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A Mix of Bulk and Ready-to-Use Modified-Texture Food: Impact on Older Adults Requiring Dysphagic Food*

Published online by Cambridge University Press:  09 August 2012

Heather H. Keller ,
Larry W. Chambers ,
Dean A. Fergusson ,
Helen Niezgoda ,
Maxim Parent ,
Danielle Caissie  and
Nicole Lemire
Heather H. Keller
Affiliation:
University of Waterloo
Larry W. Chambers
Affiliation:
Bruyère Research Institute, a partnership of Bruyère Continuing Care and the University of Ottawa
Dean A. Fergusson
Affiliation:
Ottawa Hospital Research Institute
Helen Niezgoda*
Affiliation:
Bruyère Research Institute, a partnership of Bruyère Continuing Care and the University of Ottawa
Maxim Parent
Affiliation:
Bruyère Research Institute, a partnership of Bruyère Continuing Care and the University of Ottawa
Danielle Caissie
Affiliation:
Bruyère Continuing Care, St Vincent Hospital
Nicole Lemire
Affiliation:
Bruyère Continuing Care, St Vincent Hospital
*
†Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Helen Niezgoda, B.Sc.N., M.Sc. Manager, Corporate Research Initiatives Bruyère Research Institute 43 Bruyère Street Ottawa, ON K1N 5C8 (hniezgoda@bruyere.org)
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Abstract

Ready-to-use modified-texture food (rMTF) products are commercially available and may have greater appeal than conventional in-house or commercial bulk modified-texture food (cMTF) products. A nine-month pilot study using a prospective interrupted time-series design where participants (n = 42) served as their own controls investigated the impact of cMTF + rMTF on weight goals, weight, food intake, and co-morbidity. Seventy-four per cent of participants achieved their weight goals at the end of six months on rMTF and, although insignificant, participants did have a trend towards weight gain while on rMTF (OR 3.5 p = .16). Main-plate food intake (grams) was not significantly different over time, but a downwards trajectory suggests decreased consumption that was compensated for by a significantly higher fat intake during the intervention period (p = .01). Increased co-morbidity and a decreasing volume of food consumed are common in older adults with dysphagia, and enhanced food products are needed to meet nutrient needs. Methodological issues encountered in this study can provide guidance for future work.

Résumé

Les aliments à texture modifiée prêts à servir (ATMp) sont offerts commercialement et peuvent être plus attrayant que les produits conventionnels maison ou commerciaux en vrac. Une étude prospective de neuf mois utilisant l’approche de séries temporelles interrompues, où les participants (n = 42) agissaient comme leur propre témoin, a examiné l’impact des ATMp sur le poids, les objectifs de poids, l’apport alimentaire et les comorbidités. Soixante-quatorze pour cent des participants ont atteint leurs objectifs de poids à la fin d’une période de six mois où ils consommaient les ATMp. Il était plus probable, mais pas statistiquement significatif, que les participants ont eu un gain de poids pendant l’intervention (6 mois) comparé à la période de contrôle (3 mois) offrant la diète d’aliments conventionnels (ATMc) (RC 3.5, p = .16). L’apport alimentaire (en g) n’a pas différé de façon significative à travers l’étude. Cependant, la pente légèrement négative pourrait être expliquée par une consommation significativement supérieure de gras pendant l’intervention (p = .01), ce qui a aidé à maintenir le poids des participants. L'augementation des comorbidités et une réduction de la consommation alimentaire sont communs chez les personnes âgées atteintes de dysphagie. Des aliments fortifiés en nutriments sont nécessaires pour combler leurs besoins nutritionnels. Les questions méthodologiques rencontrées dans la conduite de cette étude peuvent orienter les travaux futurs.

Keywords

vieillissementles aliments puréesaliments à texture modifiéedéglutitionnutritionagingpureed dietmodified-texture fooddeglutitionnutrition
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 31 , Issue 3 , September 2012 , pp. 335 - 348
Copyright
Copyright © Canadian Association on Gerontology 2012

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Footnotes

*

The authors thank Healthcare Food Services (HFS), Ottawa, Ontario, for providing the ready-to-use modified-texture food; Amy Nichols; Andrea Trainor; and the staff and patients/residents across Bruyère Continuing Care.

