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Blanquet M, Guiguet-Auclair C, Berland P, Ducher G, Sauvage A, Dadet S, Guiyedi V, Farigon N, Bohatier J, Gerbaud L, Boirie Y. Are Energy and Protein Intakes Lower Than Requirements in Older Adults? An Urgent Issue in Hospitals and Nursing Homes. Nutrients 2023; 15:3307. [PMID: 37571245 PMCID: PMC10421298 DOI: 10.3390/nu15153307] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/23/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
Energy and protein intakes lower than requirements are associated with worsening health outcomes. Here we set out to evaluate gaps between energy and protein intakes and requirements in older adults in hospitals and in nursing homes (NH). A cross-sectional study included 360 inpatients and residents aged 75 years and older in two acute care wards; i.e., a multidisciplinary care unit (MCU) and a geriatric care unit (GCU), a geriatric rehabilitation unit (GRU), and two NH. Intakes were measured for three days. Requirements were based on French National Health Authority recommendations. Energy and protein intakes were under the minimum requirement of 30 kcal/kg/day and 1.2 g/kg/day in 89.5% and 100% of MCU patients, respectively, 75.5% and 64.2% of GCU patients, 92.7% and 90.9% of GRU patients, and 83.8% and 83.8 of NH residents. Intake-to-requirement gaps were not significantly associated with malnutrition, except in the GCU group where non-malnourished patients had higher energy gaps than malnourished patients. Intakes fell dramatically short of requirements in older adults in both hospital and NH settings irrespective of malnutrition status. A new paradigm based on a patient-centered approach should be developed to adapt meals served in hospital and in NH.
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Affiliation(s)
- Marie Blanquet
- Unité de Recherche Clinique, CH Mauriac, 15200 Mauriac, France;
- CNRS, Institut Pascal, Université Clermont Auvergne, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (C.G.-A.); (P.B.); (L.G.)
- Service de Santé Publique, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Candy Guiguet-Auclair
- CNRS, Institut Pascal, Université Clermont Auvergne, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (C.G.-A.); (P.B.); (L.G.)
- Service de Santé Publique, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Pauline Berland
- CNRS, Institut Pascal, Université Clermont Auvergne, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (C.G.-A.); (P.B.); (L.G.)
- Service de Santé Publique, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | | | - Anaïs Sauvage
- Recherche et Développement, Nutriset, 76770 Malaunay, France;
| | | | - Vincent Guiyedi
- Unité de Recherche Clinique, CH Mauriac, 15200 Mauriac, France;
| | - Nicolas Farigon
- Nutrition Clinique, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (N.F.); (Y.B.)
| | | | - Laurent Gerbaud
- CNRS, Institut Pascal, Université Clermont Auvergne, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (C.G.-A.); (P.B.); (L.G.)
- Service de Santé Publique, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Yves Boirie
- Nutrition Clinique, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (N.F.); (Y.B.)
- Unité de Nutrition Humaine, Université Clermont Auvergne, INRA, UMR 1019, 63000 Clermont-Ferrand, France
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Msengezi NC. Experiences of mealtime assistance delivered by volunteers: an extended literature review. Nurs Older People 2023; 35:30-36. [PMID: 36628551 DOI: 10.7748/nop.2023.e1425] [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] [Accepted: 10/10/2022] [Indexed: 01/12/2023]
Abstract
Trained mealtime volunteers are ideally situated to provide mealtime assistance to older patients in general hospital settings. Older patients are at risk of becoming undernourished and dehydrated while in hospital as a result of various factors, such as cognitive impairment and lack of mealtime assistance. This article details an extended literature review that was conducted to explore the lived experiences of older patients, staff, relatives and volunteers of mealtime assistance provided by volunteers. The findings suggest that continual use of mealtime volunteers in practice could improve the quality of care. Mealtime volunteers could be educated on the importance of communicating information pertaining to patients' food and fluid intake to enhance patient monitoring. Furthermore, additional training for mealtime volunteers could be streamlined and standardised to improve patient care and safety.
