Abstract

Malnutrition in institutionalised elderly increases morbidity and care costs. Meat and dairy foods are high-quality protein sources so adequate intakes may reduce malnutrition risk. We aimed to determine whether inadequate intakes of meat and dairy foods contribute to malnutrition in institutionalised elderly. This cross-sectional study involved 215 elderly residents (70·2 % females, mean age 85·8 years) from twenty-one aged-care facilities in Melbourne, Australia. Dietary intake was assessed using observed plate waste. Food groups and serving sizes were based on the Australian Guide to Healthy Eating. Nutrient content was analysed using a computerised nutrient analysis software (Xyris). Malnutrition risk was assessed using the Mini Nutrition Assessment (MNA) tool; a score between 24 and 30 indicates normal nutritional status. Data were analysed using robust regression. Mean MNA score was 21·6 (sd 2·7). In total, 68 % of residents were malnourished or at risk of malnutrition (MNA score≤23·5). Protein intake was 87 (sd 28) % of the Australian recommended dietary intake (RDI). Consumption averaged 1 serving each of dairy foods and meat daily. Number of dairy and meat servings related to proportion of protein RDI (both P24 points). Provision of meat and dairy foods did not meet recommended levels. On the basis of current dietary intakes in aged-care residents, increasing consumption of dairy foods to the recommended four servings daily ensures protein adequacy and may reduce malnutrition risk in institutionalised elderly, and so reduce risk of comorbidities and costs associated with malnutrition.

Highlights

  • 89 % of residents being at risk of malnutrition or malnourished[1]

  • Albumin levels were positively related to Mini Nutrition Assessment (MNA) score (r 0·25, P = 0·005), but no relationship was observed between insulin-like growth factor-1 (IGF-1) and MNA score (r 0·00, P = 0·995)

  • MNA score was related to number of medical conditions (r −0·14, P = 0·039), but not number of medications (r −0·11, P = 0·132)

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Summary

Introduction

89 % of residents being at risk of malnutrition or malnourished[1]. Malnutrition is associated with higher morbidity and poorer health outcomes[2]. Institutionalised elderly are predominantly reliant on aged-care providers to meet their nutritional needs. Most food is provided through the facility’s food service, with most residents having limited access to externally prepared foods. These circumstances necessitate that aged-care providers offer nutritionally adequate meals and snacks. Despite nationally available guidelines and supervision by dietitians to assist staff with menu planning, a study of fourteen aged-care facilities revealed that foods provided do not always meet nutritional requirements, with protein intakes frequently below recommended[6]. We hypothesised that in aged-care residents, inadequate intakes of meat and dairy foods would be associated with protein insufficiency and increased risk of malnutrition

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