Effect on energy and macronutrient intake with partial replacement of external food supply by in-house cooking at a nursing home for older people in Sweden

摘要

An increased awareness of the importance of nutrition for older people's health and quality of life has underpinned projects and quality improvements for the meal situation in care establishments. The present study took place in a nursing home in a village outside an average-sized town situated in mid-Sweden. Care staff had initiated a change from external catered meals to purchase the food and cook the main meals themselves. The intention was to increase flexibility in accommodating the requests and needs of the elderly and, in doing so, to achieve increased professional pride and satisfaction. To ensure that no negative effects resulted for the residents in the nursing home, outcomes were evaluated through the present intervention study. The objective was to investigate whether and, if so, how their energy and nutrient intake and weight were affected. At the start, only one main hot meal was exchanged for home cooking to avoid work load problems as no increased costs were allowed and no extra staff were to be recruited. The study population consisted of 21 residents, aged 69-97 years. Weight, energy and nutrient intake were recorded before and during the intervention by 3-day food records validated by Goldberg's cutoff method. The same 3 days of the weekSunday to Tuesdayand the same menus were used for both measurement periods. At group level, the energy intake corresponded to the estimated energy requirements, both at baseline and at follow-up, although the intervention resulted in a significantly higher energy intake from the meals cooked in the ward kitchens. Two-thirds of the residents (n=13) slightly increased in weight from baseline to follow-up, while two participants (with body mass index 27.5 kg/m(2) and 33.5 kg/m(2), respectively) lost 5.0 kg and 6.9 kg, respectively. The total protein intake was insufficient both at baseline and follow-up and only met the participants' needs to 8122% and 83 +/- 26%, respectively. In conclusion, the intervention resulted in no adverse consequences for participants in terms of energy and nutrient intake. Most participants were weight stable or had small increases in weight, and the greatest weight gain was observed in the lighter clients. The low protein intake at both time points causes concern and suggests the need for further nutritional interventions to optimize older people's protein intake.