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Penzavecchia C, Todisco P, Muzzioli L, Poli A, Marangoni F, Poggiogalle E, Giusti AM, Lenzi A, Pinto A, Donini LM. The influence of front-of-pack nutritional labels on eating and purchasing behaviors: a narrative review of the literature. Eat Weight Disord 2022; 27:3037-3051. [PMID: 36369593 PMCID: PMC9803757 DOI: 10.1007/s40519-022-01507-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 10/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Front-of-Pack Nutritional Labels are considered a useful tool to help consumers orient themselves in their food choices and direct their behavior toward a healthier diet. FOPNL development and use are part of a framework that includes cognitive, biological, hedonic and cultural aspects, able to affect consumers' eating and purchasing behavior. AIM Given the complexity of the matter, the aim of this narrative review is to analyze the combination of different factors that drive food choices and eating behaviors and to highlight some aspects that are not fully studied. METHODS The authors conducted the research using a top-down approach at first, followed by a bottom-up approach; starting with general considerations about the purchasing process, gradually narrowing the discussion to a specific sub-population, and finally extending the discussion back to more general reasonings about the direction to adopt in future, or at least to evaluate, for effective communication. RESULTS Biases and attitudes toward food products were found to regularly interfere with buying behavior patterns, making it impossible to standardize an average consumer. This reflects in current research, increasing the complexity of the topic. All determinants influencing food choices are often assessed individually rather than in a synergistic and multidimensional context, while the purchasing scenario is characterized by multiple stimuli to which the consumer is subjected. FOPNLs' impact on perceived healthiness has been studied in different conditions, but some population subgroups have not been sufficiently represented. In particular, the effect of FOPNLs on consumers suffering from eating disorders is understudied and needs further attention. Furthermore, some approaches can be compared to "negative nutrition" or "loss-framed communication", putting nutrients out of context, emphasizing losses more than gains and risking promoting negative feelings in consumers. CONCLUSION Due to the heterogeneity of studies, evidence on what works best in driving people to adopt lasting lifestyle changes is still mixed. Science communicators and policymakers should consider the possibility that a multi-component approach incorporating nutrition information and education may be a key strategy to promote consumers' self-consciousness and to support them in their cognitive efforts toward a healthy and sustainable diet. LEVEL OF EVIDENCE Level V, narrative review.
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Affiliation(s)
- Claudia Penzavecchia
- Medical Pathophysiology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, Experimental Medicine Department, Sapienza University, Ple. Aldo Moro, 5, 00185, Rome, Italy
| | - Patrizia Todisco
- Eating Disorders Unit, Casa di Cura "Villa Margherita", Arcugnano, Vicenza, Italy
| | - Luca Muzzioli
- Medical Pathophysiology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, Experimental Medicine Department, Sapienza University, Ple. Aldo Moro, 5, 00185, Rome, Italy
| | - Andrea Poli
- NFI-Nutrition Foundation of Italy, Milan, Italy
| | | | - Eleonora Poggiogalle
- Medical Pathophysiology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, Experimental Medicine Department, Sapienza University, Ple. Aldo Moro, 5, 00185, Rome, Italy
| | - Anna Maria Giusti
- Medical Pathophysiology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, Experimental Medicine Department, Sapienza University, Ple. Aldo Moro, 5, 00185, Rome, Italy
| | - Andrea Lenzi
- Medical Pathophysiology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, Experimental Medicine Department, Sapienza University, Ple. Aldo Moro, 5, 00185, Rome, Italy
| | - Alessandro Pinto
- Medical Pathophysiology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, Experimental Medicine Department, Sapienza University, Ple. Aldo Moro, 5, 00185, Rome, Italy
| | - Lorenzo Maria Donini
- Medical Pathophysiology, Food Science and Endocrinology Section, Food Science and Human Nutrition Research Unit, Experimental Medicine Department, Sapienza University, Ple. Aldo Moro, 5, 00185, Rome, Italy.
