Provincial Differences in Long-Term Care Menu Variety and Food Intake for Residents who Consume a Regular Texture.

Purpose: To determine regular-texture menu variety offered in Canadian long-term care (LTC) homes and its association with residents' food intake. Methods: Twenty-nine LTC menus from Alberta, Manitoba, New Brunswick, and Ontario were analyzed. Items offered during the regular-texture menu cycle were categorized according to Eating Well with Canada's Food Guide food groups and variety scores were calculated per day and per week. Residents' food intake was assessed by weighing and observing intake over 3 nonconsecutive days. Diet quality was determined using a mean adequacy ratio score (MAR) for regular and soft and bite-sized consumers (n = 394). Results: Average daily and weekly menu variety scores were 24 ± 5.8 and 78 ± 17.2, respectively, with significantly higher scores in Ontario (29 ± 2.7 and 102 ± 11.7). Of all the food groups, only the variety score for the "Other" food category was positively associated with protein intake. No associations were observed between variety and energy intake or MAR score. Conclusion: This study is the first in Canada to assess LTC menu variety. Although there was variability between provinces in menu variety, this was not associated with resident diet quality or intake.

Diet quality is associated with malnutrition and low calf circumference in Canadian long-term care residents.

BACKGROUND: Older adults living in long-term care (LTC) are nutritionally vulnerable. The purpose of this study was to determine diet quality of Canadian LTC residents and its association with malnutrition and low calf circumference. METHODS: A cross-sectional study was undertaken in 32 LTC homes across four Canadian provinces. Nutrient adequacy ratios (NARs) were calculated for seventeen nutrients; mean adequacy ratio (MAR) was calculated to describe overall diet quality. Malnutrition risk was assessed with the Mini Nutritional Assessment-Short Form (MNA-SF) and diagnosis of protein/energy malnutrition with the Patient-Generated Subjective Global Assessment (PG-SGA). Calf circumference (CC) was also assessed. Linear and logistic regressions for these outcomes with diet quality as the predictor were conducted adjusting for covariates. RESULTS: Average MNA-SF score was 10.7 ± 2.5. Residents (43.5%) had mild/moderate to severe malnutrition based on the PG-SGA and 32.6% had a CC of < 31 cm. Mean MAR score was 0.79 ± 0.09 with significant differences between those requiring eating assistance (0.77 ± 0.11) and those that did not require assistance (0.80 ± 0.07) (p < .05). MAR score was significantly associated with malnutrition in fully adjusted models: MNA-SF scores [ß = 5.34, 95% Confidence interval (CI) (2.81, 7.85)] and PG-SGA [Odds ratio (OR) = 0.49, 95% CI (0.38, 0.64)]. Those who had better diet quality were more likely to be well nourished or not at risk. Although several individual nutrients were associated with low CC (< 31 cm), there was no association between overall diet quality (MAR) and low CC. CONCLUSIONS: Diet quality is associated with malnutrition and individual nutrients (NARs) with a low CC. In addition to calories and protein, nutrient dense diets that promote adequate micronutrient intake are required in LTC.

Prevalence of inadequate micronutrient intakes of Canadian long-term care residents.

This study determines the prevalence of inadequate micronutrient intakes consumed by long-term care (LTC) residents. This cross-sectional study was completed in thirty-two LTC homes in four Canadian provinces. Weighed and estimated food and beverage intake were collected over 3 non-consecutive days from 632 randomly selected residents. Nutrient intakes were adjusted for intra-individual variation and compared with the Dietary Reference Intakes. Proportion of participants, stratified by sex and use of modified (MTF) or regular texture foods, with intakes below the Estimated Average Requirement (EAR) or Adequate Intake (AI), were identified. Numbers of participants that met these adequacy values with use of micronutrient supplements was determined. Mean age of males (n 197) was 85·2 (sd 7·6) years and females (n 435) was 87·4 (sd 7·8) years. In all, 33 % consumed MTF; 78·2 % (males) and 76·1 % (females) took at least one micronutrient pill. Participants on a MTF had lower intake for some nutrients (males=4; females=8), but also consumed a few nutrients in larger amounts than regular texture consumers (males=4; females =1). More than 50 % of participants in both sexes and texture groups consumed inadequate amounts of folate, vitamins B6, Ca, Mg and Zn (males only), with >90 % consuming amounts below the EAR/AI for vitamin D, E, K, Mg (males only) and K. Vitamin D supplements resolved inadequate intakes for 50-70 % of participants. High proportions of LTC residents have intakes for nine of twenty nutrients examined below the EAR or AI. Strategies to improve intake specific to these nutrients are needed.

