Improving the dietary intake of under nourished older people in residential care homes using an energy-enriching food approach: a cluster randomised controlled study

Leslie, W.S., Woodward, M., Lean, M.E.J. , Theobald, H., Watson, L. and Hankey, C.R. (2013) Improving the dietary intake of under nourished older people in residential care homes using an energy-enriching food approach: a cluster randomised controlled study. Journal of Human Nutrition and Dietetics, 26(4), pp. 387-394. (doi: 10.1111/jhn.12020)

Abstract

Background: To examine whether the nutritional status of aged undernourished residents in care could be improved through dietary modification to increase energy intake but not portion size.<p></p> Methods: A 12-week cluster randomised controlled trial was carried out in 21 residential care homes. Participants comprised undernourished residents with a body mass index (BMI) <18.5 kg m–2. All menus were analysed to evaluate nutrient provision. Energy and macronutrient intakes of undernourished residents were estimated using 3-day weighed food intake diaries. Those resident in homes randomised to intervention had their usual meals enriched with energy-dense foods to a maximum of +1673 kJ day−1.<p></p> Results: Of 445 residents screened, 41 (9%) had a BMI <18.5 kg m–2 and entered the study. Despite adequate food provision, energy and macronutrient intakes were below UK dietary reference values. Mean (SEM) energy intake increased [+556 (372) kJ, P = 0.154] in residents allocated to intervention but fell in those residents in ‘control homes’ receiving usual care [−151 (351) kJ, P = 0.676]. Weight change [+1.3 (0.53) kg, P = 0.03] was seen in intervention residents but not in controls [−0.2 (1.5) kg, P = 0.536]. Between-group differences for changes in weight and energy intake were not significant (P = 0.08 and 0.20, respectively). Six residents allocated to the intervention increased their BMI >18.5 kg m–2 (P = 0.018).<p></p> Conclusions: Achieving weight gain in frail older people is difficult. These results suggest that enriching food could help address undernutrition and slow chronic weight loss. Interventions of a longer duration are needed to confirm or exclude the value of food enrichment.<p></p>

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Woodward, Professor Mark and Lean, Professor Michael and Leslie, Dr Wilma and Hankey, Dr Catherine
• Authors: Leslie, W.S., Woodward, M., Lean, M.E.J., Theobald, H., Watson, L., and Hankey, C.R.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Journal of Human Nutrition and Dietetics
• Publisher: Blackwell Publishing
• ISSN: 0952-3871
• Published Online: 13 December 2012