in the RAC setting, along with including a synopsis of evidence-based methods to identify malnutrition in the RAC setting, highlight the consequences of malnutrition in this population and provide future directions for practice and research.…”

Section: Introductionmentioning

confidence: 99%