Repeated assessment of energy and nutrient intake in 52 nursing home residents

Studies in Swedish nursing-home patients have shown a high prevalence of protein-energy malnutrition. One potential cause for this may be low food intake.

To examine the intake of energy and nutrients in the residents of a nursing home; to investigate changes in dietary intake and body-weight over time and to analyze two-year-mortality.

Explorative study. Five-day weighed assessment of food intake repeated three times during 1.5 years. Analysis of body composition at baseline and recording of body weight every third month. Analysis of two-year mortality.

Fifty-two residents had three complete dietary assessments. Mean age 84 +/- 7 years, 79% were female. Mean body weight was stable at 61 kg. Mean energy intake at baseline was 1501 kcal/d (25 kcal/kg/d) and mean protein intake was 53 g/d (0.9 g/kg/d). Mean intake of vitamin D, vitamin E, folic acid, selenium and dietary fibre was less than 60% of recommended. At the second assessment intake of energy and many nutrients was higher than at baseline, but at the third assessment intake had decreased. There was no correlation between energy intake and body weight over time. Two-year mortality was 52%. Male gender and low body-weight constituted an increased risk of mortality. Comparing survivors and non-survivors showed that the mean body weight was 9 kg higher in the survivors throughout the study (p=0.02). This group had a relatively lower fat free mass and higher fat mass than the non-survivors. The difference in body composition was only seen in females, possibly due to the low number of males. The survivors had higher intakes of most nutrients but this reached significance only for a few of them. The non-survivors had significantly higher intakes of sucrose.

Intake of energy and many nutrients was low in these nursing-home patients, and decreased further after one year, without any change in body weight. The significant positive relation between energy intake and body weight at group level disappeared when analyzing data at an individual level. Male gender and low body weight were associated with increased risk of mortality.