Eating disorder symptomatology: Comparative study between Mexican and Canadian university women / Sintomatología de trastornos alimentarios: Estudio comparativo entre mujeres universitarias mexicanas y canadienses

Abstract The objectives of this study were: (1) to compare Mexican and Canadian university students regarding disordered eating behaviors (DEB), body thin-ideal internalization (BTHIN), and body image dissatisfaction (BID); and (2) to examine the relationship of these three variables to body mass index (BMI) and waist circumference (WC). This cross-cultural study was carried out in a sample of 129 university women students aged from 18 to 25 years (M = 20.18, SD =1.59): 52% were Canadian (Moncton University [MU]) and 48% were Mexican (Universidad Autónoma del Estado de Hidalgo [UAEH]). The Brief Questionnaire for Disordered Eating Behaviors and Attitudes Towards Body Figure Questionnaire were applied while the BID was evaluated using a continuum of nine silhouettes. In addition, the weight, height and WC of each participant were recorded. Mexican students had greater values of overweight, obesity, abdominal obesity and DEB, with 4.6 times greater risk than UM students. In contrast, the presence of BTHIN and BID was similar between samples. Considering these findings, women from at least two different ethnic groups are vulnerable to the development of eating disorder symptomatology.

Resumen Los objetivos de este estudio fueron: 1) comparar entre estudiantes universitarias mexicanas vs. canadienses respecto a conductas alimentarias de riesgo (CAR), interiorización de la figura corporal delgada (IFCD) e insatisfacción con la imagen corporal (ISC); y 2) examinar la relación de esas tres variables con el índice de masa corporal (IMC) y la circunferencia de cintura (CC). En este estudio transcultural participaron 129estudiantes universitarias de 18 a 25 años de edad (M = 20.18, DE =1.59): 52% canadienses (Universidad de Moncton [UM]) y 48% mexicanas (Universidad Autónoma del Estado de Hidalgo [UAEH]). Fueron aplicados el Cuestionario Breve para medir Conductas Alimentarias de Riesgo y el Attitudes Towards Body Figure Questionnaire, mientras que la ISC se evaluó mediante un continuo de nueve siluetas. Además se registró el peso, la talla y la CC de cada participante. Las estudiantes mexicanas registraron significativamente mayor presencia de sobrepeso, obesidad, obesidad abdominal y CAR, con 4.6 veces mayor riesgo que las estudiantes de la UM. Por el contrario, la presencia de IFCD y de ISC fue similar entre las muestras. Con base en estos hallazgos se puede concluir que las mujeres de dos grupos étnicos diferentes son vulnerables al desarrollo de sintomatología de trastornos alimentarios.

Prevalence and Determinants of Poor Food Intake of Residents Living in Long-Term Care.

