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.
Subject(s)
Energy Intake , Feeding Behavior , Malnutrition/prevention & control , Aged , Body Weight/physiology , Dietary Carbohydrates/administration & dosage , Dietary Fats/administration & dosage , Dietary Proteins/administration & dosage , Female , Humans , Male , Netherlands , Nursing Homes , Nutrition Assessment , Nutritional Status , Risk AssessmentABSTRACT
In many Dutch nursing homes, meals are not served in a cozy setting. This study makes an inventory of project models used in nursing homes to improve the ambiance during mealtimes and identifies the beneficial factors (incentives) and barriers of the meal ambiance models. Three different meal ambiance project models were found: restaurant, cooking on the nursing ward and bulkmeals. Each of the three models was experienced as a success by the nursing home inhabitants, the nursing home management and the staff. They pointed out that the cooperation and motivation of staff, sufficient space and management support were the most important beneficial factors of the project models. The most important barriers were absence of cooperation and motivation of the staff, insufficient finances and insufficient personnel.
