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Does providing small frequent meals improve the nutritional intake among elderly residents with dysphagia who live in extended care? Taylor, Kelly


Dysphagia, which is common among the elderly population, is a disorder of the swallowing mechanism that interferes with a person's ability to safely swallow while eating. Malnutrition and dehydration are common consequences of dysphagia and, if left untreated, can lead to mortality or acute conditions requiring medical intervention. Improving the nutritional intake of this population is challenging because of factors such as prolonged feeding time, diminished physical tolerance for eating, and palatability of the diet that can negatively influence the amount of food consumed at a meal. Research has suggested that smaller, more frequent meals may be of benefit for individuals with dysphagia for managing fatigue while eating. The purpose of this crossover study was to determine if serving five-meals versus the usual three-meals per day would result in improved energy intake among elders with dysphagia who lived in extended care. Thirty-one residents (71 to 96 years of age), with a diagnosis of dysphagia, were randomly assigned on their units into one of two groups. For the first study period, one group received three meals while the other group received the same amount of calories spread over five meals. In the second study period, four weeks later, the same menu was served but the meal pattern was reversed for the two groups. Food and fluid items consumed by participants during each four-day study period were weighed and energy intakes determined using Food Smart Nutrition Management software (version 5.0). Paired sample t-test analysis revealed that the average calories consumed were not significantly different for the two meal patterns (average calories for three-meal pattern: 1325 +/- 207 Kcal/day; average calories for five-meal pattern: 1342 +/- 177 Kcal/day P=0.565). Based on the study's findings, offering five feedings a day does not appear to improve intakes of this population when compared to three feedings. Dietitians involved in the care of this vulnerable group may need to consider other nutrition intervention strategies.

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