OBJECTIVE: Poor food intake is known to lead to malnutrition in long-term care homes (LTCH), yet multilevel determinants of food intake are not fully understood, hampering development of interventions that can maintain the nutritional status of residents. This study measures energy and protein intake of LTCH residents, describes prevalence of diverse covariates, and the association of covariates with food intake. DESIGN: Multisite cross-sectional study. SETTING: Thirty-two nursing homes from 4 provinces in Canada. PARTICIPANTS: From a sample of 639 residents (20 randomly selected per home), 628 with complete data were included in analyses. MEASUREMENTS: Three days of weighed food intake (main plate, estimated beverages and side dishes, snacks) were completed to measure energy and protein intake. Health records were reviewed for diagnoses, medications, and diet prescription. Mini-Nutritional Assessment-SF was used to determine nutritional risk. Oral health and dysphagia risk were assessed with standardized protocols. The Edinburgh-Feeding Questionnaire (Ed-FED) was used to identify eating challenges; mealtime interactions with staff were assessed with the Mealtime Relational Care Checklist. Mealtime observations recorded duration of meals and assistance received. Dining environments were assessed for physical features using the Dining Environment Audit Protocol, and the Mealtime Scan was used to record mealtime experience and ambiance. Staff completed the Person Directed Care questionnaire, and managers completed a survey describing features of the home and food services. Hierarchical multivariate regression determined predictors of energy and protein intake adjusted for other covariates. RESULTS: Average age of participants was 86.3 ± 7.8 years and 69% were female. Median energy intake was 1571.9 ± 411.93 kcal and protein 58.4 ± 18.02 g/d. There was a significant interaction between being prescribed a pureed/liquidized diet and eating challenges for energy intake. Age, number of eating challenges, pureed/liquidized diet, and sometimes requiring eating assistance were negatively associated with energy and protein intake. Being male, a higher Mini-Nutritional Assessment-Short Form score, often requiring eating assistance, and being on a dementia care unit were positively associated with energy and protein intake. Energy intake alone was negatively associated with homelikeness scores but positively associated with person-centered care practices, whereas protein intake was positively associated with more dietitian time. CONCLUSION: This is the first study to consider resident, unit, staff, and home variables that are associated with food intake. Findings indicate that interventions focused on pureed food, restorative dining, eating assistance, and person-centered care practices may support improved food intake and should be the target for further research.

Making the Most of Mealtimes (M3): protocol of a multi-centre cross-sectional study of food intake and its determinants in older adults living in long term care homes.

BACKGROUND: Older adults living in long term care (LTC) homes are nutritionally vulnerable, often consuming insufficient energy, macro- and micronutrients to sustain their health and function. Multiple factors are proposed to influence food intake, yet our understanding of these diverse factors and their interactions are limited. The purpose of this paper is to fully describe the protocol used to examine determinants of food and fluid intake among older adults participating in the Making the Most of Mealtimes (M3) study. METHODS: A conceptual framework that considers multi-level influences on mealtime experience, meal quality and meal access was used to design this multi-site cross-sectional study. Data were collected from 639 participants residing in 32 LTC homes in four Canadian provinces by trained researchers. Food intake was assessed with three-days of weighed food intake (main plate items), as well as estimations of side dishes, beverages and snacks and compared to the Dietary Reference Intake. Resident-level measures included: nutritional status, nutritional risk; disease conditions, medication, and diet prescriptions; oral health exam, signs of swallowing difficulty and olfactory ability; observed eating behaviours, type and number of staff assisting with eating; and food and foodservice satisfaction. Function, cognition, depression and pain were assessed using interRAI LTCF with selected items completed by researchers with care staff. Care staff completed a standardized person-directed care questionnaire. Researchers assessed dining rooms for physical and psychosocial aspects that could influence food intake. Management from each site completed a questionnaire that described the home, menu development, food production, out-sourcing of food, staffing levels, and staff training. Hierarchical regression models, accounting for clustering within province, home and dining room will be used to determine factors independently associated with energy and protein intake, as proxies for intake. Proportions of residents at risk of inadequate diets will also be determined. DISCUSSION: This rigorous and comprehensive data collection in a large and diverse sample will provide, for the first time, the opportunity to consider important modifiable factors associated with poor food intake of residents in LTC. Identification of factors that are independently associated with food intake will help to develop effective interventions that support food intake. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT02800291 , retrospectively registered June 7, 2016.

Hoping for the Best or Planning for the Future: Decision Making and Future Care Needs.

