Protein-dense Foods Research Articles

Malnutrition and feeding difficulty in Taiwanese older with dementia

To determine differences in the physical and psychological factors and feeding difficulty between people who are well-nourished and malnourished and to determine the predictors of risk of malnutrition and malnutrition in Taiwanese residents with dementia. Malnutrition is a common problem among nursing home residents but frequently is unrecognised. Nutritional status of older people is associated with cognitive impairment and patients with dementia have high risk for malnutrition because of difficulties in eating. A cross-sectional design was used to determine predictors of risk of malnutrition and malnutrition. Subjects were recruited from five Taiwanese long-term care facilities. Data were collected using Mini Nutritional Assessment Screening Form, body mass index, Short Portable Mental Status Questionnaire, Barthel index, Edinburgh Feeding Evaluation in Dementia scale and eating time. Eighty-three subjects participated. According to the Mini Nutritional Assessment Screening Form cut-point scores, 75 (90·4%) residents with dementia had risk of malnutrition. However, using the World Health Organization (WHO) body mass index cut-point of <18·5, the prevalence rate of malnutrition was 19%. Using logistic regression, gender (odds ratio: 38·627, 95% CI: 1·927-774·407) and eating time (odds ratio: 0·814, 95% CI: 0·689-0·962) were significant predictors of risk of malnutrition. However, only gender (odds ratio: 6·12, 95% CI: 1·05-35·662) was a significant predictor of malnutrition using the WHO body mass index cut-point. The prevalence of the risk for malnutrition was high in residents with dementia in Taiwanese nursing homes. Feeding difficulty, activities of daily living dependence, cognitive impairment, number of medications and age increased with malnutrition while shorter eating times were associated with poorer nutrition. However, when the factors were considered together, only being female and eating time were significant risk factors for malnutrition. Being female was the only significant factor of malnutrition. Monthly monitoring of weight and assessment with Mini Nutritional Assessment Screening Form are essential to early identification of emerging malnutrition and implementation of interventions. Providing nutritional supplements and energy and protein-dense food may be needed for good nutrition and more time for eating or feeding assistance may delay malnutrition or even improve nutritional status.

Efficacy and Effectiveness of Community-Based Treatment of Severe Malnutrition

There is a long tradition of community-based rehabilitation for treatment of severe malnutrition: the question is whether it is effective and whether it should be advised for routine health systems. To examine the effectiveness of rehabilitating severely malnourished children in the community in nonemergency situations. A literature search was conducted of community-based rehabilitation programs delivered by day-care nutrition centers, residential nutrition centers, primary health clinics, and domiciliary care with or without provision of food, for the period 1980-2005. Effectiveness was defined as mortality of less than 5% and an average weight gain of at least 5 g/kg/day. Thirty-three studies of community-based rehabilitation were examined and summarized. Eleven (33%) programs were considered effective. Of the sub-sample of programs reported since 1995, 8 of 13 (62%) were effective. None of the programs operating within routine health systems without external assistance was effective. With careful planning and resources, all four delivery systems can be effective. It is unlikely that a single delivery system would suit all situations worldwide. The choice of a system depends on local factors. High energy intakes (> 150 kcal/kg/day), high protein intakes (4-6 g/kg/day), and provision of micronutrients are essential for success. When done well, rehabilitation at home with family foods is more cost-effective than inpatient care, but the cost effectiveness of ready-to-use therapeutic foods (RUTF) versus family foods has not been studied. Where children have access to a functioning primary health-care system and can be monitored, the rehabilitation phase of treatment of severe malnutrition should take place in the community rather than in the hospital but only if caregivers can make energy- and protein-dense food mixtures or are given RUTF. For routine health services, the cost of RUTF, logistics of procurement and distribution, and sustainability need to be carefully considered.

The implications of female household headship for food consumption and nutritional status in the Dominican Republic

Female control of household resources is often associated with consumption preferences which favor basic needs and child welfare. Using data from the Dominican Republic, this study tests differences in spending patterns, consumption preferences, and child nutritional (anthropometric) status according to four definitions of female household headship. Female-headed households (FHH) allocate the same amount or less of their budgets to food than male-headed households (MHH), in absolute and proportional terms. FHH consume higher quality, more expensive and protein-dense foods (more animal products; less of beans and rice) than MHH. Average caloric adequacy per adult-equivalent is equal or lower in FHH, but children's anthropometric status is the same or higher; it is significantly higher in low-income FHH, possibly due to intrahousehold allocation of food which favors children.