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Guo J, Zhang M, Adhikari B, Ma Y, Luo Z. Formulation and characterization of 3D printed chickpea protein isolate-mixed cereal dysphagia diet. Int J Biol Macromol 2023; 253:127251. [PMID: 37804891 DOI: 10.1016/j.ijbiomac.2023.127251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/23/2023] [Accepted: 10/03/2023] [Indexed: 10/09/2023]
Abstract
The feasibility study of making 3D printed dysphagia diet was undertaken. A mixture of corn flour and buckwheat flour was used as the model cereal and chickpea protein isolate (CPI) was used as the model protein. Printing gels (inks) of the mixed cereal (control) and CPI-cereal mixture were produced by heating the formulations at 95 °C for 30 min and then cooling them to room temperature. The results showed that all the ink formulations containing CPI had higher apparent viscosity, preferable shear thinning behavior and shape supporting characteristics than that of the control. The cohesiveness and shape supporting ability of 10%CPI-cereal and 20%CPI-cereal formulations were poor and could not produce stable printing shape. The 30%CPI-cereal and 40%CPI-cereal formulations had suitable apparent viscosity, shear thinning behavior, storage modulus, yield stress and printing accuracy and the 3D printed products were stable. The control ink and 10%CPI-cereal ink had low cohesion and also could not pass the spoon tilt test. The 50%CPI-cereal formulation had high hardness and also could not pass the fork pressing test. The 30 % to 40 % CPI-cereal formulations were found to be suitable as dysphagia products as they could be classified as level 5 dysphagia diet.
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Affiliation(s)
- Jia Guo
- State Key Laboratory of Food Science and Resources, Jiangnan University, 214122 Wuxi, Jiangsu, China; China General Chamber of Commerce Key Laboratory on Fresh Food Processing & Preservation, Jiangnan University, 214122 Wuxi, Jiangsu, China
| | - Min Zhang
- State Key Laboratory of Food Science and Resources, Jiangnan University, 214122 Wuxi, Jiangsu, China; Jiangsu Province International Joint Laboratory on Fresh Food Smart Processing and Quality Monitoring, Jiangnan University, 214122 Wuxi, Jiangsu, China.
| | - Benu Adhikari
- School of Science, RMIT University, Melbourne VIC3083, Australia
| | - Yamei Ma
- Jiangsu Gaode Food Co., 226500 Rugao, Jiangsu, China
| | - Zhenjiang Luo
- R&D center, Haitong Ninghai Foods Co., Ltd., 443000 Yichang, Hubei, China
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Lasschuijt M, Camps G, Mars M, Siebelink E, de Graaf K, Bolhuis D. Speed limits: the effects of industrial food processing and food texture on daily energy intake and eating behaviour in healthy adults. Eur J Nutr 2023; 62:2949-2962. [PMID: 37452167 PMCID: PMC10469122 DOI: 10.1007/s00394-023-03202-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 06/30/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE Frequent consumption of industrially processed foods has been associated with obesity. However, it is unknown what drives this association. Food textures of industrially processed foods that stimulate energy overconsumption may be an important driver of this association. Therefore, this study aimed to determine the independent and combined effects of food texture and level of industrial food processing (based on the NOVA classification) on daily energy intake and eating behaviour. METHODS Eighteen healthy adults (F/M: 11/7, 23 ± 3 y, 22.1 ± 2.0 kg/m2) participated in a 2 × 2 randomized crossover dietary intervention with four conditions (total of 288 meals): hard unprocessed, hard (ultra-)processed, soft unprocessed and soft (ultra-)processed. Daily diets were offered ad libitum and were equal in energy density (1 kcal/g). Food Intake (g) was measured by pre- and post-consumption weighing of the plates. Eating behaviour parameters were derived from video annotations. RESULTS Daily energy intake and food intake were, respectively, 33% (571 ± 135 kcal) and 14% (247 ± 146 g) lower in the hard compared to the soft conditions (main texture p < 0.001). Energy intake was lower in both hard conditions compared to the (ultra)processed soft condition (Tukey p < 0.04). Eating rate (g/min) was on average 85% slower (P < 0.001) in the hard compared to the soft conditions (p < 0.001). Level of processing did not affect food intake. CONCLUSION Consumption of hard-textured foods reduces daily energy intake of (ultra-) processed foods. This preliminary investigation shows that there is great variability in food properties that affect energy and food intake beyond industrial food processing. However, findings should be interpreted with precaution considering the limited sample size of this trial. Future classification systems for public health messaging should include energy intake rate to help reduce overconsumption. CLINICAL TRIAL REGISTRY NCT04280146, https://www. CLINICALTRIALS gov , February 21st 2020.
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Affiliation(s)
- Marlou Lasschuijt
- Division of Human Nutrition and Health, Wageningen University & Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands.
| | - Guido Camps
- Division of Human Nutrition and Health, Wageningen University & Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands
| | - Monica Mars
- Division of Human Nutrition and Health, Wageningen University & Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands
| | - Els Siebelink
- Division of Human Nutrition and Health, Wageningen University & Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands
| | - Kees de Graaf
- Division of Human Nutrition and Health, Wageningen University & Research, Stippeneng 4, 6708 WE, Wageningen, The Netherlands
| | - Dieuwerke Bolhuis
- Food Quality and Design Group, Wageningen University & Research, Bornse Weilanden 9, 6708 WG, Wageningen, The Netherlands
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Wu XS, Miles A, Braakhuis A. Effects of hydrolysed meat on dietary intake and nutritional status in aged care residents requiring pureed diets: a crossover randomised controlled trial. BMC Geriatr 2022; 22:905. [PMID: 36434542 PMCID: PMC9700874 DOI: 10.1186/s12877-022-03622-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 11/14/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND As a result of the high prevalence of dysphagia in aged care facilities, demand for pureed diets is increasing. One of the biggest challenges for pureed diets is the reduced nutritional density due to the cooking process, such as when blending or softening with liquid. This study aimed to investigate the impact of innovative energy and protein-enriched meat puree on the nutrition intake and nutritional status of aged care residents requiring pureed diets. METHODS This is a single-blinded randomised controlled trial conducted in two aged care facilities using a crossover design. Twenty-two residents aged 83.2 ± 7.3 years participated in a 12-week study. Participants were blocked randomised into two groups and received a 6-week of either control (unaltered freshly made pureed diets by facilities) or intervention diet, followed by a 2-week washout and then 6-week of alternative treatment. During the intervention, freshly made meat pureed portions were swapped to hydrolysed meat, which contained 144 -392 kcal and 5.6-6.8 g more energy and protein per 100 g. Nutrition intake was collected using a validated visual estimation method over 24 h on two non-consecutive days during the control and intervention phases. A two-tailed t-test was used to compare the significance. RESULTS The intervention diet significantly increased energy (147 ± 285 kcal, p = .02), protein (4 ± 7 g, p = .04), and fat (3 ± 8 g, p = .07) intake in comparison to the control diet. Nutritional status was improved by the end of the intervention as evidenced by a higher nutritional assessment score using Mini-Nutritional Assessment - Short Form (9.1 ± 1.8) and a weight gain of 1.3 ± 1.7 g, p = .04. No significant differences were found in body composition using bioelectrical impedance analysis, calf circumference and mid-upper arm circumference. Though handgrip strength did not differ at the end of control and intervention, significance was found between the changes in control and intervention period. Plasma branched-chain amino acid increased significantly with hydrolysed meat consumption. CONCLUSIONS As a dietary enrichment, hydrolysed meat is a promising intervention for pureed diet consumers in aged care facilities, improving residents' dietary intake and reducing malnutrition risk. Future larger multicentre studies with longer intervention periods are required to confirm the effectiveness and residents' acceptance. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ACTRN12622000888763).