Research has shown that relatively few older adults make plans for future care needs. In this study, we explore the thinking processes involved in planning or failing to plan for the future. Interviews were carried out with 39 older adults ( M age = 81 years) who were experiencing disability and illness but who lived in their own home. Guiding questions for the interview focused on present living circumstances, but for the present qualitative analysis, all references to the future, and to future residence changes, were extracted. This approach allowed us to observe how older adults spontaneously address issues of future planning when not constrained to do so. Results supported the use of a positivity bias, as well as a risk-aversive decision-making style. These older adults seemed to be prioritizing present emotional well-being by avoiding thoughts of future risks and thereby eschewing proactive coping.

Disordered eating behaviors in Mexican patients with and without type 2 diabetes mellitus / Conductas alimentarias de riesgo en pacientes mexicanos con y sin diabetes mellitus tipo 2

The aim of this work was to compare the distribution of disordered eating behaviors (DEB) in Mexican adult patients, with and without type 2 diabetes. A cross-sectional descriptive and comparative field research was carried out in a sample of 169 subjects (54% females; 46% males) with a mean age of 47.9 years. The sample was matched in two groups: patients with type 2 diabetes and patients without diabetes. DEB were assessed with a valid Mexican scale named EFRATA (Escala de Factores de Riesgo Asociados a Trastornos Alimentarios). Results confirmed significant differences in food and weight concern (t = 4.15, df 152.09, p = 0.000), normal eating behavior (t = 4.03, df 151.45, p = 0.000) and emotional eating (t = 1.93, df 160.76, p < 0.05), EFRATA's factors in which diabetic subjects obtained higher values in comparison with no diabetic patients. Subjects without diabetes achieved higher value only in binge eating behavior with statistically significant difference (t = 2.11, df 128.8, p < 0.05) in contrast with diabetic patients. Since these findings have been open the possibility to propose specific strategies that encourage healthy eating behaviors, both in adult patients with and without diabetes.

El objetivo de este estudio consistió en comparar la distribución de conductas alimentarias de riesgo en pacientes mexicanos adultos con y sin diabetes tipo 2. Se efectuó un estudio de campo de tipo descriptivo y comparativo en una muestra de 169 sujetos (54% mujeres; 46% hombres) con una media de edad de 47,9 años. Los sujetos fueron divididos en 2 grupos: pacientes con diabetes y pacientes sin diabetes. Para medir las conductas alimentarias de riesgo se empleó la Escala de Factores de Riesgo Asociados a Trastornos Alimentarios (EFRATA). Los resultados confirmaron diferencias significativas en preocupación por el peso y la comida (t = 4,15, df 152,09, p = 0,000), conducta alimentaria normal (t = 4,03, df 151,45, p = 0,000) y en comer por compensación psicológica (t = 1,93, df 160,76, p < 0,05), factores de la EFRATA en los que los pacientes diabéticos registraron valores más altos. En contraste con los pacientes diabéticos, los sujetos sin diabetes alcanzaron el valor más alto con diferencia estadísticamente significativa en el factor comer compulsivo (t = 2,11, df 128,8, p < 0,05). A partir de estos hallazgos se abre la posibilidad de proponer estrategias puntuales que favorezcan conductas alimentarias saludables, tanto para pacientes adultos diabéticos como sin diabetes.

[The influence of minority sociolinguistic context on home support for seniors in a rural devitalized area: the case of Acadieville New Brunswick]. / L'influence du contexte sociolinguistique minoritaire sur le maintien à domicile des aînés en milieu rural dévitalisé: le cas d'Acadieville au Nouveau-Brunswick.

New Brunswick is one of the provinces most affected by the aging of the population. Moreover, aging at home in Francophone minority communities is a major challenge in rural areas. The goal of this paper is to identify the main advantages and disadvantages of aging at home and to expose organizational strategies deployed by seniors and their families in order to promote aging in place. The case study is the method of analysis that we have recommended. Our methodology is based on content analysis of 13 semi-structured interviews with seniors and their children. The results show that family and community support, resourcefulness and resiliency, the practice of leisure activities as well as the living environment are among the principal means used by older adults to promote aging at home.