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Hospitality through negotiations: The performing of everyday meal activities among nursing staff and meal hosts. A qualitative study. Int J Gastron Food Sci 2022. [DOI: 10.1016/j.ijgfs.2022.100478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Sørensen D, Wieghorst AR, Elbek JA, Mousing CA. Mealtime challenges in patients with chronic obstructive pulmonary disease: Who is responsible? J Clin Nurs 2020; 29:4583-4593. [DOI: 10.1111/jocn.15491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 08/20/2020] [Accepted: 08/28/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Dorthe Sørensen
- Research Centre for Health and Welfare Technology Programme for rehabilitation, VIA University College Aarhus Denmark
| | - Anna Rottensten Wieghorst
- Research Centre for Health and Welfare Technology Programme for rehabilitation, VIA University College Aarhus Denmark
| | - Johanne Andersen Elbek
- Research Centre for Health and Welfare Technology Programme for rehabilitation, VIA University College Aarhus Denmark
| | - Camilla Askov Mousing
- Research Centre for Health and Welfare Technology Programme for rehabilitation, VIA University College Aarhus Denmark
- Center for Research in Clinical Nursing Viborg Denmark
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Howson FFA, Robinson SM, Lin SX, Orlando R, Cooper C, Sayer AAP, Roberts HC. Can trained volunteers improve the mealtime care of older hospital patients? An implementation study in one English hospital. BMJ Open 2018; 8:e022285. [PMID: 30082361 PMCID: PMC6078263 DOI: 10.1136/bmjopen-2018-022285] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Multinational studies report undernutrition among 39% older inpatients; importantly, malnutrition risk may further increase while in hospital. Contributory factors include insufficient mealtime assistance from time-pressured hospital staff. A pilot study showed trained volunteers could safely improve mealtime care. This study evaluates the wider implementation of a mealtime assistance programme. DESIGN Mixed methods prospective quasi-experimental study. SETTING Nine wards across Medicine for Older People (MOP), Acute Medical Unit, Orthopaedics and Adult Medicine departments in one English hospital. PARTICIPANTS Patients, volunteers, ward staff. INTERVENTION Volunteers trained to help patients aged ≥70 years at weekday lunchtime and evening meals. MAIN OUTCOME MEASURES The number of volunteers recruited, trained and their activity was recorded. Barriers and enablers to the intervention were explored through interviews and focus groups with patients, ward staff and volunteers. The total cost of the programme was evaluated. RESULTS 65 volunteers (52 female) helped at 846 meals (median eight/volunteer, range 2-109). The mix of ages (17-77 years) and employment status enabled lunch and evening mealtimes to be covered. Feeding patients was the most common activity volunteers performed, comprising 56% of volunteer interactions on MOP and 34%-35% in other departments. Patients and nurses universally valued the volunteers, who were skilled at encouraging reluctant eaters. Training was seen as essential by volunteers, patients and staff. The volunteers released potential costs of clinical time equivalent to a saving of £27.04/patient/day of healthcare assistant time or £45.04 of newly qualified nurse time above their training costs during the study. CONCLUSIONS Patients in all departments had a high level of need for mealtime assistance. Trained volunteers were highly valued by patients and staff. The programme was cost-saving releasing valuable nursing time. TRIAL REGISTRATION NUMBER NCT02229019; Pre-results.
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Affiliation(s)
- Fiona F A Howson
- Medicine for Older People, University Hospital Southampton NHS FT, Southampton General Hospital, Southampton, UK
| | - Sian M Robinson
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Sharon X Lin
- NIHR CLAHRC Wessex, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Rosanna Orlando
- NIHR CLAHRC Wessex, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Avan A P Sayer
- NIHR Newcastle Biomedical Research Centre, Newcastle University Newcastle upon Tyne, UK
- Academic Geriatric Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Helen C Roberts
- Medicine for Older People, University Hospital Southampton NHS FT, Southampton General Hospital, Southampton, UK
- NIHR CLAHRC Wessex, University of Southampton, Southampton General Hospital, Southampton, UK
- Academic Geriatric Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
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Ojo O. Meeting the nutritional needs of older patients in the hospital setting. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2018; 27:426-428. [PMID: 29683744 DOI: 10.12968/bjon.2018.27.8.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Omorogieva Ojo
- Senior Lecturer in Primary Care, Faculty of Education and Health, University of Greenwich, Avery Hill Campus, London
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