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Meal patterns in relation to energy and protein intake in older adults in home health care
Örebro University, School of Medical Sciences.
Örebro University, School of Medical Sciences.ORCID iD: 0000-0002-0362-0008
Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
2020 (English)In: Clinical Nutrition ESPEN, E-ISSN 2405-4577, Vol. 35, p. 180-187Article in journal (Refereed) Published
Abstract [en]

Background & aims: Inadequate dietary intake is common in frail elderly people, however knowledge of meal patters and their relation to dietary intake is scarce, but is important for planning meals and nutritional prevention and interventions. The aim of this study was to describe meal patterns and the relation to energy and protein intake in elderly people in home health care.

Methods: In this cross-sectional study, 69 men and women >= 65 years old with a lasting need for home health care were included. A 24-hour recall was used to analyse meal patterns as well as intake of energy and protein. Meal patterns were analysed in terms of number of eating occasions, time of the first, and the last meal each day, length of the overnight fast, timing of the energy and protein intake, energy content and time for the largest meal of the day, and classification as an early or late eater.

Results: In this population, 77% had four or five eating occasions per day. The median length of the overnight fast was 13 h and 87% of participants had an overnight fast of >11 h. Regarding the timing of the energy and protein intake, there were three peaks: in the morning, mid-day and in the evening. The mid-day meal was the most important eating occasion regarding total energy intake; mid-day was also the time of the day when most participants had a protein intake >20 g. The majority (60%) of participants were categorized as early eaters. Neither the number of eating occasions nor the length of the overnight fast was correlated with energy or protein intake; however, a large energy intake from the largest meal of the day was significantly correlated with an increased total energy and protein intake, indicating that daily energy intake is stimulated by at least one large meal per day.

Conclusions: This study showed that one large meal a day had more impact on daily energy and protein intake than did several eating occasions or a short overnight fast in elderly people in home health care. Further research is needed to elucidate how to stimulate large energy intake at main meals to stimulate daily energy and protein intake. (c) 2019 European Society for Clinical Nutrition and Metabolism.

Place, publisher, year, edition, pages
Elsevier, 2020. Vol. 35, p. 180-187
Keywords [en]
Meal patterns, Energy intake, Protein intake, Overnight fast, Elderly people
National Category
Nutrition and Dietetics
Identifiers
URN: urn:nbn:se:oru:diva-79879DOI: 10.1016/j.clnesp.2019.10.003ISI: 000509739500026PubMedID: 31987114Scopus ID: 2-s2.0-85074411085OAI: oai:DiVA.org:oru-79879DiVA, id: diva2:1393078
Available from: 2020-02-14 Created: 2020-02-14 Last updated: 2023-02-06Bibliographically approved
In thesis
1. Nutritional status in a functional perspective: A study in a cohort of older people in home health care
Open this publication in new window or tab >>Nutritional status in a functional perspective: A study in a cohort of older people in home health care
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

High age is a risk factor for most acute and chronic diseases, injuries and function disabilities, and hence, an important risk factor for nutritional problems. A great deal of elderly health care in Sweden are performed in the patient’s home environment and home health care has been transformed to more advanced medical care the last decades.

The aim of this thesis was to comprehensively describe the nutritional status and its change over time in a population of older people receiving home health care. The aim includes to propose a framework for investigating and analysing the nutritional status in older people.

Nutritional status was studied at enrolment in home health care and regularly followed up for three years. Patients that were 65 years or older and needed home health care for at least three months between 2012 and 2017 were asked to join the study, resulting in 69 participants (64%women).

Data collection and analysis of the nutritional status was based on the proposed model for assessing the nutritional status in a comprehensive functional perspective (paper 1). The model comprises four domains that affect the nutritional status and functional outcome in a bidirectional way. In paper 2 we concluded that malnutrition, sarcopenia, frailty and dehydration are highly prevalent in the population and the most important indicators were loss of appetite and dehydration. This was confirmed in paper 3, were nutritional status was analysed with a statistical approach. A total of 103 indicators of nutritional status were reduced to 19 that were suggested to be primary investigated. Also, the paper empirically confirmed the relationship within as well as between the domains suggested in paper 1. Finally, we studied meal pattern, being a part of one of the domains (paper 4). We found indications that presence of at least one large meal (high energy intake) per day had more impact on the total daily energy and protein intake than more eating occasions during the day. 

Place, publisher, year, edition, pages
Örebro: Örebro University, 2021. p. 84
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 231
Keywords
Nutritional status, nutrition, home health care, older people, geriatric, meal pattern, dehydration, appetite
National Category
General Practice
Identifiers
urn:nbn:se:oru:diva-88959 (URN)978-91-7529-372-1 (ISBN)
Public defence
2021-02-26, Örebro universitet, Campus USÖ, Södra Grev Rosengatan 32, Örebro, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2021-01-26 Created: 2021-01-26 Last updated: 2021-02-10Bibliographically approved

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Engelheart, StinaBrummer, Robert Jan

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