Abstract
BackgroundOlder adults living in long-term care (LTC) are nutritionally vulnerable. The purpose of this study was to determine diet quality of Canadian LTC residents and its association with malnutrition and low calf circumference.MethodsA cross-sectional study was undertaken in 32 LTC homes across four Canadian provinces. Nutrient adequacy ratios (NARs) were calculated for seventeen nutrients; mean adequacy ratio (MAR) was calculated to describe overall diet quality. Malnutrition risk was assessed with the Mini Nutritional Assessment-Short Form (MNA-SF) and diagnosis of protein/energy malnutrition with the Patient-Generated Subjective Global Assessment (PG-SGA). Calf circumference (CC) was also assessed. Linear and logistic regressions for these outcomes with diet quality as the predictor were conducted adjusting for covariates.ResultsAverage MNA-SF score was 10.7 ± 2.5. Residents (43.5%) had mild/moderate to severe malnutrition based on the PG-SGA and 32.6% had a CC of < 31 cm. Mean MAR score was 0.79 ± 0.09 with significant differences between those requiring eating assistance (0.77 ± 0.11) and those that did not require assistance (0.80 ± 0.07) (p < .05). MAR score was significantly associated with malnutrition in fully adjusted models: MNA-SF scores [β = 5.34, 95% Confidence interval (CI) (2.81, 7.85)] and PG-SGA [Odds ratio (OR) = 0.49, 95% CI (0.38, 0.64)]. Those who had better diet quality were more likely to be well nourished or not at risk. Although several individual nutrients were associated with low CC (< 31 cm), there was no association between overall diet quality (MAR) and low CC.ConclusionsDiet quality is associated with malnutrition and individual nutrients (NARs) with a low CC. In addition to calories and protein, nutrient dense diets that promote adequate micronutrient intake are required in LTC.
Highlights
Older adults living in long-term care (LTC) are nutritionally vulnerable
Data from this study suggests that some clinical improvements are required to prevent malnutrition and loss of muscle mass in LTC residents, such as: 1) improving nutritional intake of residents requiring texture-modified meals by the creation of nutrient dense, appealing and tasty foods to bring more pleasure to mealtimes; 2) providing quality and constant eating assistance during mealtimes to all residents who require physical support by training current LTC staff; and 3) ensuring nutrient-rich meals are provided by giving more attention to specific micronutrient content during menu planning
The new Guide does not specify servings to be consumed per day and as a result the Dietary Reference Intake is recommended for menu development to avoid micronutrient deficiency [45]
Summary
Older adults living in long-term care (LTC) are nutritionally vulnerable. The purpose of this study was to determine diet quality of Canadian LTC residents and its association with malnutrition and low calf circumference. Older adults living in long-term care (LTC) facilities are nutritionally vulnerable [1,2,3]. It is not surprising that up to 70% of residents have lower than. Some studies have determined an association between vitamin D and loss of muscle function and strength in older adults [12,13,14,15], yet few studies have examined the associations between other micronutrients and muscle mass or low CC in this population
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