Posted by ProPortion Foods Blog on Feb 17, 2020 in Aged Care, Malnutrition, Nutrition, Supplements
While malnutrition is an insidious problem in aged care, simply giving residents more biscuits and cake is not the answer.
Yet that is what many residential facilities are doing, according to research in Melbourne presented at the Royal Commission into Aged Care Quality and Safety.
In fact, the study added to evidence that aged care facilities have been spending less on food, and in the process skimping on high protein sources – critical with aging to prevent disability and malnutrition.
Previous research by the group found that two thirds of residents were malnourished or at risk of malnutrition – and inadequate protein was a major factor.
Essentially, the facilities they researched only provided one serve of high-protein food, such as lean meat, seafood, eggs, poultry and legumes per day – only half of the recommended two serves every day.
Dairy protein only amounted to one serve each day, falling well short of the recommended four servings.
At the same time, the amount of “discretionary foods” high in sugar, refined carbohydrates and unhealthy fats and devoid of nutrients has increased.
So while centres might be trying to save costs, it’s a false economy, lead researcher Dr Sandra Iuliano argues.
Malnutrition results in a host of poor outcomes including bed sores, falls, poor wound healing and general immunity.
This is not only debilitating for sufferers; it also increases hospital stays, estimated to add nearly $1,800 to the cost of each admission.
Some argue that a ban on junk foods in health care facilities is a good start, and research shows it helps shape behaviour and improve diets.
For aged care, where a healthy diet is most critical, mandatory nutrition standards would help lift and standardise the quality of food and nutrition provided – with a particular focus on delivering quality protein.
As we age, protein becomes increasingly important to prevent loss of muscle mass and related problems including frailty and sarcopenia.
Beyond protein, poor and medium quality diets have been associated with 92% and 40% greater incidence of frailty, respectively, than a high quality diet.
Lifestyle factors such as diet and exercise can also reduce the risk of dementia.
Supporting older adults to eat healthy food – even just one extra meal a day – can save lives, and even replace a big chunk of unnecessary, expensive and harmful drugs.
Enhancing the dining experience would help overcome many obstacles to eating well, such as improving the sensory experience, and making food more appealing through greater choice, communal dining, cooking smells and attractive food presentation.
Some centres have even engaged residents with cooking to help stimulate appetite with foods they are familiar with – an enjoyable, social and stimulating activity with multiple rewards.
As Sandra Iuliano says, “It’s not about adding years to life; it’s about adding quality to the years they have.”
https://www.aihw.gov.au/reports/food-nutrition/nutrition-across-the-life-stages/contents/summary
https://www1.racgp.org.au/newsgp/professional/aged-care-residents-nutrition-a-false-sense-of-sec
https://pursuit.unimelb.edu.au/articles/nourishing-old-age
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5350609/
Posted by ProPortion Foods Blog on Feb 6, 2020 in Malnutrition
You can’t tackle a problem without first spotting it. Accordingly, there are calls for routine screening of patients in hospitals and aged care facilities, particularly to identify less obvious indicators of unintentional weight loss.
Generally, staff and family should look out for these signs of malnutrition at home or in care:
Food provides calories and essential nutrients needed to produce energy. Insufficient nutrition intake can result in tiredness, weakness and dizziness. A clue here could be reduced levels of mobility. Look out for diminished muscle mass – a risk factor for sarcopenia.
It’s commonly recognised that depression can affect people’s appetite. But nutrients from food – carbohydrates, protein, healthy fats, vitamins and minerals – are also vital for healthy brain function. Not getting enough can impact mood and even lead to major depression.
As previously indicated, aging and some medications can alter taste and appetite. Eating less can, in turn, reduce appetite, so this is something to look out for.
You can’t fool your dentist. Teeth and gums are a key indicator of nutrition and health status. Swollen or bleeding gums are early oral symptoms of malnutrition. If malnutrition progresses, it can cause irreversible tooth decay.
Check brushes and clothes for excess hair. Hair loss and lack lustre hair can reflect poor nutrition status, particularly insufficient protein and iron. Nails also become dry, brittle and discoloured if essential nutrients are lacking. When iron levels drop too low, nails can start curling upwards, signalling possible iron-deficiency anaemia.
Our immune system needs nutrients to prevent and ward off disease. Frequent illness and infections can reveal poor nutrition status. Also be on the watch for easy bruising and wounds that don’t heal easily.
Chronic constipation can signal insufficient food intake to mobilise the digestive tract; it can also reflect inadequate fibre and/or dehydration – common in older adults. Conversely, watch out for persistent diarrhoea because this can decrease nutrient absorption and exacerbate malnutrition.
Our Cost of Malnutrition report outlines the problem of malnutrition and its various costs – both financial and physical – and offers a guide to its identification and management.
Download your free report HERE.
Posted by ProPortion Foods Blog on Jan 23, 2020 in Malnutrition
Malnutrition is a silent epidemic, often called the “skeleton in the hospital closet” because it tends to escape detection and treatment.
This is surprising given that more than one in three hospitalised older adults and nearly one in thirty community dwelling people over 60 are malnourished. In aged care, malnutrition afflicts up to two thirds of residents.
Its prevalence is gradually gaining recognition, but malnutrition is still not given the attention it deserves, and this is a bigger problem than ever as we face a “demographic time bomb”. In Australia, the percentage of older people has tripled in less than a century, adding to global statistics revealing that, for the first time, there are more people over 65 than under five years of age.
Our Cost of Malnutrition report outlines the problem of malnutrition and its various costs – both financial and physical – and offers a guide to its identification and management.
Download your free report HERE.
Posted by ProPortion Foods Blog on Jan 7, 2020 in Malnutrition
Malnutrition occurs when someone does not receive enough dietary nourishment to sustain their physical health needs, leading to wasting.
The most common, and most obvious symptom is weight loss; technically, it is defined as unintentionally losing 5-10% of body weight over three to six months – and a high percentage of that comprises lean muscle tissue which is a critical problem in itself.
Health bodies are calling for mandatory nutrition standards across residential aged care facilities, including staff training and awareness. While the issue is complex and needs a multi-pronged approach, a simple start is prioritising quality food in aged care budgets.
Important strategies to prevent and treat malnutrition are regular meals and snacks containing protein and energy, a variety of food from the key food groups, and regular drinks to avoid dehydration. Where patients have difficulty eating or swallowing, high energy, high protein drinks can be given between meals.
Challenging conventional wisdom, diet quality is even more important for preventing frailty than food quantity or protein intake, according to a recent study in the US. The authors found four studies showing that a Mediterranean diet reduced frailty risk – an eating pattern high in plant foods such as vegetables, fruit, legumes and healthy fats contained in extra virgin olive oil, nuts and seeds. It is low in processed foods, confectionary and red meat.
So giving custard and ice cream to patients at risk for malnutrition might not be the ticket for boosting protein and energy intake, but rather generous amounts of extra virgin olive oil for cooking and salads, a handful of nuts each day for those who can chew them, avocado, salmon, eggs and full fat dairy products such as yoghurt and cheese.
Barriers and catalysts of eating also need to be identified and addressed, and every effort made to help older people enjoy food and the enhanced wellbeing that it delivers.
Ultimately, if meals and food choices are appealing, older people are more likely to eat. The environment is very important. Cooking smells, communal eating, pleasant, relaxed surroundings and attractive food presentation can all stimulate appetite.
As Maggie Beer says, “It’s all about giving equal measures of pleasure and nutrition. Without pleasure, what is there in life?”
Our Cost of Malnutrition report outlines the problem of malnutrition and its various costs – both financial and physical – and offers a guide to its identification and management.
Download your free report HERE.