Impact of Cafeteria Service Discontinuation at a Dialysis Facility on Medium-Term Nutritional Status of Elderly Patients Undergoing Hemodialysis.

Despite evident lifestyle changes due to measures against the coronavirus disease 2019 (COVID-19) outbreak, few reports focus on the effects of eating-behavior changes on the nutritional status of elderly patients undergoing hemodialysis (HD). Thus, we examined dry-weight reduction, the simplest indicator of malnutrition among patients undergoing dialysis, and its association with the discontinuation of cafeteria services at a dialysis facility as per COVID-19 measures. This retrospective study included elderly patients (aged ≥ 65 years) undergoing HD at the Nagasaki Renal Center between December 2020 and October 2021. We collected nutrition-related data and patient characteristics and evaluated the association between the service discontinuation and dry-weight reduction 10 months after the discontinuation using multivariable logistic regression. This study included 204 patients, 79 of which were cafeteria users. During the observation period, cafeteria users showed significant dry-weight reduction; however, this was not observed among non-users. Multivariable logistic regression analysis indicated a close association between dry-weight reduction and the service discontinuation. That is, the dietary services cancelation caused dry-weight reduction in patients who relied on the cafeteria. As elderly patients undergoing HD are vulnerable to changes in their eating environment, alternative nutritional management methods need to be considered.

Study on the necessary survey days for energy intake in school children assessed by 7 day survey.

Theoretically, the longer the period of a nutrition survey, the more reliable the results. However, a long survey can impose a burden on subjects and cause the results to become inaccurate. For adults, a 3 non-consecutive day survey is usually recommended; however, for school children, at least in Japan, it has not been determined whether this is necessary. In this study we conducted a survey of 7 days and tried to find the minimum number of days necessary to determine the energy intake. The subjects were about 300 children aged from 6 to 7, 10 to 11 and 13 to 14 years old in a city in the western part of Japan. The weighing method was used for the school lunch and other meals were surveyed by 24-recalling method. For the 6-7 year-old school children, guardians were asked to keep dietary records. The final number of subjects who were able to complete the 7-day survey was 139. Energy intakes for each weekday were not statistically different (p>0.05) and those for each weekend did not differ (p>0.05). Average energy intakes on weekdays were higher than those on weekend days in 10-11 and 13-14 year-old children. The average intakes of energy in 10-11 and 13-14 year-old children were lower than Japanese estimated energy requirements (EER). However, body weight of more than 90% of subjects was within the normal range. The results suggest that a survey of one weekday is reliable for all weekdays and that of one week-end day is reliable for any weekend day and also indicate the necessity of further studies of EER in rapidly growing children.

[Effects of a food delivery service on the nutritional status of elderly persons living at home alone].

OBJECTIVE: The present study was carried out to determine whether a food delivery service can improve the nutritional status of elderly persons living at home alone. METHODS: The subjects were 74 elderly women (age range, 70-90 years; average age 80.2 +/- 3.6 years) living in T town, Miyazaki Prefecture. All were independent in activities of daily living and their nutritional status was individually evaluated using anthropometric, biochemical and dietary methods. We then compared the nutritional status between persons who used the delivery service for more than 3 months and persons who lived alone and did not use the delivery service or who lived with their families. RESULTS: Based on the anthropometric examination, all persons appeared to be in a good nutritional state. However, their total serum protein and albumin levels demonstrated some undernutrition. Total serum protein, albumin, total cholesterol, and HDL cholesterol were all higher in persons who received food from a delivery service than in the control group living alone. Persons who lived with their families had similar levels as persons using the delivery service. Individuals who lived alone tended to eat sweets more frequently than those with their families. The food delivery service resulted in a higher consumption of fat. CONCLUSIONS: The nutritional status of elderly persons living alone may be improved by dishes high in fat delivered for lunch or supper. These results suggest that food delivery services run by municipalities are efficient for nutritional care.