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Affiliation(s)
- Xiaojing Sharon Wu
- grid.9654.e0000 0004 0372 3343Department of Nutrition, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Rd, Grafton, Auckland, 1142 New Zealand
| | - Anna Miles
- grid.9654.e0000 0004 0372 3343Department of Speech Science, School of Psychology, University of Auckland, Auckland, New Zealand
| | - Andrea Braakhuis
- grid.9654.e0000 0004 0372 3343Department of Nutrition, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Rd, Grafton, Auckland, 1142 New Zealand
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Ueshima J, Shimizu A, Maeda K, Uno C, Shirai Y, Sonoi M, Motokawa K, Egashira F, Kayashita J, Kudo M, Kojo A, Momosaki R. Nutritional Management in Adult Patients With Dysphagia: Position Paper From Japanese Working Group on Integrated Nutrition for Dysphagic People. J Am Med Dir Assoc 2022; 23:1676-1682. [PMID: 35985419 DOI: 10.1016/j.jamda.2022.07.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/05/2022] [Accepted: 07/12/2022] [Indexed: 10/15/2022]
Abstract
This position paper prepared by the Japanese Working Group on Integrated Nutrition for Dysphagic People (JWIND) aims to summarize the need for nutritional management in adult patients with dysphagia, the issues that nutrition professionals should address, and the promising approaches as well as to propose a vision for the future of nutritional care for adult patients with dysphagia. JWIND is a joint certification system recognized by the Japan Dietetic Association and the Japanese Society of Dysphagia Rehabilitation; its members are mostly experts known as "Certified Specialist of Registered Dietitian for Dysphagia Rehabilitation." Malnutrition and dysphagia are associated with each other. Therefore, malnutrition detection and intervention are essential for patients with dysphagia. However, evidence on the usefulness nutritional assessment and intervention to ensure appropriate nutritional care remains insufficient. Here, we present current knowledge of the relationship between primary diseases causing dysphagia and malnutrition, the indicators used for nutritional assessment, and nutritional interventions such as texture-modified diet (TMD) quality improvement, oral nutritional supplementation, and comprehensive intervention. We also discuss the current status and issues in nutritional care for adult patients with dysphagia. Furthermore, we have proposed measures that nutrition professionals should consider based on 3 perspectives: nutritional assessment, TMD, and nutritional intervention. Individualized and specialized nutritional management by registered dietitians (RDs) through appropriate assessment of the nutritional status of adult patients with dysphagia is needed. To maintain and improve swallowing function and nutritional status, RDs should intervene from the state of risk or early dysphagia onset, providing individualized care per their expertise as part of a multidisciplinary team. However, systematic clinical practice and research regarding the association of nutrition with dysphagia are currently insufficient. Therefore, further clinical practice and evidence building, including the verification of the efficacy on nutritional support through intervention research, are needed.
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Affiliation(s)
- Junko Ueshima
- Department of Clinical Nutrition and Food Service, NTT Medical Center Tokyo, Shinagawa, Tokyo, Japan; Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Akio Shimizu
- Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan; Department of Health Science, Faculty of Health and Human Development, The University of Nagano, Nagano, Nagano, Japan
| | - Keisuke Maeda
- Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Nagakute, Aichi, Japan; Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
| | - Chiharu Uno
- Institutes of innovation for Future Society, Nagoya University, Nagoya, Aichi, Japan
| | - Yuka Shirai
- Department of Clinical Nutrition Unit, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Mika Sonoi
- Department of Foods and Human Nutrition, Faculty of Human Life Sciences, Notre Dame Seishin University, Okayama, Okayama, Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Fumie Egashira
- PEACH Atsugi of Community Nutritional Care Center, Kanagawa, Japan
| | - Jun Kayashita
- Department of Health Sciences, Faculty of Human Culture and Science, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Mika Kudo
- Department of Health and Nutrition Sciences, Komazawa Women's University, Tokyo, Japan
| | - Akiko Kojo
- Division of Medical Nutrition, Faculty of Healthcare, Tokyo Healthcare University, Tokyo, Japan
| | - Ryo Momosaki
- Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Tsu Mie, Japan
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Ni D, Smyth HE, Cozzolino D, Gidley MJ. Integrating Effects of Human Physiology, Psychology, and Individual Variations on Satiety–An Exploratory Study. Front Nutr 2022; 9:872169. [PMID: 35571942 PMCID: PMC9093687 DOI: 10.3389/fnut.2022.872169] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/28/2022] [Indexed: 12/12/2022] Open
Abstract
Satiety can influence food intake, and as a consequence has the potential to affect weight and obesity. Human factors such as physiology and psychology are likely to be important in determining satiety. However, it is not well-understood how these factors (individual variations) alone or combined contribute to satiety feelings. In addition, there have been limited or no attempts to use a holistic approach to evaluate satiety. In this study, three plant-based foods were used as mid-morning snack for 52 participants to evaluate satiety response (during three consecutive days, one-day-one-food type). The foods were served ad libitum until participants felt comfortably full prior to satiety monitoring. The study explored diverse human factors (n = 30) that might contribute to satiety including those related to oral physiology, metabolic factors, body composition and psychology. It identified important variables for satiety as well as the interactions among them and the influences of age, gender, and low satiety phenotype (consistently lower reported fullness scores) on satiety. Overall, combinations of factors rather than individual ones contributed to self-reported satiety. Food factors (e.g., type, composition) had limited effects, but there were only three types used in the study. The combination of metabolic factors [respiratory quotient, age, and body energy usage type (e.g., carbohydrate or fat)], oral sensitivity & processing, personality traits (agreeableness, conscientiousness, and neuroticism), and eating behavior (e.g., emotional and external eating) were the most important for explaining individual satiety responses. Older participants had significantly higher reported satiety than younger participants, associated with significant differences in oral physiology, increased body fat, and mature psychological characters. Moreover, different satiety phenotypes had significant differences in relationships with body fat, oral physiology, personalities, food neophobia, and eating behaviors. The results of this study indicate that much greater insights into the factors determining satiety responses can be obtained by combining multiple food and human physiological and psychological characteristics. This study used more diverse measures of individual variation than previous studies of satiety and points the way toward a more holistic approach to understanding the (control of) perceptions of fullness at both individual and group levels.
