Cater with Care : impact of protein-enriched foods and drinks for elderly people
Beelen, J. - \ 2016
Wageningen University. Promotor(en): Lisette de Groot; Frans Kok, co-promotor(en): Nicole de Roos. - Wageningen : Wageningen University - ISBN 9789462578814 - 142
undernutrition - hospital catering - hospitals - protein - elderly - protein intake - food - beverages - diet studies - dietetics - dietitians - randomized controlled trials - ondervoeding - ziekenhuiscatering - ziekenhuizen - eiwit - ouderen - eiwitinname - voedsel - dranken - dieetstudies - diëtetiek - diëtisten - gestuurd experiment met verloting
Protein undernutrition is a major health concern for older adults, especially for those who are ill. There is growing consensus for a protein intake target of 1.2 - 1.5 gram per kg bodyweight per day (g/kg/d) for these older adults. However, this target is not reached by the majority of older adults. Therefore, more effective and novel strategies to increase protein intake are warranted, including the use of protein-enriched foods and drinks. This thesis evaluated the impact of the developed protein-enriched foods and drinks on protein intake and physical performance among older adults. The studies in this thesis were done as part of the Cater with Care® project; a collaboration between the university, care organizations, and partners from the food industry. The industrial partners developed the products, focusing each on different product categories: Carezzo Nutrition developed bread, pastry, and fresh juices and soups; The Kraft Heinz Company focused on long shelf-life and convenience foods; and the Veal Promotion Foundation produced veal meat.
To fit the products to the needs of the target group, interviews with undernourished older adults (at home or hospitalized) and with dietitians were conducted (chapter 2). These interviews showed that undernutrition awareness is low among older adults. To treat undernutrition by changing their eating habits, older adults need to be aware of their health problem, they need to be willing to change, and they need to be able to understand and implement the dietitian’s advices. This process takes time while undernutrition should be treated immediately. For immediate treatment, enriched products could be used, without first creating awareness. According to the interviewees, enriched products should fit within older adults’ eating habits, and have small portion sizes.
To gain insights in food choices of hospitalized older adults (65 years and older) an observational study was conducted. In this study, energy and protein intakes of 80 hospitalized older patients at low and high risk of undernutrition were assessed (chapter 3). Patients who received an energy- and protein-rich menu, because of their risk of undernutrition, were better able to reach the protein and energy targets than patients with a low risk of undernutrition receiving a standard menu. Based on these results we proposed that all hospitalized older adults – both at low and high risk of undernutrition – should receive an energy- and protein-rich menu.
Subsequently, a pilot study was done in a care home and a rehabilitation center with the aim to explore the potential of the developed protein-enriched products to increase protein intake (chapter 4). Participants did not compensate their consumption of regular protein-rich foods (e.g. dairy, cheese) upon the introduction of protein-enriched foods and drinks. The 22 institutionalized elderly (mean age 83 years) consumed 12 gram protein per day more than they did before the intervention. Consequently, more people met the protein target of 1.2 g/kg/d than before the intervention. We concluded that protein-enriched products enabled institutionalized elderly to reach protein intake targets. Furthermore, we gained valuable feedback to improve the assortment of protein-enriched products for the effectiveness study.
In the final study, effects of the protein-enriched products on protein intake and physical performance were studied in a randomized controlled trial during hospitalization and subsequent recovery at home. During the hospital period in which 147 older patients participated, patients that received protein-enriched products increased their protein intake compared to the control group that already received a protein-rich hospital menu (chapter 5). As a result, 79% of the intervention group reached a protein intake of 1.2 g/kg/d, compared to 48% of the control group. Finally, effects of the protein-enriched products were tested at home, for a longer period (chapter 6). Half of the hospital phase participants (n = 75) continued the intervention at home for 12 weeks. The protein-enriched products were successfully implemented in the daily menu of the older adults: the intervention group had a higher average protein intake (1.5 ± 0.6 g/kg/d) than the control group (1.0 ± 0.4 g/kg/d) during the 12-week intervention period. Seventy-two percent of the intervention group reached a protein intake of 1.2 g/kg/d during the 12-week intervention, compared to 31% of the control group. Protein intake of the intervention group was mainly increased by the following protein-enriched products: bread, dairy drinks, dairy desserts, soups, and fruit juices. However, despite the successful improvement of protein intake, we found no added value on physical performance in the first 6 months after hospitalization.
