Minimal effect on energy intake by additional evening meal for frail elderly service flat residents--a pilot study.
BACKGROUND
Nutritional problems are common in frail elderly individuals receiving municipal care.


OBJECTIVE
To evaluate if an additional evening meal could improve total daily food intake, nutritional status, and health-related quality of life (HRQOL) in frail elderly service flat (SF) residents.


METHODS
Out of 122 residents in two SF complexes, 60 subjects agreed to participate, of which 49 subjects (median 84 (79-90) years, (25th-75th percentile)) completed the study. For six months 23 residents in one SF complex were served 530 kcal in addition to their regular meals, i.e. intervention group (I-group). Twenty-six residents in the other SF building were controls (C-group). Nutritional status, energy and nutrient intake, length of night time fast, cognitive function and HRQOL was assessed before and after the intervention.


RESULTS
At the start, the Mini Nutritional Assessment classified 27% as malnourished and 63% as at risk for malnutrition, with no difference between the groups. After six months the median body weight was unchanged in the I-group, +0.6 (-1.7-+1.6) kg (p=0.72) and the C-group -0.6 (-2.0-+0.5) kg (p=0.15). Weight change ranged from -13% to +15%. The evening meal improved the protein and carbohydrate intake (p<0.01) but the energy intake increased by only 180 kcal/day (p=0.15). The night time fast decreased in the I-group from 15.0 (13.0-16.0) to 13.0 (12.0-14.0) hours (p<0.05). There was no significant difference in cognitive function or HRQOL between the groups.


CONCLUSIONS
Nine out of ten frail elderly SF residents had nutritional problems. Serving an additional evening meal increased the protein and carbohydrate intake, but the meal had no significant effect on energy intake, body weight or HRQOL. The variation in outcome within each study group was large.
Odlund Olin
A
A
Department of Nursing Development, Karolinska University Hospital, Stockholm, Sweden. ann.odlund.olin@ki.se
Koochek
A
A
Cederholm
T
T
Ljungqvist
O
O
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D003071:Cognition / Q000502:physiology; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D004044:Dietary Proteins / Q000008:administration & dosage*; D002149:Energy Intake / Q000502:physiology*; D005247:Feeding Behavior; D005260:Female; D016330:Frail Elderly; D006299:Health Services for the Aged; D016852:Housing for the Elderly; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000453:epidemiology* / Q000517:prevention & control*; D009752:Nutritional Status; D010865:Pilot Projects; D011788:Quality of Life; D015430:Weight Gain
D004040:Dietary Carbohydrates; D004044:Dietary Proteins