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Robinson E, Khuttan M, McFarland-Lesser I, Patel Z, Jones A. Calorie reformulation: a systematic review and meta-analysis examining the effect of manipulating food energy density on daily energy intake. Int J Behav Nutr Phys Act 2022; 19:48. [PMID: 35459185 PMCID: PMC9026919 DOI: 10.1186/s12966-022-01287-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/25/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Dietary energy density is thought to be a contributor to obesity, but the extent to which different magnitudes and types of reductions to food energy density decreases daily energy intake is unclear. The primary objective was to systematically review and meta-analyse experimental studies that have examined the effect that manipulating energy density of food has on total daily energy intake. Secondary objectives were to examine moderators of the effect that altering energy density has on daily energy intake and effects on body weight. METHODS A systematic review and multi-level meta-analysis of studies on human participants that used an experimental design to manipulate the energy density of foods served and measured energy intake for a minimum of 1 day. RESULTS Thirty-one eligible studies sampling both children (n = 4) and adults (n = 27) contributed 90 effects comparing the effect of higher vs. lower energy density of served food on daily energy intake to the primary meta-analysis. Lower energy density of food was associated with a large decrease in daily energy intake (SMD = - 1.002 [95% CI: - 0.745 to - 1.266]). Findings were consistent across studies that did vs. did not manipulate macronutrient content to vary energy density. The relation between decreasing energy density and daily energy intake tended to be strong and linear, whereby compensation for decreases to energy density of foods (i.e. by eating more at other meals) was minimal. Meta-analysis of (n = 5) studies indicated that serving lower energy dense food tended to be associated with greater weight loss than serving higher energy dense food, but this difference was not significant (- 0.7 kg difference in weight change, 95% CIs: - 1.34, 0.04). CONCLUSIONS Decreasing the energy density of food can substantially reduce daily energy intake and may therefore be an effective public health approach to reducing population level energy intake. TRIAL REGISTRATION Registered on PROSPERO ( CRD42020223973 ).
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Affiliation(s)
- Eric Robinson
- Department of Psychology, Eleanor Rathbone Building, University of Liverpool, Liverpool, L69 7ZA, UK.
| | - Mercedes Khuttan
- Department of Psychology, Eleanor Rathbone Building, University of Liverpool, Liverpool, L69 7ZA, UK
| | - India McFarland-Lesser
- Department of Psychology, Eleanor Rathbone Building, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Zina Patel
- Department of Psychology, Eleanor Rathbone Building, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Andrew Jones
- Department of Psychology, Eleanor Rathbone Building, University of Liverpool, Liverpool, L69 7ZA, UK
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Association between food texture levels consumed and the prevalence of malnutrition and sarcopenia in older patients after stroke. Eur J Clin Nutr 2022; 76:1576-1582. [PMID: 35418607 DOI: 10.1038/s41430-022-01126-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/10/2022] [Accepted: 03/16/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Texture-modified diets (TMDs) may affect nutritional status and sarcopenia in patients after stroke. This study aimed to investigate the association of food texture levels consumed by patients after stroke with the prevalence of malnutrition and sarcopenia. SUBJECTS/METHODS This was a two-center cross-sectional study. A total of 443 patients aged ≥65 years undergoing post-stroke rehabilitation and with oral intake in rehabilitation wards in Shizuoka prefecture and Okinawa prefecture, Japan, were included in the analysis. Food textures were categorized according to the International Dysphagia Diet Standardization Initiative (IDDSI) framework. Malnutrition was diagnosed according to the Global Leadership Initiative on Malnutrition and sarcopenia was assess by the European Working Group on Sarcopenia in Older People 2 criteria. The Cochran-Armitage trend test was used to examine the prevalence of malnutrition and sarcopenia by consumption of lower food texture levels. RESULTS Malnutrition and sarcopenia were diagnosed in 245 (55.3%) and 275 (62.1%) participants, respectively. Consumption of lower food texture levels was associated with a higher prevalence of malnutrition and severe malnutrition (P < 0.001 for both). In addition, consumption of lower food texture levels was associated with a higher prevalence of probable sarcopenia and sarcopenia (P < 0.001 for both). On multivariate analysis, significant associations were observed between IDDSI levels 5 (P < 0.001) and 4 (P = 0.009) and malnutrition, and between IDDSI levels 6 (P = 0.015), 5 (P = 0.033), and 4 (P = 0.015) and sarcopenia. CONCLUSIONS In patients with stroke, consumption of lower food texture levels categorized by the IDDSI framework was associated with a higher prevalence of malnutrition and sarcopenia.
