Improving the dietary intake of frail older people

Abstract

As a population subgroup, older people are more vulnerable to malnutrition especially those who are institutionalised. Recognition of deteriorating or poor nutritional status is key in reversing the effects of undernutrition and reinforces the value of regular weight checks and/or the use of screening tools. Commercially produced supplements are often the first option used to address undernutrition in both acute and community settings. They can be expensive and, although regularly prescribed, have undergone only limited evaluation of their effectiveness in community settings. An alternative but less researched approach to improve the nutritional status of undernourished people is food fortification. This approach may be particularly useful for older people, given their often small appetites. The ability to eat independently has been significantly related to decreased risk of undernutrition. Assisting people who have difficulty feeding themselves independently should become a designated duty and may be crucial in optimising nutritional status. Lack of nutrition knowledge has been identified as the greatest barrier to the provision of good nutritional care. Education and training of care staff are pivotal for the success of any intervention to address undernutrition. The development of undernutrition is a multi-factorial process and a package of approaches may be required to prevent or treat undernutrition. Nutrition must be at the forefront of care if national care standards are to be met.

A Role for Identification in the Gradual Decline in the Pleasantness of Flavors With Age

“…All participants were provided with similar instructions, and were given enough time and enough of each drink to make all ratings. All participants were required to report no known taste impairments prior to participation, but we took no account of illnesses, medication use, dentition, oral health or other similar factors that may impact on taste without a participant being aware ( Duffy et al, 1999 ; Griep et al, 1997 ; Leslie, 2011 ; Koskinen et al, 2003 ; Kremer, Bult, et al, 2007b , Kremer, Mojet, et al, 2007 ). Furthermore, illness, medication use, etc, are likely to increase with age, thus our effects of age may be due to increased illness, etc, as opposed to advanced years ( Kremer, Mojet, et al, 2007c ), but the practical implications of this distinction are negligible.…”

“…This under-nutrition is a result, at least in part, of low levels of consumption ( Cowan et al, 2004 ; Leslie, 2011 ). Liking is a strong determinant of consumption in older adults ( Appleton, McGill, Neville, & Woodside, 2010 ; Best & Appleton, 2013 ; Leslie, 2011 ), but various reports demonstrate lower ratings for liking or the pleasantness of food items in older compared with younger individuals ( de Graaf, Polet, & van Staveren, 1994 ; de Graaf, van Staveren, & Burema, 1996 ). These lower likings have been strongly linked to decreases in chemosensory abilities ( de Graaf et al, 1994 , 1996 ; Kalviainen, Roininen, & Tuorila, 2003 ).…”

Perceptions of older consumers regarding food packaging as a prerequisite for its improvement: A case study of Polish market

“…Several factors should be considered when preparing the model approach. In order to fulfil consumer needs, expectations and preferences, the product and its packaging should also somehow address functional and cognitive limitations of older people (Leslie, ). In this way, older consumers will begin to be appreciated as consumers capable of purchasing more goods and services.…”

Quality indicators of nutritional care practice in elderly care

“…Previous studies have found quality indicators, such as the presence of adapted guidelines and policies, and the systematic education of staff, to be meaningful for the improvement of nutritional care practices ( 8 - 10 ). These quality indicators, together with nutritional competence and attitude, are described as vital for achieving interventions addressing malnutrition ( 11 - 13 ). Studies of links between food service practice and residents’ risk of malnutrition have further reported that overall meal satisfaction and menu cycle length, among other quality indicators, are associated with nutritional status ( 14 ).…”