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A recipe for improving food intakes in elderly hospitalized patients.

BACKGROUND & AIMS: The aim of this study was to compare food wastage and intake between the normal hospital menu and one where more energy dense but smaller portions were provided. METHODS: This study was carried out on an Elderly Rehabilitation ward in a University hospital. Patients were randomly allocated to receive either a normal or a reduced portion size fortified menu for a 14 day cycle and then swapped-over at the end of each cycle for the 56 day study. One group received a cooked breakfast and normal menus throughout the study. RESULTS: All the menu combinations could meet the patients recommended intake. The fortified menu provided 14% more energy than the normal menu. Food wastage was highest in the cooked breakfast group (32%) and lowest in the Fortified group (27%). The total weight of wasted food was less than in the previous study. Nutritional intakes were 25% higher on the fortified menu compared with the normal menu. The mean protein intakes were still below that recommended. All patients had higher energy intakes on the Fortified menu compared with their intake on the normal menu despite being served a lower weight of food. CONCLUSIONS: We conclude from our own data and that of others that it is possible for elderly patients to achieve their nutritional targets using a combination of smaller portions of increased energy and protein density and between-meal snacks. The needs of other groups of patients also needs to be assessed in a similar way to make hospital food appropriate to the needs of the sick.

Aged↗

Hospital food.

Explore the source record for details and available documents.

Eating↗

Promotions to increase lower-fat food choices among students in secondary schools: description and outcomes of TACOS (Trying Alternative Cafeteria Options in Schools).

OBJECTIVES: (1) To describe promotional activities, particularly student-led, targeting lower-fat à la carte foods that were conducted in secondary schools; and (2) to describe the relationships between the number and duration of total promotional activities for lower-fat à la carte foods and cafeteria sales of such foods over two years. DESIGN: Promotional activities were implemented in schools that were randomised to the intervention condition of a larger, two-year, school-based, randomised, controlled nutrition intervention trial. SETTING: Ten Minnesota secondary schools. SUBJECTS: Students and school faculty, school food-service and research staff (measured at the school level). RESULTS: Over two years, 181 promotions were implemented (n=49 in Year 1 and n=132 in Year 2). In Year 1, the number of promotions conducted in schools was significantly associated with percentage lower-fat food sales. In Year 2, the duration of promotions was significantly associated with percentage lower-fat food sales. CONCLUSIONS: Collaborative efforts among students, school food-service staff and research staff can be successful in implementing a large number of nutrition-related, school-wide promotional activities. These efforts can increase the sales of lower-fat foods in à la carte areas of school cafeterias.

Adolescent↗

Maximizing foodservice in an inpatient hospice setting.

The philosophy of maximizing patient comfort and enhancing quality of life impacts on all aspects of foodservice in an inpatient hospice setting. The foodservice department's focus in the palliative care environment is to meet patients' physical, psychological, and social needs. The menu incorporates variety and comfort foods to meet the special requests of hospice patients. Food production and delivery provides for flexibility in meal preferences and meal serving times. Finally, sanitation standards and inservice training extend beyond the main foodservice operation to include the hospice "family" kitchen to protect the hospice patient from food-borne infections.

Efficiency, Organizational↗

Meals identified as healthy choices on restaurant menus: an evaluation of accuracy.

This study evaluated the accuracy of restaurant entrees identified as healthy choices on menus at two fast food restaurant chains. Entrees were purchased at two different locations of each restaurant 35 days apart. Samples were processed in duplicate for total fat contents, sodium analysis, and adiabatic bomb calorimeter for total energy. t-Tests compared (a) the mean experimental values to claimed values for fat, energy, and sodium, (b) nutritional content at different locations for the same restaurant, and (c) the mean experimental values for fat, energy, and sodium levels to the recommended Daily Values. Results indicate that entrees identified as healthy choices at these selected restaurants are in fact healthy choices, are accurately labeled, and are consistent among different locations of the same restaurant chains.

California↗

Nutritional management of the female with phenylketonuria during pregnancy.

This paper discusses a rational approach to appropriate nutritional management of the pregnant woman with phenylketonuria (PKU). Special food items, including new formulas and low-phenylalanine products, as well as allowable nutral foods are described. Particular emphasis is placed on the nutritional adequacy of this PKU diet during pregnancy. Such a diet should be palatable and tolerated well and should also take into consideration important economic, cultural, and psychological aspects. Clinics caring for PKU individuals should be so prepared because many otheir females are approaching childbearing age.

Amino Acids, Essential↗

Estimation of available dietary iron.

Dietary iron requirements are dependent on the amount and availability of food iron ingested. On the basis of recent studies of food iron absorption employing extrinsic tag techniques, the availability of heme iron has been defined and estimates of the availability of nonheme iron based on the amounts of enhancing substances appear possible. A model has been developed whereby the availability of iron in a given meal may be estimated. Calculations are made on a meal basis of 1) the amount of heme iron and its availability, and 2) the amount of nonheme iron and its availability as influenced by the meal's content of enhancing factors. Examples of these calculations are provided.

Absorption↗

A simple method to estimate neutral detergent fiber content of typical daily menus.

The purpose of this research was to develop a simple method to estimate daily intakes of the insoluble fraction of dietary fiber, that portion most effective in increasing stool weight and defecation frequency and decreasing gastrointestinal transit time. Neutral detergent fiber (NDF) contents of 53 foods were determined by analysis and used to calculate the NDF content of typical institutional menus; mean NDF content (n = 14 days) was 10.8 +/- 1.4 g/day. Average NDF content of one serving of fruits and vegetables was approximately 1 g, of the refined grain products, approximately 0.5 g. Estimating daily NDF content of the menus was simplified without a loss of accuracy by substituting the mean NDF content of one serving of refined grains, vegetables, and fruits for the actual values, and by eliminating foods present at less than 1/4 of a serving. Crude fiber was a poor predictor of the NDF in a menu.

Diet↗

An audit of meal provision in an elderly care hospital.

OBJECTIVES: To estimate the nutritional provision to elderly patients, to compare with United Kingdom (UK) Government dietary reference values (DRV), to modify food provision to correct any major deficiencies, and to evaluate these modifications for their acceptability and consumption. METHODS: Energy, principal macro nutrients, vitamins, minerals and non-starch polysaccharide (NSP) and dietary fibre provision were measured prospectively throughout the menu cycle in a 72-bedded hospital for patients over 65 years before and after dietary supplementation with both energy-rich foods and high-fibre cakes. RESULTS: At baseline, mean energy provision was 1472(320) kcal, 6153(1340) kJ, representing less than the estimated average requirement (EAR) for elderly males and females. Fat provided 49% of total energy, daily protein provision exceeded the EAR for males and females (16% energy) and provision of the micro nutrients thiamine, riboflavin, vitamins B12, C, A, calcium and iron met or exceeded these recommendations. Vitamin B6 provision was only adequate for females. Provision of niacin, folate, vitamin D, NSP and dietary fibre was also below recommendations. Supplementation allowed energy provision to reach the target EAR and fibre provision the reference nutrient intake. CONCLUSIONS: Nutritional provision in hospital is meeting some, but not all, available Government standards for nutritional guidelines in elderly people. Increased fibre provision was poorly tolerated, but dietary supplementation with energy-rich foods was well tolerated.

Aged↗