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Teo PS, Lim AJ, Goh AT, R J, Choy JYM, McCrickerd K, Forde CG. Texture-based differences in eating rate influence energy intake for minimally processed and ultra-processed meals. Am J Clin Nutr 2022; 116:244-254. [PMID: 35285882 PMCID: PMC9257473 DOI: 10.1093/ajcn/nqac068] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 03/10/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Consumption of ultra-processed foods has been linked with higher energy intakes. Food texture is known to influence eating rate (ER) and energy intake to satiation, yet it remains unclear whether food texture influences energy intakes from minimally processed and ultra-processed meals. OBJECTIVES We examined the independent and combined effects of food texture and degree of processing on ad libitum food intake. We also investigated whether differences in energy intake during lunch influenced postmeal feelings of satiety and later food intake. METHODS In this crossover study, 50 healthy-weight participants [n = 50 (24 men); mean ± SD age: 24.4 ± 3.1 y; BMI: 21.3 ± 1.9 kg/m2] consumed 4 ad libitum lunch meals consisting of "soft minimally processed," "hard minimally processed," "soft ultra-processed," and "hard ultra-processed" components. Meals were matched for total energy served, with some variation in meal energy density (±0.20 kcal/g). Ad libitum food intake (kcal and g) was measured and ER derived using behavioral coding of videos. Subsequent food intake was self-reported by food diary. RESULTS There was a main effect of food texture on intake, whereby "hard minimally processed" and "hard ultra-processed" meals were consumed slower overall, produced a 21% and 26% reduction in food weight (g) and energy (kcal) consumed, respectively. Intakes were higher for "soft ultra-processed" and "soft minimally processed" meals (P < 0.001), after correcting for meal pleasantness. The effect of texture on food weight consumed was not influenced by processing levels (weight of food: texture*processing-effect, P = 0.376), but the effect of food texture on energy intake was (energy consumed: texture*processing-effect, P = 0.015). The least energy was consumed from the "hard minimally processed" meal (482.9 kcal; 95% CI: 431.9, 531.0 kcal) and the most from the "soft ultra-processed" meal (789.4 kcal; 95% CI: 725.9, 852.8 kcal; Δ=↓∼300 kcal). Energy intake was lowest when harder texture was combined with the "minimally processed" meals. Total energy intake across the day varied directly with energy intakes of the test meals (Δ15%, P < 0.001). CONCLUSIONS Findings suggest that food texture-based differences in ER and meal energy density contribute to observed differences in energy intake between minimally processed and ultra-processed meals.This trial was registered at clinicaltrials.gov as NCT04589221.
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Affiliation(s)
- Pey Sze Teo
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Amanda JiaYing Lim
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Ai Ting Goh
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Janani R
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Jie Ying Michelle Choy
- Clinical Nutrition Research Centre, Singapore Institute of Food and Biotechnology Innovation, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Keri McCrickerd
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
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Gallego M, Barat JM, Grau R, Talens P. Compositional, structural design and nutritional aspects of texture-modified foods for the elderly. Trends Food Sci Technol 2022. [DOI: 10.1016/j.tifs.2021.12.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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10
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Lower Energy-Dense Ready Meal Consumption Affects Self-Reported Appetite Ratings with No Effect on Subsequent Food Intake in Women. Nutrients 2021; 13:nu13124505. [PMID: 34960060 PMCID: PMC8708992 DOI: 10.3390/nu13124505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 11/20/2022] Open
Abstract
Slimming World (SW), a commercial weight management organisation, has designed a range of low energy-dense ready meals (LEDRMs) in line with their programme. This randomised crossover study compared commercially available equicaloric ready meals differing in energy density on satiety and food intake. It was hypothesised that the LEDRM would reduce energy intake (EI) whilst increasing fullness and reducing hunger compared to higher energy-dense ready meal (HEDRM, control). A total of 26 female participants (aged 18–65 years; body mass index of 28.8 ± 3.0 kg·m−2) attended two test days. The participants ate a standard breakfast, and four hours later, ate either a LEDRM or HEDRM at lunch. EI was measured four hours later at an ad libitum tea. Satiety measurements were recorded throughout the day using visual analogue scales and a weighed food diary was completed for the remainder of the day. The results revealed that the LEDRM reduced hunger and increased fullness (both p < 0.001). There was no difference in EI at the evening meal between the ready meals (p > 0.05), however, during the whole LEDRM testing day, the participants consumed significantly less fat (7.1%) and saturated fat (3.6%) (both p < 0.01), but significantly more carbohydrates, sugars, fibre, protein, and salt (all p < 0.01). The results indicate that the participants felt more satiated after consuming ready meals of the same energy content but larger portion size. Despite no significant difference in short-term EI between the ready meals, the results indicated that the LEDRM produced beneficial subjective satiety responses and, therefore, can help to improve the nutritional content of meals i.e., reduce saturated fat consumption.
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Zanini M, Catania G, Ripamonti S, Watson R, Romano A, Aleo G, Timmins F, Sasso L, Bagnasco A. The WeanCare nutritional intervention in institutionalized dysphagic older people and its impact on nursing workload and costs: A quasi-experimental study. J Nurs Manag 2021; 29:2620-2629. [PMID: 34342076 PMCID: PMC9292428 DOI: 10.1111/jonm.13435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 07/21/2021] [Accepted: 07/30/2021] [Indexed: 12/29/2022]
Abstract
AIM The aim of this study is to explore how a nutritional intervention that improves the biochemical and functional profile of dysphagic older people impacts on nursing workload and costs for nursing homes. BACKGROUND Dysphagic institutionalized older people particularly at risk of malnutrition require more intensive support from nursing staff and higher costs for nursing homes. METHOD This is an open pre-post longitudinal multicentre quasi-experimental study without a control group. RESULTS There is a significant reduction in the number of enemas (from 3.51 to 1.11 enemas), with an average nursing workload reduction from 52 to 16 min per patient every month. Each nurse also spent 20 h less per patient every month spoon-feeding. This resulted in nursing staff cost savings. CONCLUSIONS The nutritional intervention led to a significantly better quality of life for the patients manifested through increased independence and social engagement. This reduced workload for nursing staff and costs for nursing home administrators. IMPLICATIONS FOR NURSING MANAGEMENT Sensitive, targeted nutritional interventions have the potential to improve nursing home residents' quality of life and enable a more efficient use of resources. This study revealed reduced workload and cost savings due to less time spent administering enemas and spoon-feeding, in addition to reduced malnutritional consequences.
