Foods fortified in protein increase the protein intake of the elderly living in institutions

Can fortifying familiar foods with protein help treat malnutrition in the elderly? Researchers investigated this question and the results were published in the magazine J Nutr Health Aging.

Combating malnutrition in the elderly has many obstacles, including physiological and gustatory ones.

Adding extra portions of food or using oral nutritional complements rich in protein is not always the best solution as older people tend to have smaller appetites and specific tastes. Looking for alternative solutions, scientists from the University of Wageningen developed four fortified versions of common foods usually enjoyed by the elderly and very easy to consume: bread (slightly cooked/well cooked), soup (mushroom, broccoli or tomato), fruit juices (orange, apple/raspberry or apple/blackcurrant) and mashed potatoes.

22 subjects living in institutions aged 83 on average tested those products during 10 days. The goal was to evaluate the efficiency of these foods in fulfilling protein recommendations of 1.2g of proteins/kg of their weight/day.

Meat, naturally rich in protein, complemented the menu. 

An 11.8g of protein increase per day in 10 days.

Throughout the experience, the consumption of bread and fruit juices fortified in protein increased, whilst consumption of soup remained stable. The puree and the meat were not consumed as much, probably due to the overwhelming amount of choice the patients were offered.

Protein intake increased by 11.8g/day on average between the beginning and the end of the intervention, so about 0.18g/kg of weight/day. Energy, fat and carbohydrate intake did not change.

Before the intervention, 19 out of the 22 subjects had protein intakes of 0.8g/kg of weight/day on average and 4 subjects reached the recommended 1.2g/kg of weight/day. By the end of the experiment, all 22 subjects obtained 0.8g/kg of weight/day and 9 subjects reached 1.2g/kg of weight/day.

Breakfast and evening snacks should be favored.

Throughout the 6 moments of food intake during the day, dinner allowed for the greatest consumption of protein, with an average of 29g of protein. However, these quantities remained stable between the beginning and the end of the intervention.

Two meals saw increases in protein consumption between the beginning and the end of the intervention: breakfast, where consumption increased from 12.2g to 16g, and the evening snack, where it increased from 2.6g to 4.8g.

This 10 day intervention shows that protein intake by the elderly can efficiently be increased with the help of some products fortified in protein

These products could help older people reach 0.8g/kg of weight/day, or even more (1.2g/kg/d) for some.

The combination of different types of products fortified in protein (bread, juice, soup…) has many assets: it can allow an increase in meals, lets the residents to choose what they want to eat, and can facilitate the work of the staff.

This alternative lifts the obstacle of having to give patients extra portions or to have to use oral nutritional complements. It leads to protein intake equal or even superior to those methods.

Finally, the patients showed that the bread and the juices fortified in protein were enjoyable. https://www.ncbi.nlm.nih.gov/pubmed/28112772