Advertisement

The journal of nutrition, health & aging

, Volume 20, Issue 2, pp 178–184 | Cite as

Effectiveness of food-based fortification in older people a systematic review and meta-analysis

  • J. C. Morilla-Herrera
  • F. J. Martín-Santos
  • J. Caro-Bautista
  • C. Saucedo-Figueredo
  • S. García-Mayor
  • Jose Miguel Morales-AsencioEmail author
Article

Abstract

Background

Early intervention with nutritional support has been found to stop weight loss in older people malnourished or at risk of malnutrition. Enriched food could be a more attractive alternative to improve meals, than conventional oral nutritional supplements.

Aims

To determine the effectiveness of food-based fortification to prevent risk of malnutrition in elderly patients in community or institutionalized elderly patients.

Methods

A systematic review was conducted of randomized controlled trials, quasi-experimental, and interrupted time series including a longitudinal analysis.

Participants

Elderly patients who are institutionalized, hospitalized or community-dwelling, with a minimum average age of 65 years. All type of patient groups, with the exception of people in critical care, or those who were recovering from cancer treatment, were included.

Intervention

Studies had to compare food-based fortification against alternatives. Studies that used oral nutritional supplementation such as commercial sip feeds, vitamin or mineral supplements were excluded. The search was conducted in Cochrane, CINAHL, PubMed, EMBASE, LILACS, and Cuiden. An independent peer review was carried out.

Results

From 1011 studies obtained, 7 were included for the systematic review, with 588 participants. It was possible to perform meta-analysis of four studies that provided results on caloric and protein intake. Food-based fortification yielded positive results in the total amount of ingested calories and protein. Nevertheless, due to the small number of participants and the poor quality of some studies, further high quality studies are required to provide reliable evidence.

Implications for practice

Despite the limited evidence, due to their simplicity, low cost, and positive results in protein and calories intake, simple dietary interventions based on the food-based fortification or densification with protein or energy of the standard diet could be considered in patients at risk of malnutrition.