Strategies for Aging in Place: The Experience of Language-Minority Seniors With Loss of Independence.

For healthy and independent older adults, aging in place can be seen as identical to any other adult living at home. Little is known about how frail seniors, particularly those who speak a minority language, manage the challenges of aging in place. The present qualitative descriptive study explores the strategies that Canadian French-speaking seniors have put in place to counter their loss of independence and promote their ability to stay in their home. Semistructured individual interviews were conducted with 39 older adults and transcribed, followed by content analysis to identify common themes related to study objectives. Six themes emerged in response to strategies described for aging in place. Findings reveal the limited extent to which language issues were perceived as a barrier by participants. In conclusion, the results of this study provide us with fruitful insights to guide community nursing practice, future research, and public policy.

[Healthy ageing in a linguistic minority situation in Canada: issues, challenges and collective mobilization]. / Vieillir en sante en situation minoritaire linguistique au Canada: enjeux, defis et mobilisation collective.

In Canada, the health of both French and English speakers living in linguistic minority situations is a subject of interest to several researchers and community organizations. This article draws upon a symposium on the theme of healthy ageing in a linguistic minority situation, presented at the 4th International Colloquium for Local and Regional Health Programmes. Three aspects are presented: the identification of factors associated with perceived health, home care and malnutrition screening. The results describe: (a) The determinants of perceived health, such as health care services, the vitality of the minority community and education; (b) The lack of changes to home care services, despite the ageing of the population; and (c) The high prevalence of malnutrition among the elderly in New Brunswick, Canada. Finally, we make suggestions regarding the design and implementation of a national policy on ageing in Canada, in order to ensure high-quality services along the entire health continuum.

[Nutritional screening among seniors in health care institutions: comparison between the institutions Francophones and Anglophones]. / Dépistage nutritionnel chez les aînés en établissements de soins de santé : comparaison entre les établissements francophones et anglophones.

OBJECTIVES: Malnutrition among the elderly is a widespread problem in hospitals and nursing homes. However, data on the practice of nutritional screening in these facilities are limited, particularly in Francophone establishments. This study aimed to compare nutritional screening practices among the elderly in Anglophone and Francophone health care facilities in New Brunswick (NB), as well as perceptions and practices of health care professionals. METHODS: Information on screening parameters was taken directly from elderly patients'/residents' medical records. Health care professionals' (doctors, nurses, dietitians) perceptions and practices of nutritional screening were collected through questionnaires. RESULTS: A total of five hospitals and 31 nursing homes in NB took part in the study. Of these, 421 patients/residents and 457 health professionals participated. Significant differences in the availability of screening parameters were observed between Francophone and Anglophone patients/residents. Certain screening parameters, such as weight at admission, loss of appetite and meal fractions consumed were less available in Francophone patients'/residents' records. In addition, health care professionals' perceptions regarding nutritional screening varied by occupation and language of the establishment. Several barriers to screening were also identified. CONCLUSION: Reduced availability of screening parameters in Francophone establishments and the underestimation of malnutrition in elderly patients/residents by doctors and nurses are barriers that can influence nutritional screening in Francophone health care facilities.

[The perception of seniors Francophones in a minority situation coping with the challenges and issues related to the maintenance at home in urban areas New Brunswickers]. / La perception des aînés francophones en situation minoritaire face aux défis et aux enjeux liés au maintien à domicile en milieu urbain néo-brunswickois.

OBJECTIVE: Explore the needs and the degree of satisfaction of Francophone seniors living in a minority socio-linguistic urban community in regards to aging-in-place. METHOD: An ethnographic case study was conducted in an urban community in the province of New Brunswick between October 2010 and June 2011. Individual interviews were completed with leaders of different community organizations (n=9) and focus groups were held with socio-linguistic minority French-speaking older adults (n=19). RESULTS: Francophone seniors explained their willingness to age-in-place; however, the lack of services and support in the community makes aging-in-place difficult. Despite this identified absence of services, leaders of various community organizations have no plans to review current services in order to facilitate better quality of life for seniors. CONCLUSION: Aging-in-place for French-speaking seniors living in socio-linguistic minority communities requires concerted efforts from family members, the community and the government. The Ottawa Charter of Health clearly states housing as a prerequisite of health. Housing and social support are important determinants of health. Therefore, the development and implementation of a public policy with regard to seniors, and particularly those in a socio-linguistic minority, seems fundamental in the context of population aging.