References

Allard, J.P., Aghdassi, E., McArthur, M., McGeer, A., Simor, A., Abdolell, M., et al. . (2004). Nutrition risk factors for survival in the elderly living in Canadian long-term care facilities. Journal of the American Geriatrics Society, 52, 59–65.CrossRefGoogle ScholarPubMed
Amunrud, E.A., Mitchell, C.O., & Sun, M.M. (1999). Acceptability and health effects of commercially prepared puree foods in nursing home residents. Journal of the American Dietetic AssociationSeptember. 99(9), A119).CrossRefGoogle Scholar
Bannerman, E., & McDermott, K. (2011). Dietary and fluid intakes of older adults in care homes requiring a texture modified diet: The role of snacks. Journal of the American Medical Directors Association, 12, 234–239.CrossRefGoogle ScholarPubMed
Canadian Institute for Health Information. (2007). CCRS analysis in brief the “Younger” generation in Ontario complex continuing care. Internet [On-line] Retrieved from: https://secure.cihi.ca/free_products/cc_aib_younger_patients_e.pdf.Google Scholar
Chen, C.C., Schilling, L.S., & Lyder, C.H. (2001). A concept analysis of malnutrition in the elderly. Journal of Advanced Nursing, 36, 131–142.CrossRefGoogle ScholarPubMed
Computrition. (2011). Hospitality suite: Computrition foodservice and healthcare software. Internet [On-line]. Retrieved fromhttp://www.computrition.com/hospitality_suite.htm.Google Scholar
Comstock, E.M., St Pierre, R.G., & Mackiernan, Y.D. (1981). Measuring individual plate waste in school lunches. Visual estimation and children’s ratings vs. actual weighing of plate waste. Journal of the American Dietetic Association, 79, 290–296.CrossRefGoogle ScholarPubMed
Crogan, N.L., & Pasvogel, A. (2003). The influence of protein-calorie malnutrition on quality of life in nursing homes. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 58, 159–164.Google Scholar
Dhingra, P., Sazawa, S., Menon, V.P., Dhingra, U., & Black, R.E. (2007). Validation of visual estimation of portion size consumed as a method for estimating food intake by young Indian children. Journal of health, Population, and Nutrition, 25, 112–115.Google ScholarPubMed
Etland, C. (2008). Mortality prognostication in long-term residents: The MDS-CHESS scale. In Doctor of philosophy in nursing. San Diego: University of San Diego–Hahn School of Nursing and Health Science.Google Scholar
Germain, I., Dufresne, T., & Gray-Donald, K. (2006). A novel dysphagia diet improves the nutrient intake of institutionalized elders. Journal of the American Dietetic Association, 106, 1614–1623.CrossRefGoogle ScholarPubMed
Green, S.M., & Watson, R. (2006). Nutritional screening and assessment tools for older adults: Literature review. Journal of Advanced Nursing, 54, 477–490.CrossRefGoogle ScholarPubMed
Hirdes, J.P., Frijters, D.H., & Teare, G.F. (2003). The MDS-CHESS scale: A new measure to predict mortality in institutionalized older people. Journal of the American Geriatrics Society, 51, 96–100.CrossRefGoogle Scholar
Hirdes, J.P., & Carpenter, G.I. (1997). Health outcomes among the frail elderly in communities and institutions: Use of the minimum data set (MDS) to create effective linkages between research and policy. Canadian Journal on Aging, 16, 53–69.CrossRefGoogle Scholar
Holmes, S. (2008). Nutrition and eating difficulties in hospitalised older adults. Nursing standard, 22, 47–57.Google Scholar
Ilhamto, N. (2011). Factors of importance in the production of in-house pureed food: A perspective from nutrition managers and cooks in long-term care [thesis]. Guelph, Ontario, Canada: Univeristy of Guelph.Google Scholar
Information Services Group Health Data Branch. (2008). Long-term care home system report as of February 29, 2008. Toronto, Ontario, Canada: Ministry of Health and Long-term Care.Google Scholar
Johnson, R.M.S.-W.H., & Soucy, I.M.R.J.S. (1995). Nutrient intake of nursing-home residents receiving pureed foods or a regular diet. Journal of the American Geriatrics Society, 43, 344–348.CrossRefGoogle ScholarPubMed
Keller, H.H. (1993). Malnutrition in institutionalized elderly: How and why? Journal of the American Geriatrics Society, 41, 1212–1218.CrossRefGoogle ScholarPubMed
Keller, H.H., Chambers, L.W., Niezgoda, H., & Duizer, L. (2012). Issues associated with the use of modified-texture foods. Journal of Nutrition, Health and Aging 16(3), 195–200.CrossRefGoogle ScholarPubMed
Keller, H.H., & Hirdes, J.P. (2000). Using the minimum data set to determine the prevalence of nutrition problems in an Ontario population of chronic care patients. Canadian Journal of Dietetic Practice and Research, 61, 165–171.Google Scholar
