Validation of a dietary record routine in geriatric patients using doubly labelled water

Abstract

Objective: To validate a 7-day estimated dietary record routine with standardized portion sizes and household measuring in a clinical setting with the doubly labelled water (DLW) method as the reference method. Design: Energy expenditure was measured with deuterium ( 2 H) and oxygen-18 ( 18 O), and water loss was estimated by 2 H dilution as part of the DLW measurements. Energy and water intake was measured with a 7 day dietary record. Setting: Five nursing home wards in Sweden. Subjects: Thirty-one geriatric patients with a mean age of 86 y. Inclusion criteria were stable body weight, de®ned as a maximum change of + 4% during the last 4 months of + 2% during the last 2 months and without any acute illness. Results: The mean daily energy intake was 7.2 MJ (1727 kcal) and the mean daily energy expenditure was 6.7 MJ (1595 kcal). The mean daily water intake was 1787 ml and mean daily water loss assessed by labelled water was 1774 ml. Using the dietary record routine, the staff overestimated the patients' energy intake by 8% and water intake from food and beverages by`1% compared to DLW. Conclusion: The 7 day dietary record routine based on standardized portion sizes and household measuring seems to be a valid method for assessing the intake of energy and¯uids by geriatric patients.

The accuracy of food intake charts completed by nursing staff as part of usual care when no additional training in completing intake tools is provided

“…Bjornsdottir et al [3] reported significant, high correlations between a food chart and weighed food records for daily energy (r ¼ 0.922, p < 0.001) and protein (r ¼ 0.896, p < 0.001) intakes using a larger sample size (n ¼ 73) and trained staff. Lorefalt et al [5] and Persson et al [6] had similar sample sizes to our study, yet also found higher correlations (r ¼ 0.97, p < 0.001; r ¼ 0.81, p < 0.001, respectively) for daily energy intake with additional staff training. Masson et al [16] suggested that an acceptable level of agreement occurs when 10% of test data is grossly misclassified.…”

“…The FCRR and FCSI therefore had an unacceptable level of agreement at most meals and mid-meals. Yet Persson et al [6] had trained staff and found acceptable agreement using an intake estimation tool as nil patients were grossly misclassified by tertiles. The limits of agreement for both test methods were wide for energy and protein intakes at all meals and mid-meals (À497eþ552 kCal, À27eþ36 g protein), indicating poor agreement at the individual level.…”

“…Yet nursing staff completed the visual estimation tools in only three of the five validation studies, with only one of these validating the reference tools against weighed food records [3,5,6]. Further, all of these short-term studies provided staff training (either verbal, written or practical) on completing visual estimation intake tools just prior to data collection.…”

The feasibility of serving liquid yoghurt supplemented with probiotic bacteria, Lactobacillus rhamnosus LB 21, and Lactococcus lactis L1A — A pilot study among old people with dementia in a residential care facility

“…The mean knee height for the participants was 49 cm (range 47-56), corresponding to a calculated mean stature of 156 cm (range 149-175) and the mean BMI, 26 kg/m 2 , was within the normal range (24)(25)(26)(27)(28)(29) suggested for old people (23). Three people had a BMI < 23 and two >30 kg/m 2 .…”

“…A record of BW, body height, bowel movements frequency (BMF), bowel movements consistency (BMC), dietary intake (24) and physical activity was kept during a 14-day period prior to the intervention. A 7-day dietary and activity registration and the assessments of the BW were repeated 3 times during the intervention (at baseline, and after 3 and 6 months).…”