title: Effect of family-style meals on energy intake and risk of malnutrition in dutch nursing home residents: a randomized controlled trial.
abstract: BACKGROUND
  Social facilitation and meal ambiance have beneficial effects on food intake in healthy adults. Extrapolation to the nursing home setting may lead to less malnutrition among the residents. Therefore, we investigate the effect of family-style meals on energy intake and the risk of malnutrition in Dutch nursing home residents.
  
  
  METHODS
  In 2002 and 2003, a randomized controlled trial was conducted among 178 residents (mean age 77 years) in five Dutch nursing homes. Within each home, two wards were randomized into an intervention (n = 94) and a control group (n = 84). For 6 months, the intervention group received their meals family style, and the control group received the usual individual preplating services. Outcome measures were intakes of energy (kJ), carbohydrates (g), fat (g), and protein (g) and Mini Nutritional Assessment (MNA) score (0-30).
  
  
  RESULTS
  The change in daily energy intake between the control and intervention group differed significantly (991 kJ; 95% confidence interval [CI], 504-1479). The difference in intake of macronutrients was 29.2 g (95% CI, 13.5-44.9) for carbohydrate, 9.1 g (95% CI, 2.9-15.2) for fat, and 8.6 g (95% CI, 3.4-13.6) for protein. The percentage of residents in the intervention group classified by the MNA as malnourished decreased from 17% to 4%, whereas this percentage increased from 11% to 23% in the control group.
  
  
  CONCLUSIONS
  Family-style meals stimulate daily energy intake and protect nursing home residents against malnourishment. Therefore, replacement of the preplating meal services with family-style meals in nursing homes is recommended.
authors.affiliation: Division of Human Nutrition, Wageningen University, The Netherlands. Kristel.Nijs@wur.nl
authors.forename: Kristel A N D
authors.initials: KA
authors.lastname: Nijs
authors.forename: Cees
authors.initials: C
authors.lastname: de Graaf
authors.forename: Els
authors.initials: E
authors.lastname: Siebelink
authors.forename: Ybel H
authors.initials: YH
authors.lastname: Blauw
authors.forename: Vincent
authors.initials: V
authors.lastname: Vanneste
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Kok
authors.forename: Wija A
authors.initials: WA
authors.lastname: van Staveren
mesh_terms: D000368:Aged; D001835:Body Weight / Q000502:physiology; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000517:prevention & control*; D009426:Netherlands; D009735:Nursing Homes; D015596:Nutrition Assessment; D009752:Nutritional Status; D018570:Risk Assessment
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004044:Dietary Proteins