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Affiliation(s)
- Milko Zanini
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | - Gianluca Catania
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | | | - Roger Watson
- Faculty of Health and Social Care, University of Hull, Hull, UK
| | - Antonio Romano
- Pharmaceutical and Technical Chemistry, Head R&D Healthy Ageing Research Group, Cremona, Italy
| | - Giuseppe Aleo
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | - Fiona Timmins
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin, Ireland
| | - Loredana Sasso
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | - Annamaria Bagnasco
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
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Appleton KM, Newbury A, Almiron‐Roig E, Yeomans MR, Brunstrom JM, de Graaf K, Geurts L, Kildegaard H, Vinoy S. Sensory and physical characteristics of foods that impact food intake without affecting acceptability: Systematic review and meta-analyses. Obes Rev 2021; 22:e13234. [PMID: 33754456 PMCID: PMC8365638 DOI: 10.1111/obr.13234] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/27/2021] [Accepted: 02/18/2021] [Indexed: 12/20/2022]
Abstract
This systematic review with meta-analyses aimed to identify the sensory and physical characteristics of foods/beverages which increase satiation and/or decrease/delay subsequent consumption without affecting acceptability. Systematic searches were first undertaken to identify review articles investigating the effects of any sensory and physical food characteristic on food intake. These articles provided some evidence that various textural parameters (aeration, hardness, homogeneity, viscosity, physical form, added water) can impact food intake. Individual studies investigating these effects while also investigating acceptability were then assessed. Thirty-seven individual studies investigated a textural manipulation and provided results on food intake and acceptability, 13 studies (27 comparisons, 898 participants) investigated effects on satiation, and 29 studies (54 comparisons, 916 participants) investigated effects on subsequent intake. Meta-analyses of within-subjects comparisons (random-effects models) demonstrated greater satiation (less weight consumed) from food products that were harder, chunkier, more viscous, voluminous, and/or solid, while demonstrating no effects on acceptability. Textural parameters had limited effects on subsequent consumption. Between-subjects studies and sensitivity analyses confirmed these results. These findings provide some evidence that textural parameters can increase satiation without affecting acceptability. The development of harder, chunkier, more viscous, voluminous, and/or solid food/beverage products may be of value in reducing overconsumption.
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Affiliation(s)
| | - Annie Newbury
- Department of PsychologyBournemouth UniversityBournemouthUK
| | - Eva Almiron‐Roig
- Center for Nutrition ResearchUniversity of NavarraPamplonaSpain
- Navarra Institute for Health Research (IdiSNa)PamplonaSpain
| | | | | | - Kees de Graaf
- Division of Human Nutrition and HealthWageningen University and ResearchWageningenNetherlands
| | | | | | - Sophie Vinoy
- Nutrition DepartmentMondelez International R&DSaclayFrance
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Wu XS, Miles A, Braakhuis AJ. Texture-Modified Diets, Nutritional Status and Mealtime Satisfaction: A Systematic Review. Healthcare (Basel) 2021; 9:624. [PMID: 34073835 PMCID: PMC8225071 DOI: 10.3390/healthcare9060624] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 12/24/2022] Open
Abstract
While the association between dysphagia and malnutrition is well established, there is a lack of clarity regarding the nutritional status and mealtime satisfaction of those consuming texture-modified diets (TMDs). This systematic review summarises and critically appraises the nutritional status and mealtime satisfaction of adults consuming TMDs. A systematic database search following PICO criteria was conducted using Cochrane Central (via Ovid), MEDLINE, CINAHL, EMBASE and Scopus. Nutritional status, mealtime satisfaction and costs were identified as primary outcomes. Eligible studies were grouped according to outcome measurement. In total, 26 studies met the inclusion criteria. Twenty studies evaluated the nutritional status by weight change or using malnutrition screening tools and found the consumption of TMDs correlated with weight loss or malnutrition. Nine studies evaluated mealtime satisfaction, with two reporting poor satisfaction for people on thickened fluids (TFs). Nutrition intervention through adjusting texture and consistency and nutrition enrichment showed positive effects on weight and mealtime satisfaction. The majority of the studies were rated as 'neutral' quality due to the limited number of experiments. TMD consumers had compromised nutritional status and poor mealtime satisfaction. More research input is required to identify promising strategies for improving the nutritional status and mealtime satisfaction of this population. Food services need to consider texture, consistency and fortification in designing menus for people on TMDs to avoid weight loss and malnutrition, and to enhance mealtime enjoyment.
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Affiliation(s)
- Xiaojing Sharon Wu
- Faculty of Medical and Health Sciences, Discipline of Nutrition, The University of Auckland, Auckland 1010, New Zealand;
| | - Anna Miles
- Faculty of Science, School of Psychology, Speech Science, The University of Auckland, Auckland 1010, New Zealand;
| | - Andrea J. Braakhuis
- Faculty of Medical and Health Sciences, Discipline of Nutrition, The University of Auckland, Auckland 1010, New Zealand;
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Food texture influences on satiety: systematic review and meta-analysis. Sci Rep 2020; 10:12929. [PMID: 32737349 PMCID: PMC7395742 DOI: 10.1038/s41598-020-69504-y] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 07/14/2020] [Indexed: 12/29/2022] Open
Abstract
Obesity is one of the leading causes of preventable deaths. Development of satiety-enhancing foods is considered as a promising strategy to reduce food intake and promote weight management. Food texture may influence satiety through differences in appetite sensations, gastrointestinal peptide release and food intake, but the degree to which it does remains unclear. Herein, we report the first systematic review and meta-analyses on effects of food texture (form, viscosity, structural complexity) on satiety. Both solid and higher viscous food reduce hunger by − 4.97 mm (95% confidence interval (CI) − 8.13, − 1.80) and − 2.10 mm (95% CI − 4.38, 1.18), respectively compared to liquid and low viscous food. An effect of viscosity on fullness (95% CI 5.20 (2.43, 7.97) and a moderate effect of the form of food (95% CI − 26.19 (− 61.72, − 9.35) on food intake were noted. Due to the large variation among studies, the results should be interpreted cautiously and modestly.
