Evaluation of iron, zinc, copper, manganese and selenium in oral hospital diets

Nutritional Intake and Meal Composition of Patients Consuming Texture Modified Diets and Thickened Fluids: A Systematic Review and Meta-Analysis

Texture-modified diets (TMDs) play an important role in ensuring safety for those with dysphagia but come with risks to nutrition and quality of life. The use of TMDs has been addressed with the increasing prevalence of dysphagia in previous decades. However, there is limited literature that investigates the nutrition perspectives of TMD consumers. This review summarises the nutrition outcomes of adults consuming TMDs and thickened fluids (TFs) and identifies the limitations of TMD and TF productions. A systematic database search following PICO criteria was conducted using Cochrane Central (via Ovid), MEDLINE, CINAHL, EMBASE, and Scopus databases. Nutrition intake, meal consumption, adequacy, and meal composition were identified as relevant outcomes. 35 studies were included for analysis. Consumption of TMDs demonstrated a poorer intake compared to regular diets, in particular significant in energy and calcium. Meta-analysis of mean differences showed favourable effects of shaped TMDs on both energy (-273.8 kJ/d; 95%CI: -419.1 to -128.6, p = 0.0002) and protein (-12.4 g/d; 95%CI: -17.9 to -6.8, p < 0.0001) intake compared to traditional cook-fresh TMDs. Nutrition intake was compromised in TMD consumers. Optimisation of nutrition intake was achievable through enrichment and adjusting meal texture and consistency. However, the heterogeneity of studies and the missing verification of the consistencies lead to difficulty in drawing conclusions regarding particular texture or intervention.

Oral intake evaluation in patients following critical illness: an ICU cohort study

Timely and adequate nutrition improves health outcomes for the critically ill patient. Despite clinical guidelines recommending early oral nutrition, survivors of critical illness experience significant nutritional deficits. This cohort study evaluates the oral nutrition intake in intensive care unit (ICU) patients who have experienced recent critical illness. The oral nutrition intake of a convenience sample of ICU patients post-critical illness was observed during a 1-month period. Data pertaining to both the amount of oral nutrition intake and factors impacting optimal oral nutrition intake were collected and analysed. Inadequate oral intake was identified in 62% of the 79 patients assessed (n = 49). This was noted early in the ICU stay, around day 1-2, for most of the patients. A significant proportion (25%) of patients remained in the hospital with poor oral intake that persisted beyond ICU day 5. Unsurprisingly, these were the patients who had longer ICU stays. Critical illness weakness was a factor in the assessment of poor oral intake. To conclude, patients who have experienced critical illness also experience suboptimal oral nutrition. The three key factors that were identified as impacting optimal oral nutrition were early removal of nasogastric tubes, critical illness weakness and poor appetite post-critical illness. Seven key recommendations are made based on this cohort study. These recommendations are related to patient assessment, monitoring, documentation and future guidelines. Future research opportunities are highlighted, including the investigation of strategies to improve the transition of patients' post-critical illness to oral nutrition.

Analysis of micromineral contents of school meals

BACKGROUND/OBJECTIVES

Korean ordinary diets are referred to be good for human health in worldwide. However it is uncertain whether they provide microminerals enough for growth and health of teenagers. A main purpose of this study was to identify micromineral contents in school meals.

MATERIALS/METHODS

The fifty cuisines were collected from elementary schools and middle schools in Gyeongnam area. The contents of Fe, Zn, Cu and Mn among microminerals were analyzed by using ICP-OES method. Data were expressed as mean, standard deviation and range value and linear regression analysis performed.

RESULTS

Fe level of Pangibuseotpaprika-salad was the highest among side-dishes (average 346.6 µg) and Zn level of Sullung-tang was highest among soups (average 229.1 µg). Cu level of Buchu-kimchi was the highest among kimchies (average 217.5 µg) and Mn level of Gumeunkongyangnyum-gui was highest among side-dishes (average 198.4 µg). Generally cooked-rices as main dish had relative smaller amounts of microminerals than the other cuisines. The results showed that the ratio of Cu : Fe : Zn was approximately 12 : 4 : 1 and the relationship between Fe versus Zn or Fe versus Cu was significantly positive.

CONCLUSION

Comparing to Korean Dietary Recommended Intakes (KDRI) level, school meals provided not sufficient amount (<25% DRI) of Fe, Zn or Mn, while they did excessive amount (>125% DRI) of Cu.