Keller, H. (2000). The development of: Seniors in the community: Risk evaluation for eating and nutrition. Canadian Journal of Dietetic Practice and Research, 61, 67–72.Google Scholar
Landry, K. (2009). A closer look at pureed diets. Gerontology Nutrition Link: Official Newsletter of the Dietitians of Canada, Spring, 7–9.Google Scholar
Lee, J. (2009). Survival prediction in nursing home residents using the minimum data set subscales: ADL self-performance hierarchy, cognitive performance and the changes in health, end-stage disease and symptoms and signs scales. European Journal of Public Health, 19, 308–312.Google Scholar
Morley, J.E. (1997). Anorexia of aging: physiologic and pathologic. American Journal of Clinical Nutrition, 66, 760–773.Google Scholar
Niezgoda, H., Trainor, A., Chambers, L.W., Keller, H.H., Caissie, D. (2011). Taking the weight: Standardizing weight measuring and documentation in continuing care. Canadian Nurse, 107(8), 20–22.Google Scholar
Pai, M.P., & Paloucek, F.P. (2000). The origin of the “ideal” body weight equations. The Annals of Pharmacotherapy, 34, 1066–1069.CrossRefGoogle ScholarPubMed
Parrott, M.D., Young, K.W., & Greenwood, C.E. (2006). Energy-containing nutritional supplements can affect usual energy intake postsupplementation in institutionalized seniors with probable Alzheimer’s disease. Journal of the American Geriatrics Society, 54, 1382–1387.CrossRefGoogle ScholarPubMed
Persson, M., Hytter-Landahl, A., Brismar, K., & Cederholm, T. (2007). Nutritional supplementation and dietary advice in geriatric patients at risk of malnutrition. Clinical Nutrition, 26, 216–224.CrossRefGoogle ScholarPubMed
Poss, J.W., Jutan, N.M., Hirdes, J.P., Fries, B.E., Morris, J.N., Teare, G.F., et al. . (2008). A review of evidence on the reliability and validity of minimum data set data. Healthcare Management Forum, 21, 33–39.CrossRefGoogle ScholarPubMed
Reuben, D.B. (2007). Quality indicators for the care of undernutrition in vulnerable elders. Journal of the American Geriatrics Society, 55(Suppl. 2), S438–S442.CrossRefGoogle ScholarPubMed
Salva, A., Corman, B., Andrieu, S., Salas, J., Porras, C., & Vellas, B. (2004). Minimum data set for nutritional intervention studies in the elderly IAG/ IANA task force consensus. The Journal of Nutrition, Health & Aging, 8, 202–206.Google ScholarPubMed
Shatenstein, B., Claveau, D., & Ferland, G. (2002). Visual observation is a valid means of assessing dietary consumption among older adults with cognitive deficits in long-term care settings. Journal of the American Dietetic Association, 102, 250–252.CrossRefGoogle ScholarPubMed
Shatenstein, B., Kergoat, M.J., & Nadon, S. (2001). Weight change, nutritional risk and its determinants among cognitively intact and demented elderly Canadians. Canadian Journal of Public Health, 92, 143–149.CrossRefGoogle ScholarPubMed
Simmons, S.F., Cleeton, P., & Porchak, T. (2009). Resident complaints about the nursing home food service: Relationship to cognitive status. Journals of Gerontology Series B: Psychological Sciences & Social Sciences, 64B, 324–327.Google Scholar
Simmons, S.F., Peterson, E.N., & You, C. (2009). The accuracy of monthly weight assessment in nursing homes: Implications for the identification of weight loss. The Journal of Nutrition, Health and Aging, 13, 284–288.CrossRefGoogle ScholarPubMed
Simmons, S.F., & Reuben, D. (2000). Nutritional intake monitoring for nursing home residents: a comparison of staff documentation, direct observation, and photography methods. Journal of the American Geriatrics Society, 48, 209–213.CrossRefGoogle ScholarPubMed
Simmons, S.F., & Schnelle, J.F. (2006). Feeding assistance needs of long-stay nursing home residents and staff to provide care. Journal of the American Geriatrics Society, 54, 919–924.CrossRefGoogle ScholarPubMed
Steele, C.M., Greenwood, C., Ens, I., Robertson, C., & Seidman-Carlson, R. (1997). Mealtime difficulties in a home for the aged: Not just dysphagia. Dysphagia, 12, 43–50.Google Scholar
Welch, P., Porter, J., & Endres, J. (2003). Efficacy of a medication pass supplement program in long-term care compared to a traditional system. Journal of Nutrition for the Elderly, 22, 19–28.Google Scholar
Wright, L., Cotter, D., & Hickson, M. (2008). The effectiveness of targeted feeding assistance to improve the nutritional intake of elderly dysphagic patients in hospital. Journal of Human Nutrition and Dietetics, 21, 555–562.Google Scholar
Wright, L., Cotter, D., Hickson, M., & Frost, G. (2005). Comparison of energy and protein intakes of older people consuming a texture modified diet with a normal hospital diet. Journal of Human Nutrition and Dietetics, 18, 213–219.Google Scholar