Patricia Welch

Position of the American Dietetic Association: Liberalized Diets for Older Adults in Long-Term Care

Abstract It is the position of the American Dietetic Association (ADA) that the quality of life and nutritional status of older residents in long-term care facilities may be enhanced by a liberalized diet. The Association advocates the use of qualified dietetics professionals to assess and evaluate the need for medical nutrition therapy according to each persons individual medical condition, needs, desires, and rights. One of the major determinants among the predictive factors of successful aging is nutrition. Long-term care includes a continuum of health services ranging from rehabilitation to supportive care. Nutrition care for older adults in long-term settings must meet two goals: maintenance of health through medical care and maintenance of quality of life. However, these goals often seem to compete, resulting in the need for a unique approach to medical nutrition therapy (MNT). Typically, MNT includes assessment of nutritional status and development of an individualized nutrition intervention plan that frequently features a theraperutic diet appropriate for managing a disease or condition. MNT must always address medical needs and individual desires, yet for older adults in long-term care this balance is especially critical because of the focus on maintaining quality of life. Dietetics professionals must help residents and health care team members assess the risks versus the benefits of therapeutic diets. For frail older adults, overall health goals may not warrant the use of a therapeutic diet because of its possible negative effect on quality of life. A diet that is not palatable or acceptable to the individual can lead to poor food and fluid intake, which results in weight loss and undernutrition, followed by a spiral of negative health effects. Often, a more liberalized nutrition intervention that allows an older adult to participate in his or her diet-related decisions can provide for the persons nutrient needs and allow alterations contingent on medical conditions while simultaneously increasing the desire to eat and enjoyment of food. This ultimately decreases the risks of weight loss, undernutrition, and other potential negative effects of poor nutrition and hydration.

Nutrition Education, Body Composition, and Dietary Intake of Female College Athletes.

In brief: This study examined the effects of nutrition education (through individual counseling) on the body composition and diet patterns of 39 female college athletes. Anthropometric and diet data were collected before and after the playing season. Ten of the athletes received individual nutrition counseling during the season and comprised group 1; the other 29 made up group 2. Neither group met the recommended dietary allowance for energy before or after the season, but group 1 significantly lowered fat and cholesterol levels and increased carbohydrate and fiber intakes. The findings suggest that individual counseling is effective in improving the diet quality of female athletes.

Factors affecting the formation of food preferences in preschool children

It has been found that a complex and varied diet increases the probability that foods containing essential nutrients will be consumed by the pre‐school child. Because variety in the diet is beneficial identification of factors that affect the development of food preferences in young children is important. Such factors include familiarity, age, parents, peers, teachers and programs designed to influence food habits. Each of these are discussed and recommendations are given to pre‐school programs for creating an atmosphere conducive to trying new foods.

Diabetics in Long‐Term Care: Effect of Sweetness on Dietary Intake

This study reported on the dietary intake of the institutionalized diabetics consuming low-kilocalorie sweeteners or fructose. The dietary intake was comparable to that for nondiabetics and consistent with the data from NHANES II. Nutrient intakes for diabetics met 100% of the RDA when either sweetener was used. Because of the increase in carbohydrates from fructose, the percentage of calories from fat approximated more closely the 30% recommended for diabetic adults. When fructose diets were used, there was a decrease in sucrose intake, which may help keep serum glucose and insulin responses within a normal range. The additional energy from fructose probably had little negative effect on the institutionalized diabetic population (which was not obese) and may have provided energy for weight maintenance. The use of calorie-dense sweeteners with the general population of diabetics who tend to be overweight requires further study.

Acceptance of Soy Foods by the Elderly in a Long-Term Care Facility

Abstract Soy foods were successfully substituted for traditional foods in a three-week cycle menu serving 260 long-term care facility residents. Plate waste from 9,298 resident meals showed there was no significant difference in grams eaten between the study periods. Residents ate 66% of the items served during both soy and traditional food service periods. Energy values between study weeks, by meals, and products were not significantly different. Protein values were significantly higher (P < 0.01) for the soy study period. Soy foods can be acceptably substituted for traditional foods while increasing protein intake in the elderly.

Procedures for Use of Soy Protein in Long-Term Care Menus

ABSTRACT Incorporating soy products into long-term care foodservice can be successful. This article discusses how planning for the use of soy needs to include the menu system, the nutritional guidelines, staffing patterns and issues concerning ready-made soy products versus adjusting current recipes. Many types of soy ingredients and products are described along with usage ideas. A one-week sample menu is included.

Soy-Enhanced Products can Increase Protein Intake of Long-Term Care Residents

Abstract The importance of sufficient protein intake of the elderly, especially those in long-term care facilities (LTCF), is well established. Marginal protein intake has been shown to result in loss of lean muscle mass and immune function. Soy is a complete, high quality protein, which can be added to a wide variety of products to enhance the texture and nutritional quality of foods such as meats, breads, desserts, and cereals. This study was conducted with 74 residents having a mean age of 78 years in a 460 bed LTCF. The study consisted of two, three-week cycle menus where either traditional or soy-enhanced cycle menus were served. During the soy enhanced weeks, four to six items per day from the traditional menus were replaced with similar soy-enhanced products, reaching a goal of 30 grams of soy per day. To determine amounts served, five random trays were selected and individual food items were weighed for each meal. Plate waste measurements from the 9,298 trays over the six-week study provided data on differences in acceptance of the respective cycle menus. Nutritional content of foods was calculated using the NDS system developed by the University of Minnesota. Data were subjected to an analysis of covariance to test for differences between the traditional and soy-enhanced menus regarding amount eaten, energy values, and protein values in matched meals. There was no significant difference in amount of food or energy consumed between study weeks, although the soy-enhanced products were more protein dense. The amount of protein consumed increased (p≤0.01) by 19.6% per day (13.2 grams) in the soy-enhanced compared with traditional menus. In conclusion, the energy and protein content of the foods consumed during the traditional and soy-enhanced weeks was comparable to that reported in the literature for similar populations. Soy-enhanced products incorporated into traditional LTCF menus can significantly enhance the overall protein consumption by the elderly.

Nutrients and Fiber In Supplemented Diets Of Low Income Preschoolers

The purpose of this study was to report on the energy, nutrient, and fiber values from dietary intakes of low income children receiving supplemental foods. Di etary records for 434 preschool children participating in the Supplemental Food Program for Women, Infants, and Children (WIC) were collected. The sample was divided into the upper and lower quartiles based on fiber values. The upper quartile met the RDA for energy and also had more nutrient dense diets for car bohydrate, fiber and magnesium due to larger quantities and more frequent servings of fruits, vegetables, grains and legumes. The diets of the lower quartile were more nutrient dense for fat, vitamins B12, and D due to larger servings of meats, desserts and high-fat snacks. The upper group reported a larger quantity of WIC foods, especially the approved cereals, which contributed some fiber to the diets. Overall, WIC foods supplied higher values for many nutrients, espe cially iron, but provided only small quantities of fiber.