Availability of nutrition screening parameters in New Brunswick hospitals and nursing homes.

We explored the availability of parameters for a nutrition screening system among elderly people in New Brunswick (NB) health care facilities. Patients aged 65 or older were asked to participate in the study; each participant had been admitted to one of four hospitals or lived in one of six nursing homes. Availability of nutrition screening parameters (weight, height, weight change, serum albumin level, appetite, and food intake record) was assessed by auditing the participants' medical charts. When data were not available, the feasibility of obtaining them was determined. Additional data related to nutrition screening were also obtained. In total, 421 participants were recruited for the study: 140 (33.2%) who lived in nursing homes and 281 (66.8%) who were in hospitals. Parameters needed to conduct nutrition screening, such as weight upon admission, were available for 83.6% of participants; usual weight was available for 43.0%, height for 86.0%, and serum albumin level for 47.5%. Our findings show that basic parameters for nutrition screening are available, and that implementation of a nutrition screening system is feasible for patients in NB health care facilities.

Nutrition screening for seniors in health care facilities: a survey of health professionals.

PURPOSE: Several studies show that malnutrition is prevalent in health care facilities, especially among elderly patients and nursing home residents. Although validated screening tools exist, little evidence exists on the feasibility of implementing nutrition screening in health care facilities. We examined New Brunswick health care professionals' perceptions of and practices involving nutrition screening in elderly clients, as well as barriers to screening. METHODS: A survey was conducted with questionnaires intended for physicians, nurses, and dietitians. RESULTS: Participants were 457 health care professionals (physicians, 34.6%; nurses, 50.3%; dietitians, 15.1%). Perceptions of nutrition screening varied. For example, most nurses (94.7%) and dietitians (98.5%) indicated that screening was important/very important, while only 63.5% of physicians indicated this. Screening methods also differed among professionals and few used a screening tool. Several barriers to implementing nutrition screening were reported, such as lack of time, lack of professional resources, and clients' short stays. CONCLUSIONS: These findings will help professionals address the feasibility of implementing standardized screening tools in health care facilities. A more consistent and systematic approach for detecting populations at high nutritional risk may result.

Exploring adolescents' awareness of diabetes using the free association technique.

PURPOSE: Healthy adolescents' awareness of diabetes was explored, and gender and grade-level differences in understanding were determined. METHODS: Adolescents without diabetes in grades five, eight, and 10 (n=128) at four New Brunswick schools wrote down all words/expressions that came to mind when they heard the word "diabetes" (i.e., they used the free association technique). Answers were classified into categories using content analysis. RESULTS: Eighty-eight girls and 40 boys completed the activity (n=44, 52, and 32 in grades five, eight, and 10, respectively). Nine principal categories were identified: 66% of the adolescents cited sugar (e.g., eating too much sugar, not enough sugar), 48% treatment (e.g., needles, injections), 45% the nature of diabetes (e.g., a disease, types of diabetes, heredity), 41% nutrition (e.g., diet, sugar-containing foods, other foods), 38% blood (e.g., too much/not enough sugar in blood), 18% complications (e.g., death), 11% physiological manifestations/symptoms (e.g., fainting), 6% obesity, and 6% physical activity. No differences were found in category citation frequency between boys and girls and grade levels, except that grade 10 students more frequently cited the categories of treatment, blood, and obesity (p=0.05). CONCLUSIONS: Students thought of diabetes in terms of sugar and injections. Words related to obesity, prevention, and complications were cited infrequently.

