Modified Texture Food Use is Associated with Malnutrition in Long Term Care: An Analysis of Making the Most of Mealtimes (M3) Project

• Published in: The Journal of nutrition, health & aging health & aging, 2018-10, Vol.22 (8), p.916-922
• Main Authors: Vucea, V., Keller, Heather H., Morrison, J. M., Duizer, L. M., Duncan, A. M., Carrier, N., Lengyel, C. O., Slaughter, S. E., Steele, C. M.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Aging; Canada - epidemiology; Cross-Sectional Studies; Diet - statistics & numerical data; Female; Food; Geriatrics/Gerontology; Homes for the Aged; Humans; Long term health care; Long-Term Care; Male; Malnutrition; Malnutrition - epidemiology; Meals; Medicine; Medicine & Public Health; Neurosciences; Nutrition; Nutrition Assessment; Nutritional Status; Older people; Prevalence; Primary Care Medicine; Quality of Life Research; Risk Factors; Weight Loss
• ISSN: 1279-7707; 1760-4788
• DOI: 10.1007/s12603-018-1016-6

Objective Modified texture food (MTF), especially pureed is associated with a high prevalence of under-nutrition and weight loss among older adults in long term care (LTC); however, this may be confounded by other factors such as dependence in eating. This study examined if the prescription of MTF as compared to regular texture food is associated with malnutrition risk in residents of LTC homes when diverse relevant resident and home-level covariates are considered. Design Making the Most of Mealtimes (M3) is a cross-sectional multi-site study. Setting 32 LTC homes in four Canadian provinces. Participants Regular (n= 337) and modified texture food consumers (minced n= 139; pureed n= 68). Measurements Malnutrition risk was determined using the Mini Nutritional Assessment short-form (MNA-SF) score. The use of MTFs, and resident and site characteristics were identified from health records, observations, and standardized assessments. Hierarchical linear regression analyses, accounting for clustering, were performed to determine if the prescription of MTFs is associated with malnutrition risk while controlling for important covariates, such as eating assistance. Results Prescription of minced food [F(1, 382)=5.01, p=0.03], as well as pureed food [F(1, 279)=4.95, p=0.03], were both significantly associated with malnutrition risk among residents. After adjusting for age and sex, other significant covariates were: use of oral nutritional supplements, eating challenges (e.g., spitting food out of mouth), poor oral health, and cognitive impairment. Conclusions Prescription of minced or pureed foods was significantly associated with the risk of malnutrition among residents living in LTC facilities while adjusting for other covariates. Further work needs to consider improving the nutrient density and sensory appeal of MTFs and target modifiable covariates.