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Dietary energy density and appetite: A systematic review and meta-analysis of clinical trials. Nutrition 2019; 69:110551. [PMID: 31525704 DOI: 10.1016/j.nut.2019.110551] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 05/03/2019] [Accepted: 05/28/2019] [Indexed: 12/15/2022]
Abstract
Studies have suggested that dietary energy density (DED) may affect weight gain by altering appetite. Although many studies have investigated the effect of DED on appetite, findings are inconsistent and, to our knowledge, there are no systematic reviews and meta-analyses on this topic. Therefore, the aim of this systematic review and meta-analysis was to summarize the effect of DED on appetite. The current meta-analysis revealed changing the DED had no significant effect on hunger but increased fullness. More high-quality randomized controlled trials are needed to investigate the effects of DED on appetite components. We searched titles, abstracts, and keywords of articles indexed in ScienceDirect, MEDLINE, and Google Scholar databases up to July 2018 to identify eligible RCT studies. Random effects model was used to estimate the pooled effect of DED on appetite. Among the 21 studies identified in the systematic literature search, 11 reports were included in the meta-analysis. Based on the Cochrane Collaboration Risk of Bias tool, 6 studies were considered as good quality, two were fair, and three studies were poor. The mean ± standard deviation for energy density, in studies which assessed fullness, was 1.65 ± 1 in high energy dense (HED) diet and 0.93 ± 0.93 in low energy dense (LED) diet. The corresponding values for hunger were 1.67 ± 0.69 and 0.70 ± 0.32, respectively. Compared with a LED diet, consumption of HED increased fullness (weighed mean difference [WMD] 2.95 mm; 95% CI 0.07-5.82, P = 0.044, I2 98.1%) but had no significant effect on hunger (WMD 1.31 mm; 95% CI -7.20 to 9.82, P = 0.763, I2 99.1%). The current meta-analysis revealed changing the DED had no significant effect on hunger but increased fullness. More high-quality RCTs are needed to investigate the effects of DED on appetite components.
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Pizzorni N, Valentini D, Gilardone M, Scarponi L, Tresoldi M, Barozzi S, Corbo M, Schindler A. The Mealtime Assessment Scale (MAS): Part 2 - Preliminary Psychometric Analysis. Folia Phoniatr Logop 2019; 72:182-193. [PMID: 30995652 DOI: 10.1159/000494136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 09/26/2018] [Indexed: 11/19/2022] Open
Abstract
AIMS The Mealtime Assessment Scale (MAS) was developed to assess swallowing safety and efficacy during the meal. The study aims to perform a preliminary validation of MAS by investigating internal consistency, inter-rater agreement, concurrent and known-group validity, and responsiveness. METHODS MAS was tested on 100 persons without dysphagia (group 1) and 100 persons with dysphagia (group 2). Fifty subjects were simultaneously evaluated at mealtime using MAS by two independent clinicians to test inter-rater agreement. For concurrent validity, MAS was correlated with the Mann Assessment of Swallowing Ability (MASA) and American Speech-Language-Hearing Association National Outcomes Measurement System (ASHA NOMS) swallowing scale. MAS scores of groups 1 and 2 were compared for known-group validity. Responsiveness was tested reassessing 36 patients from group 2 after diet improvement. RESULTS Internal consistency and responsiveness were established for efficacy but not for safety. For inter-rater agreement, an average deviation index <0.66 was found for all items. MAS showed strong correlations with MASA and ASHA NOMS. MAS scores were significantly different between groups 1 and 2. CONCLUSION Preliminary evidence of the validity and reliability of MAS was established, except for the internal consistency and the responsiveness of the safety subscale. Further studies need to complete the validation process.
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Affiliation(s)
- Nicole Pizzorni
- Department of Biomedical and Clinical Sciences "L. Sacco," Università degli Studi di Milano, Milan, Italy, .,Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milan, Italy,
| | - Debora Valentini
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milan, Italy
| | - Marco Gilardone
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milan, Italy
| | - Letizia Scarponi
- Department of Biomedical and Clinical Sciences "L. Sacco," Università degli Studi di Milano, Milan, Italy
| | - Martina Tresoldi
- Department of Biomedical and Clinical Sciences "L. Sacco," Università degli Studi di Milano, Milan, Italy
| | - Stefania Barozzi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milan, Italy
| | - Antonio Schindler
- Department of Biomedical and Clinical Sciences "L. Sacco," Università degli Studi di Milano, Milan, Italy
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Maeda K, Ishida Y, Nonogaki T, Shimizu A, Yamanaka Y, Matsuyama R, Kato R, Mori N. Burden of Premorbid Consumption of Texture Modified Diets in Daily Life on Nutritional Status and Outcomes of Hospitalization. J Nutr Health Aging 2019; 23:973-978. [PMID: 31781727 DOI: 10.1007/s12603-019-1237-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Due to the water-rich cooking process required to soften texture modified diets (TMDs), TMDs may have poorer nutrition. The aim of this study was to investigate the associations between daily premorbid TMD consumption and nutritional status at the time of hospitalization, and its burden on hospitalization outcomes. DESIGN Retrospective observational study. SETTING An academic hospital. PARTICIPANTS The cohort comprised 3,594 older adult patients aged ≥65 years admitted to the hospital. MEASUREMENTS Patients were interviewed on admission using a premorbid daily consumption meal form to determine whether the patient ate a TMD. Nutritional status was examined using nutritional screening tools (Mini-Nutritional Assessment Short Form [MNA-SF], Malnutrition Universal Screening Tool [MUST], Geriatric Nutritional Risk Index [GNRI]) and the European Society of Clinical Nutrition and Metabolism (ESPEN)-defined criteria of malnutrition at admission. Length of hospital stay (LOS) and in-hospital mortality were considered outcomes of hospitalization. Multivariate analyses were performed to detect associations between premorbid TMD consumption and nutritional status and outcomes. RESULTS The mean age of the subjects was 75.9±7.0 years, including 58% males. Overall, 110 (3.1%) patients consuming a premorbid TMD were identified. They were older (p<0.001), had poor nutritional status (lower MNA-SF score [p<0.001] and GNRI value [p<0.001], higher MUST score [p<0.001], and more prevalent ESPEN-defined malnutrition [61.8% vs. 14.0%, p<0.001] than did patients without a TMD. The mortality rate and LOS of patients with TMD was higher (7.3% vs. 2.9%, p=0.017) and longer (19 days vs. 8 days, p<0.001) than those without TMD. Multivariate analyses showed that TMD consumption was independently associated with poor nutritional status and prolonged LOS after adjusting confounders. CONCLUSION Daily consumption of a TMD during the premorbid period affects nutritional status at the time of hospitalization and outcomes. Further studies are necessary to investigate whether nutritional intervention can improve outcomes for people on a TMD.
