Nutritional status of Irish older people in receipt of meals‐on‐wheels and the nutritional content of meals provided

Abstract

Background: Research has suggested that meals-on-wheels recipients can be at risk for poor nutritional status. Despite this, few countries have statutory minimum requirements for the nutrient content of meals-on-wheels. This study examined both the nutritional status of a sample of Irish recipients and the nutrient content of a sample of meals provided to determine whether Irish recipients would benefit from statutory minimum nutritional standards.Methods: The study had two phases. Firstly, a nutritional assessment was carried out in order to analyse the nutritional status of a sample of Irish meals-on-wheels recipients (MNA and 24-hour dietary recall with 63 self-selected respondents).Secondly, an assessment of the nutrient content of a sample of 46 meals from 8 mealson-wheels services was undertaken in order to characterise the nutritional content of the meals.Results: Over one-third of recipients (38.5%) were malnourished or at-risk of malnutrition and over half (52.3%) were overweight or obese. The mean energy (kcalorie) content of the meals assessed was 719 kcalories (SD 119.1), contributing 35-40% of the RDA for males aged 65 years and over and 42-45% of the RDA for females aged 65 years and over. In the meals assessed, the levels of vitamin C (25.3%), vitamin D (11.6%), folate (24.8%) and calcium (20.9%) were below onethird of the Irish RDA for these nutrients.Conclusions: Irish recipients may not be receiving adequate micronutrients from meals-on-wheels. Legislation that sets out minimum standards for the nutrient content of meals-on-wheels and greater variation in the portion sizes offered, may benefit recipients.

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“…By supporting the nutritional status of older adults, MOW aims to promote independence and improve quality of life (8). However, studies from Australia and other countries have demonstrated that even with the provision of home-delivered meals, some MOW clients still have poor nutritional status due to their multiple medical and social risk factors (9)(10)(11).…”

Hospital admissions in poorly nourished, compared with well‐nourished, older South Australians receiving ‘Meals on Wheels’: Findings from a pilot study

“…In South Australia, approximately 10% of persons aged 65 years or over receive some publically funded home-care service such as MOW. Services like MOW appear, intuitively, vital to assist older persons remain healthy and functionally independent, and while some research has shown that the provision of homedelivered meals improves the nutritional intake of older people [11][12][13], others have reported that the nutritional content of the meals is less than adequate [14,15]. For example, guidelines for health-care providers, including dieticians, highlight the limited research that has been carried out to best identify and treat malnutrition in community dwelling older adults [16].…”

What's on the tray? Nutritional intake of Meals on Wheels clients

“…MOW also provides variation in types of meals provided (hot, chilled or frozen), as well as being able to support special dietary meal requirements, such as texture modified variations. Studies from Australia and other countries have demonstrated that even with the provision of home-delivered meals, some MOW clients still have a poor nutritional status due to their multiple medical and social risk factors [2,3].…”