Monitoring of dietary quality in outpatients by qualitative meal classification method

Abstract

Background: The aim of this study was to evaluate whether qualitative meal‐classification used as a dietary evaluation tool reflects eating frequency and key nutrients in the diet, and whether it could be used to monitor the dietary quality in elderly outpatients. The qualitative meal‐classification tool used was based on eight food categories combined into four types of meals: Complete, Incomplete, Less Balanced and Vegetarian Meals, and three types of snacks: High‐, Mixed‐ and Low‐Quality Snacks. Methods: Dietary intake was assessed during 7 consecutive days by use of an estimated food record in nine elderly women with leg ulcers. Mean 7‐day dietary intakes of energy, macronutrients, beta‐carotene, retinol, vitamin E, ascorbic acid, calcium, iron, zinc and dietary fibre were calculated. Each eating event was classified in accordance with the food‐based classification method. The frequency of the four types of meals and three types of snacks, their energy content and nutrients, and their contribution to total intake were subsequently analysed. Results: Meals were associated with a higher energy, vitamin and mineral content than were snacks. Complete Meals were the major source for beta‐carotene and ascorbic acid. Intakes from Low‐Quality Snacks were relatively high in energy, fat and sucrose. Conclusion: The qualitative meal‐classification tool was found to be simple to use and useful for reflecting meal order and the nutritional roles of different types of meals and snacks in the diet. This method is recommended for dietary monitoring.

Food-based Classification of Eating Episodes (FBCE)

“…In this short report, the principles of the FBCE concept are described together with results from applications in dietary surveys in 16 shift-workers (Lennernäs et al, 1993a;Lennernäs et al, 1993b), nine female leg ulcer patients (Wissing et al, 1998), 20 elderly men and 25 women in a retrospective study (Sidenvall et al, 1996), and finally in 23 obese men and their 33 lean controls (Andersson 1997).…”

“…The first version of the FBCE concept was applied to the studies by Lennernäs et al (1993a,b) and Sidenvall et al (1996). The modified version was applied to the studies of Wissing et al (1997Wissing et al ( , 1998 and Andersson (1997). The modification affects primarily the content of ascorbic acid in "incomplete meals" that now may contain ascorbic acid (from potatoes).…”

“…All types in food-based classification of eating events Other intakes All types in food-based classification of eating events Data from Andersson, 1997 Female leg ulcer patients For female leg ulcer patients, data was available on consumed amounts (Wissing et al, 1997(Wissing et al, , 1998. The pattern of frequency of eating events and their contribution to total intake of energy and ascorbic acid is very similar to the shift worker data; the "incomplete meals" being more frequent than the "complete meals" and the "low-quality snacks" being more frequent than the "high-quality snacks" (Table 4).…”

Meal patterns and meal quality in patients with leg ulcers

“…The number of High Quality Snacks was low, which may also affect the healing process as they have a higher density of essential nutrients compared with other types of snacks. Furthermore, a high frequency of Low Quality Snacks may contribute to high intakes of energy, fat and sucrose as they contain more of these nutrients than High Quality Snacks and more sucrose than Mixed Quality Snacks ( Wissing et al ., 1998 ). High intakes of fat and sucrose in addition to restricted mobility may contribute to the BMI values indicating overweight.…”

“…Data on time of the day for eating events and a detailed description of the different food items consumed were recorded. Amounts of foods were not necessary since the classification was qualitative and based on food types consumed ( Lennernäs et al ., 1993 ; Wissing et al ., 1998 ; Lennernäs & Andersson, 1999). Patients who wanted to start the recording in connection with the home visit and the supervision were allowed to do so even if a weekend day was not included.…”