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Affiliation(s)
- K Maeda
- Keisuke Maeda, M.D., Ph.D., Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan, Phone: +81-561-62-3311; Fax: +81-561-78-6364, E-mail:
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Beavan S, Baker R, Sadler H, Collinson A. Improving the nutritional intake of hospital patients: how far have we come? A re-audit. J Hum Nutr Diet 2018; 32:372-384. [PMID: 30334301 DOI: 10.1111/jhn.12607] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Malnutrition affects up to 33.6% of hospitalised patients, with consequences that are detrimental for both patients and healthcare providers. In 2015, an audit demonstrated inadequate nutritional provision and consumption by hospitalised patients, comprising a major risk factor for malnutrition. This re-audit evaluates whether patients are meeting recommended energy and protein standards and estimated individual requirements, subsequent to food service improvements since 2015. METHODS Patients (n = 111) were included from a South West hospital, and Malnutrition Universal Screening Tool scores (MUST) categorised patients as 'nutritionally well' (MUST 0) or 'nutritionally vulnerable' (MUST ≥ 1). Individual energy and protein requirements were estimated using weight-based equations. Nutritional intakes were assessed via 24-h dietary recall and compared against the British Dietetic Association's Nutrition and Hydration Digest standards, as well as estimated individual requirements. RESULTS In total, the Digest standards for energy and protein were met by 35% and 63% of patients respectively, which is an increase of 19% and 36% since 2015. 'Nutritionally well' patients were more likely to meet nutrient standards for protein (62%) than estimated individual requirements (30%) (P ≤ 0.001). 'Nutritionally vulnerable' patients were more likely to meet estimated individual requirements for energy (60%) than the Digest standards (30%) (P = 0.047). CONCLUSIONS The proportion of patients meeting the Digest standards has increased considerably following numerous food service changes. Nutritional training for housekeepers, energy/protein-dense snacks and drinks, and fortified dietary items may further increase nutritional intakes. Additionally, as a result of discrepancies between the Digest standards and individual estimated requirements, more research is required to identify the most appropriate auditing standards that reflect best practice.
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Affiliation(s)
- S Beavan
- Department of Nutrition and Dietetics, Cambridge University Hospital, Cambridge, UK
| | - R Baker
- Department of Nutrition and Dietetics, East Sussex Healthcare NHS Trust, Conquest Hospital, St Leonards-on-Sea, UK
| | - H Sadler
- Department of Nutrition and Dietetics, Derriford Hospital, Plymouth, UK
| | - A Collinson
- School of Health Professions, University of Plymouth, PAHC, Plymouth, UK
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The effect of preload/meal energy density on energy intake in a subsequent meal: A systematic review and meta-analysis. Eat Behav 2017; 26:6-15. [PMID: 28131006 DOI: 10.1016/j.eatbeh.2016.12.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 12/20/2016] [Accepted: 12/30/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To conduct a systematic review and meta-analysis of the effects of preload/meal energy density on energy intake in a subsequent meal(s). METHODS Multiple databases were searched for studies published through December 2016 on the effects of preload/meal energy density on energy intake in a subsequent meal(s). We extracted information on mean energy intake in a subsequent meal(s) and on variables that could contribute to between-subject heterogeneity. RESULTS Forty and Thirty nine eligible studies were identified for our systematic review and meta-analysis, respectively. The meta-analysis showed that preload/meal energy density did not affect energy intake in a subsequent meal(s) (95% CI:-21.21, 21.29). As heterogeneity was remarkable among studies, we stratified the studies by intervention type into "meal" or "preload" classifications. In the "preload" subgroup, studies used either fixed energy or fixed weight preloads. The results reveal that in comparison to a high energy-dense (HED) preload, consuming a low energy-dense (LED) preload with same weight resulted in higher energy intake in a subsequent meal (95% CI: 9.72, 56.19). On the other hand, decreased energy intake was observed after consuming an LED preload compared to after consumption of an HED preload with same energy content (95% CI: -138.71, -57.33). In the "meal" subgroup, studies were categorized by different subsequent meal (i.e., "afternoon or evening", "lunch" and "dinner or post-dinner"). Meta-analysis showed that an LED meal resulted in more energy intake only in afternoon or evening meals (95% CI: 14.82, 31.22). CONCLUSION In summary, the current analysis revealed that we can restrict the energy intake by consuming an LED preload. Moreover, consuming an LED preload could favorably affect preload+meal energy intake.
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Campbell CL, Wagoner TB, Foegeding EA. Designing foods for satiety: The roles of food structure and oral processing in satiation and satiety. FOOD STRUCTURE-NETHERLANDS 2017. [DOI: 10.1016/j.foostr.2016.08.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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McCrickerd K, Lim CM, Leong C, Chia EM, Forde CG. Texture-Based Differences in Eating Rate Reduce the Impact of Increased Energy Density and Large Portions on Meal Size in Adults. J Nutr 2017; 147:1208-1217. [PMID: 28446630 DOI: 10.3945/jn.116.244251] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 12/22/2016] [Accepted: 03/27/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Large portions and high dietary energy density promote overconsumption at meal times. This could be reduced by eating slowly.Objective: Two studies investigated whether texture-based reductions in eating rate and oral processing moderate consumption at breakfast in combination with variations in energy density and portion size.Methods: Adults attended 4 breakfast sessions (2 × 2 repeated-measures design) to consume rice porridge, combining a 45% reduction in eating rate [thin porridge (140 g/min) compared with thick porridge (77 g/min)] with a 77% increase in energy density (0.57 compared with 1.01 kcal/g) in study 1 [n = 61; aged 21-48 y; body mass index (BMI; in kg/m2): 16-29] and a 50% increase in portion size (100% compared with 150%) in study 2 (n = 53; aged 21-42 y; BMI: 16-29). Oral processing behaviors were coded by using webcams. Porridge intake was measured alongside changes in rated appetite.Results: Increases in energy density and portion size led to increases of 80% and 13% in energy intake at breakfast, respectively (P < 0.001), but only portion size increased the weight of food consumed (13%). The thicker porridges were consumed at a slower rate and led to 11-13% reductions in food weight and energy intake compared with the thin versions (P < 0.001). Combined, the least energy was consumed when the thick "slow" porridge was served with a lower energy density or smaller portion (P < 0.05). Although intake was reduced for the thick porridges, they were expected to be more filling than the thin versions and experienced as equally satiating postconsumption.Conclusions: Adults eat in response to external features of the food environment. An opportunity exists to use a combination of energy-density dilution, smaller portions, and natural variations in food texture to design meals that promote reductions in energy intake while maintaining satiety.
