Protein for Community-Dwelling Older People: Aspects That Influence the Perception of Commercially Available Protein Drinks

Promoting Protein Intake in an Ageing Population: Product Design Implications for Protein Fortification

Protein is a macronutrient of interest for an ageing population and intake requirements increase with age. Accordingly, protein is often fortified into products for older adults to help alleviate malnutrition and impede sarcopenia. However, more emphasis needs to be placed upon designing protein-fortified products to ensure suitability for older adults. This study involved a two-stage approach: (1) an initial review of products commonly fortified with protein and (2) two questionnaires for younger and older adults (n = 73; 18-30; 65+) to investigate optimal portion sizes (drinks and cakes) as well as attitudes, consumption habits and preferences towards protein fortification. The initial literature and market review demonstrated protein-fortified products are typically in liquid or snack format; however, there is considerable variability in terms of product types, serving size and protein sources. There were no age-related differences found for ideal cakes portion size whereas there were for liquids. Older adults are typically not consuming protein-fortified products; therefore, more importance should be placed on the consumption moment (breakfast or as snacks between meals) and on cereals, pasta, porridge, cakes, and biscuits. Older adults need increased awareness of, and more education on, the benefits of protein consumption, coupled with products tailored and designed to encourage intake.

Effects of an individualised nutritional intervention to tackle malnutrition in nursing homes: a pre-post study

PURPOSE

Individualised interventions are recommended to tackle malnutrition in older adults, but approaches for nursing home (NH) residents are scarce. This study investigated the effects of an individualised nutritional intervention in NH residents with (risk of) malnutrition.

METHODS

In a pre-post study, 6 weeks (w) of usual care were followed by 6w of intervention. The intervention consisted of up to three supplement modules (sweet and savoury protein creams and protein-energy drink, single or combined) and, if required, reshaped texture-modified meals (RTMM).

RESULTS

Fifty residents completed the study (84 ± 8 years, 74% female). One-third (32%) received RTMM. Additional 258 ± 167 kcal/day and 23 ± 15 g protein/day were offered. Mean daily energy intake increased by 207 (95%CI 47-368, p = 0.005) kcal and protein intake by 14 (7-21, p < 0.001) g (w12 vs w1). Quality of life (QoL) increased in the subscale "care relationship" (+ 9 (3-15) points, p = 0.002, w12 vs w6). Body weight, handgrip strength, and other QoL subscales did not change.

CONCLUSION

Our intervention improved dietary intake and one QoL subscale in NH residents with (risk of) malnutrition. As a next step, randomized controlled trials are needed to investigate the impact of individualised interventions more comprehensively.

Determining the Distinguishing Features of Different Eating Action Types in Germany Using a Mixed-Method Approach

Food-related behavior is a very complex topic, as it affects the most diverse areas of life. Accordingly, wide varieties of disciplines have already dealt with the topic to understand it better. The result is that there is neither a uniform nutrition knowledge nor a uniform nutrition behavior. In order to reduce the complexity of a field of study, there is the methodical means of type-building. Both commercial and academic studies have already formed nutrition types, either by means of standardized questionnaires or with a specific content focus. However, since both individual and social aspects influence food-related behavior, we investigate how people integrate eating into their everyday life against the background of (competing) individual and social demands by focusing on the individual point of view, for which a mixed methods approach is used. Based on 42 semi-structured, problem-centered interviews conducted in Germany in 2017, we built qualitative food-related types in a first step, which are analyzed in this article using a quantitative content analysis and cross-over analysis to identify the particular distinguishing feature(s) of each type and test them for significance. The results show the prominent characteristics for each type and indicate furthermore that subjectivization, self-determination, the body as an instrument of power, adaptation to the environment and being overstrained with the own behavior are particularly prominent when it comes to eating. Moreover, we clearly identified The Overstrained and The Relaxed as independent eating action types, which we could not find anywhere else. The study shows that interventions, especially for The Overstrained and The Controlled, are necessary to achieve a relaxed approach to eating in everyday life. At the same time, systematic approaches should be used to intervene in cases of overstraining or controlled behavior.

An Individualised Nutritional Intervention Concept for Nursing Home Residents with or at Risk of Malnutrition: An enable Study

Dietary intake and requirements in nursing home (NH) residents vary individually, but concepts for individualised interventions are currently lacking. Therefore, we present an individualised modular nutritional intervention concept for NH residents with (risk of) malnutrition and describe its application and acceptability. Three enrichment modules—a sweet and a savoury protein cream (40 g, 125 kcal, 10 g protein) and a protein-energy drink (250 mL, 220 kcal, 22 g protein)—were offered to residents of two German NHs single or in combination in five levels of enrichment from level 0 (no enrichment) to 4 (all enrichment modules) to compensate for individual energy and protein deficiencies. Residents with chewing and/or swallowing difficulties received reshaped instead of usual texture-modified meals. The intervention concept was applied to 55 residents (Mean age of 84 ± 8 years, 76.0% female, 25.5% malnutrition). Despite (risk of) malnutrition, 18.2% received no enrichment (level 0). Level 1 was allocated to 10.9%, level 2 to 27.3%, level 3 to 20.0% and level 4 to 23.6% of the residents. 32.7% received reshaped texture-modified meals (RTMM). Participants consuming RTMM were more often assigned to level 4 than residents receiving usual meals (38.8% vs 16.2%). We proposed and successfully applied an individualised modular nutritional intervention concept to NH residents with (risk of) malnutrition. In the next step, the effects of the concept and its transferability to other NHs need to be demonstrated.