Keywords

Food fortified nutrition older people systematic review 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Elmadfa I, Meyer AL. Body composition, changing physiological functions and nutrient requirements of the elderly. Ann Nutr Metab 2008;52 Suppl 1:2–5. doi: 10.1159/000115339CrossRefPubMedGoogle Scholar
  2. 2.
    Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56:M146–156.CrossRefPubMedGoogle Scholar
  3. 3.
    Meijers JMM, Halfens RJG, van Bokhorst-de van der Schueren MAE, et al. Malnutrition in Dutch health care: prevalence, prevention, treatment, and quality indicators. Nutrition 2009;25:512–519. doi: 10.1016/j.nut.2008.11.004CrossRefPubMedGoogle Scholar
  4. 4.
    Shepherd A. Nutrition through the life span. Part 3: adults aged 65 years and over. Br J Nurs 2009;18:301–302, 304–307.CrossRefGoogle Scholar
  5. 5.
    Guigoz Y. The Mini Nutritional Assessment (MNA) review of the literature—What does it tell us? J Nutr Health Aging 2006;10:466–85; discussion 485–7. doi: 17183419PubMedGoogle Scholar
  6. 6.
    Arrowsmith H. A critical evaluation of the use of nutrition screening tools by nurses. Br J Nurs 2000;8:1483–90.CrossRefGoogle Scholar
  7. 7.
    Barton AD, Beigg CL, Macdonald IA, Allison SP (2000) A recipe for improving food intakes in elderly hospitalized patients. Clin Nutr 2000;19:451–4. doi: 10.1054/clnu.2000.0149CrossRefPubMedGoogle Scholar
  8. 8.
    Lorefält B, Wissing U, Unosson M. Smaller but energy and protein-enriched meals improve energy and nutrient intakes in elderly patients. J Nutr Health Aging 2005;9:243–7.PubMedGoogle Scholar
  9. 9.
    Smoliner C, Norman K, Scheufele R, et al. Effects of food fortification on nutritional and functional status in frail elderly nursing home residents at risk of malnutrition. Nutrition 2008;24:1139–44. doi: 10.1016/j.nut.2008.06.024CrossRefPubMedGoogle Scholar
  10. 10.
    Wong A, Burford S, Wyles CL, et al. Evaluation of strategies to improve nutrition in people with dementia in an assessment unit. J Nutr Health Aging 2008;12:309–312.CrossRefPubMedGoogle Scholar
  11. 11.
    Review Manager (RevMan) [Computer program]. The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark, 2014Google Scholar
  12. 12.
    de Jong N. Sensible Aging: Using Nutrient-Dense Foods and Physical Exercise With the Frail Elderly. Nutrition today 2001;36:202–207.CrossRefGoogle Scholar
  13. 13.
    Weekes CE, Emery PW, Elia M. Dietary counselling and food fortification in stable COPD: a randomised trial. Thorax 2009;64:326–331. doi: 10.1136/thx.2008.097352CrossRefPubMedGoogle Scholar
  14. 14.
    Castellanos VH, Marra MV, Johnson P. Enhancement of select foods at breakfast and lunch increases energy intakes of nursing home residents with low meal intakes. J Am Diet Assoc 2009;109:445–51. doi: 10. 1016/j.jada.2008.11.035CrossRefPubMedGoogle Scholar
  15. 15.
    Gall MJ, Grimble GK, Reeve NJ, Thomas SJ. Effect of providing fortified meals and between-meal snacks on energy and protein intake of hospital patients. Clin Nutr 1998;17:259–64.CrossRefPubMedGoogle Scholar
  16. 16.
    Odlund Olin A, Armyr I, Soop M, et al. Energy-dense meals improve energy intake in elderly residents in a nursing home. Clin Nutr 2003;22:125–31.CrossRefPubMedGoogle Scholar
  17. 17.
    Mcwhirter JP, Pennington CR. A comparison between oral and nasogastric nutritional supplements in malnourished patients. Nutrition 1996;12:502–6.CrossRefPubMedGoogle Scholar
  18. 18.
    Beattie AH, Prach AT, Baxter JP, Pennington CR. A randomised controlled trial evaluating the use of enteral nutritional supplements postoperatively in malnourished surgical patients. Gut 2000;46:813–818.PubMedCentralCrossRefPubMedGoogle Scholar
  19. 19.
    Stratton RJ, Ek A-C, Engfer M, et al. Enteral nutritional support in prevention and treatment of pressure ulcers: a systematic review and meta-analysis. Ageing Res Rev 2005;4:422–450. doi: 10.1016/j.arr.2005.03.005CrossRefPubMedGoogle Scholar
  20. 20.
    Milne AC, Avenell A, Potter J. Meta-analysis: protein and energy supplementation in older people. Ann Intern Med 2006;144:37–48.CrossRefPubMedGoogle Scholar
  21. 21.
    Fiatarone Singh MA, Bernstein MA, Ryan AD, et al. The effect of oral nutritional supplements on habitual dietary quality and quantity in frail elders. J Nutr Health Aging 2000;4:5–12.PubMedGoogle Scholar
  22. 22.
    Beaufrère AM, Neveux N, Patureau Mirand P, Buffière C, Marceau G, Sapin V, Cynober L, Meydinal-Denis D. Long-term intermittent glutamine supplementation repairs intestinal damage (structure and functional mass) with advanced age: assessment with plasma citrulline in a rodent model. J Nutr Health Aging. 2014;18(9):814-9.CrossRefGoogle Scholar
  23. 23.
    Kesse-Guyot E, Andreeva VA, Touvier M, Jeandel C, Ferry M, Hercberg S, Galan P; SU. VI. MAX 2 Research Group.. Overall and abdominal adiposity in midlife and subsequent cognitive function. J Nutr Health Aging. 2015;19(2):183–9.CrossRefPubMedGoogle Scholar
  24. 24.
    Dunne A. Malnutrition: supplements and food fortification in the older population. Br J Community Nurs 2007;12:494–499.CrossRefPubMedGoogle Scholar
  25. 25.
    Cruz-Jentoft AJ, Calvo JJ, Durán JC, et al. Compliance with an oral hyperproteic supplement with fibre in nursing home residents. J Nutr Health Aging 2008;12:669–73.CrossRefPubMedGoogle Scholar

Copyright information

© Serdi and Springer-Verlag France 2016

Authors and Affiliations

  • J. C. Morilla-Herrera
    • 1
    • 7
  • F. J. Martín-Santos
    • 2
    • 7
  • J. Caro-Bautista
    • 3
  • C. Saucedo-Figueredo
    • 4
  • S. García-Mayor
    • 5
  • Jose Miguel Morales-Asencio
    • 6
    Email author
  1. 1.Residential Care UnitDistrict of Primary Health Care of MálagaMálagaSpain
  2. 2.Nursing ServicesDistrict of Primary Health Care of MálagaMálagaSpain
  3. 3.Community Nursing Services. Health Centre El LimonarDistrict of Primary Health Care of MálagaMálagaSpain
  4. 4.District of Primary Health Care Costa del SolCosta del SolSpain
  5. 5.Faculty of Health SciencesUniversity of MálagaMálagaSpain
  6. 6.Research and Evidence Based Health Care. Faculty of Health SciencesUniversity of MálagaMalagaSpain
  7. 7.University of MálagaMálagaSpain

Personalised recommendations