Healthy adolescents' social representations of diabetes.

OBJECTIVE: This study explores healthy adolescents' social representations of diabetes in terms of its definition, origins and prevention. METHODS: Focus groups were conducted with students in Grades 5, 8 and 10 from 4 francophone schools in New Brunswick, Canada. Audiotaped discussions were transcribed and categorized using qualitative content analysis (Atlas.ti software). Chi-square and Fisher's exact tests were used to determine sex and grade-level differences in frequency of category citations. RESULTS: Nineteen focus groups involved 130 adolescents. Students defined diabetes as a disease (13 groups) related to sugar (15 groups) and blood (13 groups), but only a few mentioned the role of insulin/pancreas, types of diabetes and/or complications. Symptoms/physiological manifestations (11 groups), monitoring blood sugar (10 groups) and insulin injections (5 groups) were discussed primarily in terms of behaviours observed among family and friends with diabetes, demonstrating the importance of social environment in their representations. Half of the groups identified heredity, age, obesity, physical activity and poor diet as playing a role in developing diabetes. Students had a general idea about the importance of good eating habits and physical activity in terms of managing and preventing diabetes. Eleven groups had the misconception that sugar causes diabetes. Although each focus group had at least 1 adolescent with a family member affected by the disease, only half of the groups cited feeling at risk of diabetes - girls more likely than boys (p≤0.05). CONCLUSION: Healthy adolescents in Moncton, New Brunswick, have a limited comprehension of diabetes, which could make it difficult for them to take preventive action to contain this epidemic disease.

[Perceived stress and its influence on the eating behaviours of students at the University of Moncton, Moncton Campus]. / Le stress perçu et son influence sur le comportement alimentaire des étudiants de l'Université de Moncton, Campus de Moncton.

PURPOSE: Measure and analyze the link between perceived stress and eating behaviours of first (St1) and fourth-year students (St4) at the University of Moncton at the beginning (T1) and end (T2) of an academic trimester. METHODS: Ninety-four subjects from various university programs participated in the study. The Perceived Stress scale was used to measure perceived stress. A three-day food record and a food frequency questionnaire were used to measure food consumption and its frequency. RESULTS: At T1, both first and fourth-year students show low levels of perceived stress. At T2, the perceived stress levels of St4 increase significantly (22,3 +/- 1,4; p =0,005) As stress increases, dietary profiles of students, measured according to the level of conformity to the Canada's Food Guide for Healthy Eating, show an increased consumption of milk and milk products for St1, T1 (p=0,05) and of breads and cereals for St4, T2 (p=0,02). Significant negative correlations were found among St4 between perceived stress and thiamine(r= -0,48; p=0,006) and zinc (r= -0,42; p=0,02). ingestion. No other correlations with perceived stress were found with either energy or other nutrient intakes. CONCLUSION: These results demonstrate the importance of intervening within the university student population and implementing information sessions on stress management and healthy eating behaviours among university students.

Outcomes of screening and nutritional intervention among older adults in healthcare facilities.

A nutritional screening and early intervention program was administered to older adults in a subacute care facility. The study group was recruited among patients aged 65 or older, who were admitted to the geriatric and rehabilitation units of two hospitals. Two simple, reliable, and valid tools were used to screen subjects for the risk or presence of malnutrition. Those determined to be at high nutritional risk (n=62) were included in the study. Dietitians then conducted a full nutritional assessment and implemented a nutritional care plan for these subjects. Weekly follow-up was completed to measure oral intake, weight, and biochemical indices. A Short-Form 36 Health Survey was administered upon admission and discharge. Results showed significant increases in energy (p=0.0001) and protein (p=0.01) intakes, and in serum albumin (p=0.001), prealbumin (p=0.003), transferrin (p=0.024), and hematocrit (p=0.026) levels. There was also a significant increase in seven of the eight dimensions of the health-related quality of life questionnaire (p<0.05). Outcomes improve when older adults are screened for the risk or presence of malnutrition and receive an early nutritional care program.