Effects of food fortification on nutritional and functional status in frail elderly nursing home residents at risk of malnutrition.
OBJECTIVE
Malnutrition is a frequent problem in the elderly and is associated with an impaired functional status and higher morbidity and mortality. In this study we evaluated the effect of a 12-wk nutritional intervention with fortified food on nutritional and functional status in nursing home residents at risk of malnutrition.


METHODS
Nutritional status was assessed with the Mini Nutritional Assessment. Body composition was measured with bioelectrical impedance analysis. Functional status was assessed with handgrip strength, peak flow, the Barthel Index, and the Physical Functioning component of the Short Form 36 questionnaire. The residents were assigned to a group receiving the standard food of the nursing home or a group with a protein- and energy-enriched diet and snacks.


RESULTS
Sixty-five nursing home residents were included; 62 were at nutritional risk and 3 were severely malnourished according to the Mini Nutritional Assessment. Protein intake was significantly higher in the group on the enriched diet, whereas energy intake did not differ from the group on the standard diet. Both groups significantly improved most nutritional and body composition parameters during the intervention period. We did not observe convincing improvements in muscle function. Furthermore, the Barthel Index and the Physical Functioning component of the Short Form 36 questionnaire declined in all participants.


CONCLUSIONS
Standard food in this nursing home provided sufficient energy and macronutrients. Provision of snacks was not effective in increasing energy intake. Although nutritional status improved, functional status did not increase as a consequence. Functional frailty in this study population seems to be influenced more by age-related morbidity and immobilization than by nutritional intake.
Smoliner
Christine
C
Medizinische Klinik mit Schwerpunkt Gastroenterologie, Hepatologie und Endokrinologie, Charité Universitätsmedizin Berlin, Berlin, Germany.
Norman
Kristina
K
Scheufele
Ramona
R
Hartig
Wolfgang
W
Pirlich
Matthias
M
Lochs
Herbert
H
D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition / Q000502:physiology; D004044:Dietary Proteins / Q000008:administration & dosage*; D017097:Electric Impedance; D002149:Energy Intake / Q000502:physiology; D005260:Female; D005527:Food, Fortified; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods; D018737:Hand Strength / Q000502:physiology; D006305:Health Status Indicators; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000401:mortality / Q000517:prevention & control*; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D009735:Nursing Homes; D015596:Nutrition Assessment; D009747:Nutritional Physiological Phenomena / Q000502:physiology*; D009752:Nutritional Status; D012307:Risk Factors; D011795:Surveys and Questionnaires
D004044:Dietary Proteins