Assessment of food consumption, energy and protein intake in the meals offered in four Spanish nursing homes.

BACKGROUND/OBJECTIVE: The elderly, and especially those attending nursing homes, are at great risk from certain nutritional deficiencies. The aim of this study was to examine the percentage of energy wasted, energy and protein intake and percentage consumed of meal offered by a group of healthy institutionalized elderly in four nursing homes in Spain. DESIGN AND METHODS: This was a multicentre observational study of a sample of the institutionalized population over the age of 65. Our final sample comprised a total of 62 individuals. Dietary data were collected using double weight method for each meal during 21 days. We calculated the following consumption variables: percentage of food consumed (% food consumed) for each subject in each meal. We also calculated the energy intake (kcal/day), the wasted energy (kcal/day), the protein intake (g protein/ day) and the energy density (kcal/g meal) for each of the meals eaten. To analyse the overall differences we used analysis of variance test (ANOVA). The significance level used was 0.05 (p < 0.05). RESULTS: The largest meals were lunch (781 g/day [728.4, 833.6]) and dinner (653 g/day [612.1, 693.9]). The percentage of total consumption was 81.9% [79.3, 84.6]. The average energy consumption was 1,575.4 kcal/day [1,508.3, 1,642.6]. The percentage of caloric distribution varied depending on the center. The highest percentage of wasted food was found in the main meals. Forty four percent did not consume enough energy to meet the recommended intakes. Protein intake was 63.6 g protein / day [61.2, 66.1]. 12.5% of women and 4.55% of men did not consume the recommended intakes for the elderly. Breakfast and the bedtime snack had the highest energy density with 1.10 [0.9, 1.25] and 1.04 [0.9, 1.08] kcal/g food served respectively [Energy density]. DISCUSION/CONCLUSIONS: The best strategy for increasing the energy intake of the institutionalized elderly without raising the amount of food that is rejected may be to provide higher energy density foods in the same serving sizes.

Assessing risk screening methods of malnutrition in geriatric patients: Mini Nutritional Assessment (MNA) versus Geriatric Nutritional Risk Index (GNRI).

INTRODUCTION: Elderly subjects are considered a vulnerable group and they have more risk of nutritional problems. The risk of malnutrition increases in hospitalized geriatric patients. OBJECTIVES: To compare the correlation between MNA and GNRI with anthropometric, biochemical and Barthel Index in hospitalized geriatric patients and to test the concordance between MNA and GNRI and between Mini Nutritional Assessment Short Form (MNA-SF) and MNA. METHODS: It was a cross-sectional study on a sample of 40 hospitalized geriatric patients. For determination nutritional status we used MNA and GNRI; we evaluated the correlation between this both test with biochemical and anthropometric parameters and functional questionnaires. We used Pearson's simple correlation model, oneway ANOVA and multiple logistic regression to evaluate the relationship between MNA and GNRI. RESULTS: According to MNA, 17 patients (42.5%) were malnourished and according to GNRI, 13 patients (32.5%) had high risk of nutritional complications. The concordance of MNA and GNRI was 39% and between MNA-SF and MNA was 81%. The most significant differences were detected in weight, BMI, arm and calf circumference and weight loss parameters. Barthel index was significantly different in both tests. The MNA and GRNI had significant correlations with albumin, total protein, transferring, arm and calf circumference, weight loss and BMI parameters. CONCLUSIONS: In conclusion, it would be reasonable to use GRNI in cases where MNA is not applicable, or even use GRNI as a complement to MNA in hospitalized elderly patients. There is no reason why they should be deemed incompatible, and patients could benefit from more effective nutritional intervention.