Influence of the consumption of fruits and vegetables on the nutritional status of a group of institutionalized elderly persons in the Madrid region

A systematic review and meta-analysis of the dietary fiber menu provision and consumption for older adults living in residential care facilities

BACKGROUND

Older adults living in residential care facilities are commonly given laxatives to treat constipation; however, these may not always provide full relief, and side effects include diarrhea. Dietary fiber effectively prevents constipation, and international guidelines recommend 25 g/d for optimal laxation. Older adults in residential care rely on the facility menu to provide their nutritional requirements, including adequate dietary fiber. Little is known about how much dietary fiber is provided and consumed.

OBJECTIVES

We aimed to determine the provision and consumption of dietary fiber for older adults living in residential care facilities.

METHODS

We systematically searched available literature for studies reporting the analysis of residential care menus and meals consumed by residents aged over 65 y. A meta-analysis was performed on the studies that provided the mean amount of dietary fiber provided and consumed by residents. A random effect model was applied due to the heterogeneity of study methodologies.

RESULTS

The literature search yielded 4406 publications, but only 28 studies were eligible for our meta-analysis. The study sample comprised 4817 residents. The mean amount of fiber provided to residents was 21.4 g/d [standard error (SE): 1.2; 95% confidence interval: 18.8, 24.2 g/d], the mean amount of fiber consumed by residents was 15.8 g/d (SE: 0.6; 95% confidence interval: 14.7, 16.9 g/d).

CONCLUSIONS

Older adults living in care facilities are provided with dietary fiber below the recommended guidelines. Compounding this is that residents consume much less than what is provided and do not meet the recommendations for dietary fiber consumption. There is scope to improve dietary fiber provision, promote consumption to residents to aid laxation, and potentially reduce laxative use and the unwanted side effects of diarrhea. This trial was registered at PROSPERO as CRD42023427265.

Relationships between oral function, dietary intake and nutritional status in older adults aged 75 years and above: a cross-sectional study

BACKGROUND

Malnutrition is related to impaired oral health and function that causes poor dietary intake, declining the general health of older adults. The role of dietary intake in the association between oral function and nutritional status of Chinese older adults (aged 75 and above) was examined in this cross-sectional study.

METHODS

Through the randomized cluster sampling method, 267 older adults living in rural areas of Qingdao, Shandong (aged 81.4 ± 4.3, 75-94 years) were chosen as the primary research participants. A Mini Nutritional Assessment - Short Form was used to determine nutritional status, and Food Frequency Questionnaire and 24-hour Food Intake Recall were used to assess dietary intake. The oral function was evaluated by analyzing the teeth, oral problems, bite force, tongue pressure, lip sealing pressure, chewing function questionnaire, whole saliva flow rate, 10-Item Eating Assessment Tool, and water swallow test.

RESULTS

Based on the MNA-SF score, it was divided into a well-nourished group and a malnutrition group, with the malnutrition group comprising 40.6% of participants. The participants in the malnutrition group showed a higher rate of xerostomia, lower bite force, tongue pressure, and lip sealing pressure, and higher Chewing Function Questionnaire and 10-Item Eating Assessment Tool scores. Furthermore, their plant fat, iron, cereals and potatoes, vegetables, fruits, and seafood intake were relatively low. The regression model indicated that exercise frequency, stroke, chewing and swallowing function, intake of vegetables and fruits were risk factors for nutritional status of older adults.

CONCLUSION

Malnutrition was relatively common among the Chinese older adults aged 75 and above, and it was significantly correlated with exercise frequency, stroke, chewing and swallowing function, and intake of vegetables and fruits. Therefore, nutrition management should be carried out under the understanding and guidance of the oral function and dietary intake of the older adults.

Fruit and vegetable intake in older hospitalized patients

PURPOSE OF REVIEW

Regular intake of fruit and vegetables (F&Vs) has been widely recommended to improve the health of the population. Observational studies show a preventive effect of long-term consumption of adequate nutrients on cancer, diabetes, dementia and other age-related diseases. However, the short-term impact of F&V intake in more specific populations has been under-researched. In the hospital setting, economic choices and logistic problems result in poor quality of food in general, and particularly in fresh F&Vs. As hospital geriatricians, we set out to address the issue of F&V intake in elderly hospitalized patients, for whom we felt F&Vs might be beneficial in association with a protein and energy-dense diet.

RECENT FINDINGS

In the community and in nursing homes, F&V consumption is associated with better overall food intake and improved quality of life in older patients.

SUMMARY

General inspection of the literature suggests that F&Vs may be beneficial to elderly hospitalized patients, but no clinical studies have been conducted. There is a need to address the question of the impact of improved quality and quantity of F&Vs on quality of life, total food intake and constipation, particularly in hospitalized elderly patients who often stay in hospital for long periods. Positive results might help to promote F&V consumption in diverse populations, with the objective of improving eating pleasure for better health.