Introduction
Institutionalized older people with swallowing impairment are easily exposed to under-nutrition and malnutrition (1) because of the limit of preparing their food with the right consistency (2) and in an adequate amount to be swallowed without distress for patients (3). Malnutrition in older people has a negative effect on mortality, days of hospitalization, infection, wound healing, and risk of developing bedsores (4). It also affects patients’ quality of life. Therefore, it is very important to prevent malnutrition and improve nutritional intake in this frail population.
Objective
Assess the clinical effects of a texture-modified food program for older people with swallowing impairment on the nutritional, biochemical, and functional profile in a cohort of institutionalized older people.
This is a quasi-experimental study without a control group. The sample included about 200 patients with swallowing impairment recruited from nursing homes in Northern Italy. Starting from October 2018, anthropometrical, biochemical, nutritional, and functional parameters will be collected at time zero and, prospectively, every eight weeks for at least six months after implementing the dedicated food program for a total of at least six experimental evaluations.
A formal written consent is obtained from the patients and/or their official caregivers in cases ofcognitive impairment.
Intervention
The WeanCare program is provided by a University Partner and includes meals without nutritional supplementation. Food technology is applied to achieve personalized levels of density, viscosity, texture and particle sizes. All patients will be fed according to the WeanCare program, offering a personalised level of food texture for 6 months. Serologic, anthropometric and nutritional performance measures will be collected to check the evolution of these parameters and how these impact on patients’ wellbeing. Personalized menus are prepared according to patients’ food preferences and values, and reproduce the standard menu of the nursing home, creating a familiar environment also for people on an MTF diet.
Results
Preliminary results obtained from the sample (n=36) recruited to date have shown a significant modification of some biochemical profiles , such as Lymphocyte total mean count from T0 1.81/mmc (SD 0.44) to T3 2.32/mmc (SD 1.02); two-tailed P-value was equal to 0.0207, with a 95% confidence interval from 0.9390 to -0.081; body weight and Body Mass Index (BMI) remained almost the same and no side effects were reported. We are still recruiting individuals and collecting data.
Conclusions
These preliminary results are in agreement with our previous study (5), which showed how a dedicated food program with an adequate protein, caloric, macronutrient and micronutrients content, balanced bromatological properties, and appropriate texture and palatability properties significantly improved the nutritional, biochemical, and functional profile in a cohort of institutionalized older people with swallowing impairment.
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