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Affiliation(s)
- Keri McCrickerd
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, and National University Health System, Singapore, Singapore
| | - Charlotte Mh Lim
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, and National University Health System, Singapore, Singapore
| | - Claudia Leong
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, and National University Health System, Singapore, Singapore
| | - Edwin M Chia
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, and National University Health System, Singapore, Singapore
| | - Ciaran G Forde
- Clinical Nutrition Research Centre, Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research, and National University Health System, Singapore, Singapore
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Zanini M, Bagnasco A, Catania G, Aleo G, Sartini M, Cristina ML, Ripamonti S, Monacelli F, Odetti P, Sasso L. A Dedicated Nutritional Care Program (NUTRICARE) to reduce malnutrition in institutionalised dysphagic older people: A quasi-experimental study. J Clin Nurs 2017; 26:4446-4455. [PMID: 28231616 DOI: 10.1111/jocn.13774] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2017] [Indexed: 10/20/2022]
Abstract
AIMS AND OBJECTIVES To assess the effects of a texture-modified food program for dysphagia on the nutritional, biochemical and functional profile in a cohort of institutionalised older people in Italy. BACKGROUND Dysphagic institutionalised older people, often also affected by dementia, are frequently exposed to malnutrition. Malnutrition in older people has negative effects on mortality, days of hospitalisation, infection, wound healing and risk of pressure injuries. Therefore, it is very important to prevent malnutrition in this frail population. DESIGN A pre-post study without a control group. METHODS The study included 479 dysphagic institutionalised older people from 20 nursing homes. Anthropometrical, biochemical, nutritional and functional parameters were collected retrospectively, 6 months before the study intervention, at time zero and, prospectively for 6 months after implementing the NUTRICARE food programme, for a total of nine evaluations. The NUTRICARE programme includes meals without nutritional supplementation, and personalised levels of density, viscosity, texture and particle size. RESULTS The total mean body mass index of our sample passed from 17.88-19.00; body weight averagely improved by 7.19%, as well as their nutritional and biochemical profiles. There was a progressive improvement of total protein and serum albumin values. Nutritional parameters (serum transferrin and lymphocytes) displayed similar changes. Plasma lymphocytes reached normal levels in 98.23% of the sample. Plasma creatinine levels remained steady throughout the study and within the normal range. No side effects were reported. CONCLUSION The NUTRICARE food programme with a adequate proteins, calories, balanced nutritional and bromatological properties, and appropriate texture and palatability significantly improved the nutritional, biochemical and functional profile in a cohort of institutionalised dysphagic older people. RELEVANCE TO CLINICAL PRACTICE The introduction of a balanced nutritional programme, using high-quality natural ingredients, appropriate texture and palatability can significantly improve health and quality of life in dysphagic older people.
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Affiliation(s)
- Milko Zanini
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | - Gianluca Catania
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Giuseppe Aleo
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Marina Sartini
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | | | | | - Fiammetta Monacelli
- Department of Internal Medicine & Medical Specialties, University of Genoa, Genoa, Italy
| | - Patrizio Odetti
- Department of Internal Medicine & Medical Specialties, University of Genoa, Genoa, Italy
| | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
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Larsen DS, Tang J, Ferguson LR, James BJ. Increased textural complexity in food enhances satiation. Appetite 2016; 105:189-94. [DOI: 10.1016/j.appet.2016.05.029] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 04/18/2016] [Accepted: 05/23/2016] [Indexed: 11/29/2022]
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Mikuš RP, Vičič V, Dahmane R. The Assessment Of Energy And Protein Needs Coverage In Hospitalized Patients: OCENA POKRITOSTI POTREB PO ENERGIJI IN BELJAKOVINAH MED HOSPITALIZIRANIMI BOLNIKI. Zdr Varst 2016; 55:126-33. [PMID: 27284383 PMCID: PMC4845774 DOI: 10.1515/sjph-2016-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 12/16/2015] [Indexed: 11/25/2022] Open
Abstract
Aim Aiming at assessing sufficiency of energy/protein intake in hospitalized patients, the objective was to monitor and analyze actual food intake of patients hospitalized in three clinical wards of one of major Slovenian hospitals. Methods 53 patients were included in the study. Food intake was assessed 3 times daily from leftovers. Nutritional status was assessed with Nutritional Risk Screening tool 2002. The observed outcomes were percentage of energy coverage (PEC) and percentage of protein coverage (PPC). In PEC energy nutritional value of the menu (ENVM), and in PPC protein nutritional value of the menu (PNVM) were considered as the main modifiable risk factors. Data were analyzed univariately and multivariately by using logistic regression method. Results The patients did not cover energy needs (67.4±24.5%). Multivariate model for PEC was highly significant (R2=0.347; pmodel<0.001) with ENVM showing high strength of association (b=0.040; p=0.004). Patients also did not cover protein needs (84.0±40.2%). Multivariate model for PEC was highly significant (R2=0.477; pmodel<0.001) and PNVM showing high strength of association (b=0.937; p=0.002). Conclusion For successful prevention and early detection of malnutrition, food intake in hospitals is vital and should be constantly monitored. A simple method for monitoring is proposed. The menus provided to patients should also be adequate in terms of energy and protein content.
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Affiliation(s)
- Ruža Pandel Mikuš
- University of Ljubljana, Faculty of Health Sciences, Nursing Department, Zdravstvena pot 5, 1000 Ljubljana, Slovenia
| | - Vid Vičič
- University of Ljubljana, Faculty of Health Sciences, Nursing Department, Zdravstvena pot 5, 1000 Ljubljana, Slovenia
| | - Raja Dahmane
- University of Ljubljana, Faculty of Health Sciences, Nursing Department, Zdravstvena pot 5, 1000 Ljubljana, Slovenia
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Are Post-Exercise Appetite Sensations and Energy Intake Coupled in Children and Adolescents? Sports Med 2014; 44:735-41. [DOI: 10.1007/s40279-014-0160-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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