Optimizing sensory quality and variety: An effective strategy for increasing meal enjoyment and food intake in older nursing home residents

Abstract

A decline in appetite and consequently in food intake is often observed with ageing, particularly in older adults living in nursing homes. Several strategies have been tested in nursing homes to counter this phenomenon. However, the approaches have rarely focused on food improvement, and most studies have assessed the impact of flavor enhancement on eating behavior. The present experiment aimed to assess the impact of improving sensory quality versus increasing sensory variety on food intake and meal enjoyment in elderly individuals living in a nursing home. Four conditions were compared: control condition, a Quality+ condition (recipes were improved according to sensory preference of the target population), a Variety+ condition (participants were offered a variety of main dishes and several condiments throughout the meal) and a Quality&Variety+ condition combining the two previous conditions. Eighty-two residents (age range: 71-101 years) participated in eight lunchtime sessions (2 replicates  4 conditions). Compared to control condition, our results showed that improving the sensory quality of the dishes and/or providing variety led to increased meal enjoyment and food intake (energy intake: +5% for Quality+; +7% for Variety+). No additional effect was observed when the two factors were combined (+7% for Quality&Variety+). These results suggest that meal improvement strategies can be used to increase food intake in order to prevent and treat malnutrition in dependent older adults.

The Nutritional Issue of Older People Receiving Home-Delivered Meals: A Systematic Review

“…In line with the studies carried out by Sulmont-Rossé et al (82), it would be interesting to optimize the sensory quality of the meals by recruiting the tasting panel among HDM recipients. Improving meals according to older people's feedback led to an increase of food intake in nursing home (83). In addition, improvements could also target the quality of the service such as providing choice and providing social support during the meal.…”

“…In addition, it can be hypothesized that the combination of several levers is necessary to have significant improvements in food intake rather than implementing only one lever in the fields. In fact, such multidimensional interventions were implemented in nursing homes and proved to be efficient (83)(84)(85)(86)(87). For instance, Kremer et al (86) combined improvement at the product level (e.g., attractive visual presentation), at the people level (e.g., promoting choice to give the older residents more control), and at the situation level (e.g., promoting an attractive social environment) to improve the meals in nursing homes.…”

Enrolled nurses' perceptions of providing nutritional care to hospitalised older people in Singapore's acute care setting: A qualitative descriptive study

“…To counter mundane menus and unappetising appearances of food, participants in this study suggested to offer greater variety of menu choices and add more colour to food. This was supported by Van Wymelbeke et al (2020)'s study, which found that greater meal varieties could increase both food enjoyment and intake of nursing home residents. Nurses in Murphy et al (2017)'s study also recommended for hospital kitchens to retain the colour and aroma of food in puree form to improve presentation of semi‐solid diets, especially for patients with dementia who experience great sensory and taste changes.…”

Home-Delivered Meals: Characterization of Food Intake in Elderly Beneficiaries

“…From a sensory point of view, the sensory qualities of the meals delivered could be optimized (meat texture, seasoning) to better match the expectations and preferences of elderly consumers. This approach, which consists of reworking recipes that are based on the results of tests carried out among the elderly, has proven to be effective in increasing eating pleasure and food intake in retirement homes [ 64 , 65 ]. A second way could be to promote more complete home-delivered meal services, covering more meals and not just one meal per day of a few meals per week.…”

“…It would be interesting for home-delivery meals services to consider diversifying their offer (more menu options, possibility of having additional food products delivered) in order to provide their beneficiaries an opportunity to better balance food consumption throughout the day. In fact, several studies found this approach to be effective in retirement homes [ 65 , 66 , 67 , 68 , 69 ].…”