Caregiver feeding senior with dementia

Concentrated, nutrient-dense food products blended on site in nursing homes provide sufficient calorie intake for residents with swallowing difficulties, or dysphagia, a study supported by Nestlé Health Science has found.

These modified-texture diets also have preparation time and cost advantages over homemade, the scientists, from Spanish health institutions, say.

It’s estimated that half of elderly people living in nursing homes and other group settings live with dysphagia, and preventing malnutrition can be challenging in these cases, the researchers said. The investigation described the nutritional and microbiological properties and costs of two food types prepared in different ways: facility-made pureed food; concentrated nutrient-dense commercial food products that are hand-blended on site; and nutrient-dense commercial food products prepared using an automatic blender on site.

Observations were made in three nursing homes in Spain among 62 older adult participants. Study subjects were in stable clinical condition, with 43% experiencing malnourishment, and 79% shown to have a good appetite. Data were collected on demographic and clinical characteristics, modified-texture diet adherence, symptoms relating to dysphagia during the meal, appetite, and kitchen resources for meal preparation. Nursing homes were chosen for availability and experience in on-site food preparation and the experience of dietary staff in prescribing modified-texture diets.

Fully 95% of residents offered the homemade, pureed food ate what was served. But calorie counts consumed in this group averaged 88 per portion — far lower than the groups consuming the nutrient-dense foods. 

Participants served nutrient-dense commercial food blended by hand consumed 90% of their food and averaged 288 calories per portion. And the same commercial foods processed in a commercial mixer elicited an 80% consumption rate and an average 287 calories per portion. Portions in nursing homes that served homemade foods were smaller in size when compared with facilities that offered commercial food, perhaps influencing the final portion amounts consumed, the researchers noted.

A significant difference was observed between the amount of time needed to puree the homemade food — 11.2 minutes — versus 1.7 minutes for the hand-blended commercial food and 1.6 minutes for commercial food mixed using an automatic blender.

In addition, costs per portion and the cost per 100 grams served were lower for the commercial food diets than for the homemade ones, the researchers wrote. No potentially harmful microorganisms were found in any of the meals.

Concentrated, nutrient-dense food products, particularly those produced using an automatic food blender, can help ensure a high caloric intake and allow quick and safe food preparation, the authors concluded. 

The study was led in part by an endocrinologist, a catering manager, a bromatologist, and a food technologist who also participated in the interpretation of study results. 

Full findings were published online ahead of print in the journal Nutrición Hospitalaria.