Too low protein and energy intake in nursing home residents

Jos Borkent; Marleen Manders; Annemarie Nijhof; Lianda Wijker; Edith Feskens; Elke Naumann; Marian de van der Schueren

doi:10.1016/j.nut.2023.112005

Too low protein and energy intake in nursing home residents

Nutrition. 2023 Jun:110:112005. doi: 10.1016/j.nut.2023.112005. Epub 2023 Feb 24.

Authors

Jos Borkent¹, Marleen Manders², Annemarie Nijhof², Lianda Wijker², Edith Feskens³, Elke Naumann², Marian de van der Schueren⁴

Affiliations

¹ HAN University of Applied Sciences, Nijmegen, The Netherlands; Wageningen University, Wageningen, The Netherlands. Electronic address: jos.borkent@wur.nl.
² HAN University of Applied Sciences, Nijmegen, The Netherlands.
³ Wageningen University, Wageningen, The Netherlands.
⁴ HAN University of Applied Sciences, Nijmegen, The Netherlands; Wageningen University, Wageningen, The Netherlands.

PMID: 36966585
DOI: 10.1016/j.nut.2023.112005

Abstract

Objectives: An optimal diet contributes to reducing malnutrition prevalence in the nursing home population. For this population, recommended daily intakes are ≥1.0 g protein/kg body weight and ≥27 energy kcal/kg body weight. The aim of this study was to identify the protein and energy intake of nursing home residents and to assess groups at increased risk for low intake.

Methods: Cross-sectional data regarding food intake was collected by three-day observations in 189 residents (aged ≥65 y, mean age 85.0 y) of five different nursing homes. Linear mixed models were used to examine associations of protein and energy intake as dependent variables with demographic and disease-related problems as determinants. Results were adjusted for age, sex, and mobility levels and stratified by a protein/energy-enriched diet (P/E+).

Results: The daily protein intake of the residents was 0.80 (SD 0.22) g/kg body weight, with 84.7% having an intake below the recommended daily 1 g/kg body weight. Mean daily energy intake was 20.7 (SD 6.1) kcal/kg body weight, with 85.2% having an intake below recommendation. Protein/energy intake was higher in the P/E+ group compared with standard diet: 0.92 (SD 0.23) versus 0.74 (SD 0.19) g/kg body weight, and 23.9 (SD 6.1) versus 19.1 (SD 5.4) kcal/kg body weight, respectively. The oldest age groups (>85 y), chair-bound residents, women, and residents having difficulties with chewing, dysphagia, a reported decreased food intake, or a decreased appetite were at a higher risk for a low protein/energy intake.

Conclusion: Nearly all nursing home residents were at increased risk for not meeting the minimum protein/energy requirements. Intakes should, on average, be increased with ≥15 g protein and ≥520 kcal to reach the minimum intake targets. Although using a P/E+ diet was associated with higher intakes, even these residents had intakes below the requirements.

Keywords: Food intake; Long-term care facility; Nutritional status; Older adults; Undernutrition.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged, 80 and over
Body Weight
Cross-Sectional Studies
Diet, Protein-Restricted
Dietary Proteins*
Energy Intake
Female
Humans
Nursing Homes
Nutrition Assessment*
Nutritional Status

Substances

Dietary Proteins