It was concluded that with the protein-enriched familiar foods and drinks, we have a feasible, acceptable, and appetizing long-term strategy to increase protein intake of older adults in various settings. We envisage a beneficial role of these protein-enriched products in combination with physical activity in older adults with lower protein intakes.
|Arts en diëtist samen verantwoordelijk
Vasse, E. ; Wijnans-Aerts, G.J.M. ; Witkamp, R.F. ; Binsbergen, J.J. van - \ 2010
Nederlands Tijdschrift voor Voeding en Dietetiek 65 (2010)4. - ISSN 1875-9955 - p. 7 - 10.
voeding - farmacologie - geneesmiddelen - geneesmiddeleffecten - hart- en vaatziekten - voedingsstof-geneesmiddel interacties - diëtisten - voeding en gezondheid - nutrition - pharmacology - drugs - drug effects - cardiovascular diseases - nutrient drug interactions - dietitians - nutrition and health
Het voorkómen van ongewenste interacties tussen medicatie en voeding zou onderdeel moeten zijn van de behandeling van patiënten met chronische hart- en vaatziekten. De diëtist moet dan wel beschikken over meer kennis over geneesmidddelen.
|Het meten van lichaamssamenstelling in de eerstelijnszorg : bio-impedantie steeds populairder, maar op individueel niveau niet betrouwbaar
Hulshof, P.J.M. - \ 2009
Nederlands Tijdschrift voor Voeding en Dietetiek 64 (2009)5. - ISSN 1875-9955 - p. 7 - 10.
voedingstoestand - lichaamssamenstelling - lichaamsgewicht - diëtisten - lichaamsvet - impedantie - nutritional state - body composition - body weight - dietitians - body fat - impedance
Lichaamssamenstelling is een maat voor de voedingstoestand. Een groot scala aan methoden staat ter beschikking om lichaamssamenstelling te meten. Sommige van deze methoden zijn geschikt voor toepassing in de eerste lijn, zoals antropometrie en bio-impedantie. Andere, meer kostbare en geavanceerde technieken - zoals MRI, CT, DEXA en isotopen-verdunningsmethoden - zijn geschikter voor toepassing in een onderzoeksomgeving. Met name bio-impedantie wordt steeds populairder
Maak kennis met elkaars werkwijze en vakgebied : Vraag het de Expert: Senioren’ bijeenkomsten
Groot, C.P.G.M. de - \ 2009
VoedingsMagazine 22 (2009)5. - ISSN 0922-8012 - p. 21 - 23.
ouderen - gezondheid - diëtisten - gezondheidsbevordering - voeding en gezondheid - elderly - health - dietitians - health promotion - nutrition and health
About 4.2 million people over 55 years of age ('senior citizens') are currently living in the Netherlands, and anticipations are that their number will increase to 6 million by the year 2035. Like for other age groups, behavioural change yields health benefits for older people. Smoking cessation, a healthier diet and more physical exercise have positive health effects. Even if people do not pick up such behavioural change until after the age of 65, that change can still be effective. For example, men who quit smoking when they are 65 years old, live 1.4-2.0 years longer, and women even 2.7-3.7 years. For all people healthy ageing is a precondition for a happy life. Healthy ageing also implies living independently a life of good quality and taking part in society. The chance of realizing that is greater when senior citizens are coached by primary care professionals
|Anamnesemethode: snel en doelmatig? : geautomatiseerde voedingsanamnese voor het vaststellen van energie-inname
Hiemstra, G.K. ; Roos, N.M. de; Vries, J.H.M. de; Leibrandt, A. ; Rasmussen, E. ; Remijnse, T.A. ; Staveren, W.A. van - \ 2005
Nederlands Tijdschrift voor Dietisten 60 (2005)4. - ISSN 0166-7203 - p. 88 - 96.
voedselconsumptie - energieopname - voedselopname - dieetadvisering - vragenlijsten - eetpatronen - diëtisten - patiënten - food consumption - energy intake - food intake - diet counseling - questionnaires - eating patterns - dietitians - patients
Doel van dit onderzoek was: meten van de reproduceerbaarheid van een bestaande voedselfrequentievragenlijst (VVL) bij een groep patiënten met ongewijzigd dieetadvies; meten van verandering in energie-inname bij een groep patiënten met gewijzigde dieetadvies; en evalueren van de bruikbaarheid van VVL bij patiënt en diëtist