41 increases to 1.1 to 1.2 grams of protein per kilogram of body weight. Ultimately, 15% to 20% of the energy intake should be protein (15). Low protein intake over time causes weak muscles and impaired general condition as well as other ailments and diseases.
In a previous study of older adults, an information office for food was sought for older adults. This need can be further emphasized in this context as older adults living at home can become sicker when they move from the home to a nursing home (19). The number of older adults with dementia in Norway is expected to double, from approximately 70000 people, by 2040 (11). Thus, older adults living in their own homes need to have a well-balanced diet which provides enough protein, energy, and the required vitamins, adapted to their age and any diagnoses they might have. The older adults who participated in this study showed a limited protein supplement, despite receiving protein in their ready-made meals. Only one participant received hot meals for the whole week (see Figure 1).
Another cause for concern is that several participants had few products in their refrigerators, including only a few protein sources. Although most had eggs, consumption over time did not seem to be high. It is reasonable to assume that the delivered ready-made is evenly distributed between meat and fish dishes. Important protein sources are meat, poultry, and seafood, with eggs being the least expensive (2). In Norway, both pure meat and fish are expensive for consumers.
The storage of ready-made meals is clearly communicated to the older adults who subscribe to the food service. The delivery institution and manufacturer of the ready-made meals recommend storing them in a refrigerator for up to 14 days and heating them in a microwave oven. However, the pictures showed that a few participants stored the food in the freezer, which can reduce the quality of some foods containing potatoes.
Limitations
This article has some limitations. The number of participants in the survey was low, but pictures of the contents of the refrigerator must be regarded as an intimate form of information gathering. The number can therefore be considered satisfactory. Another limitation may be that not all products are visible, although the pictures provide a good overview of the most important energy and protein sources.
Conclusion
This article presented results from the investigations into elderly participants’
refrigerators. A large variation occurred in the number of ready-made meals participants had delivered. Several participants indicated that they do not eat dinner every day—at least, not meals delivered from the institution—which is concerning. One possibility is that some participants split the dinners over two or more days, which decreases their daily protein intake. If dinner is a major part of their daily protein intake, it is critical to eat dinner every day. The fact that many older people have few products in their fridges
42 means variations in dinner and other meals are reduced. In addition, the older adults might be using the contents of the refrigerator to meet their dietary needs (e.g., protein).
Some of the ready-made meals delivered were photographed as being opened and wrapped in new plastic, suggesting that portion sizes are too large, but participants have no other size choices from the delivery company. Future research should conduct a longer study adjusted to each individual and measure food intake using well-known nutritional screening tools. Another area to investigate is the packaging of ready-made meals as well as the menus and portion sizes.
References
1.Anderson GH, Tecimer SN, Shah D, Zafar TA. Protein Source, Quantity, and Time of Consumption Determine the Effect of Proteins on Short-Term Food Intake in Young Men. The Journal of Nutrition. 2004;134(11):3011-5.
2.Chernoff R. Protein and Older Adults. Journal of the American College of Nutrition.
2004;23(sup6):627S-30S.
3.Summit WF. Better Food For more People Copenhagen: Ministry of Food and
Environment of Denmark. 2018 [Available from:
https://bfmp.dk/servicemenu/communications-material/].
4.WHO. Keep fit for life. Meeting the nutritional needs for older people. 2002.
5.Nyberg M, Olsson V, Pajalic Z, Örtman G, Andersson HS, Blücher A, et al. Eating difficulties, nutrition, meal preferences and experiences among elderly: a literature overview from a Scandinavian context. Journal of Food Research. 2015;4(1):22-37.
6.Buys DR, Campbell AD, Godfryd A, Flood K, Kitchin E, Kilgore ML, et al. Meals Enhancing Nutrition After Discharge: Findings from a Pilot Randomized Controlled Trial. Journal of the Academy of Nutrition and Dietetics. 2017;117(4):599-608.
7.Augustenborg CC. The Endogenous Feedback Network: A new approach to the comprehensive study of consciousness. Consciousness and Cognition. 2010;19(2):547-79.
8.Thomas KS, Smego R, Akobundu U, Dosa D. Characteristics of Older Adults on Waiting Lists for Meals on Wheels: Identifying Areas for Intervention. Journal of Applied Gerontology. 2017;36(10):1228-42.
9.Walton K, Charlton KE, Manning F, McMahon AT, Galea S, Evans K. The nutritional status and energy and protein intakes of MOW clients and the need for further targeted strategies to enhance intakes. Appetite. 2015;95:528-32.
10.Hansen KV, Frøiland CT, Testad I. Porcelain for all – study in a nursing home.
International Journal of Health Care Quality Assurance. 2018;31(7).
11.Helse_og_Omsorgsdepartementet. Demensplan 2020. 2015;12.
12.Helsedirektoratet. Kosthåndboken – veileder i ernæringsarbeid i helse- og omsorgstjenesten. Oslo: Helsedirektoratet. 2012.
13.Grini ISB. Alder og aldring Ås: Nofima. 2018 [Available from:
https://nofima.no/nyhet/2018/07/alder-og-aldring/].
43 14.Johansson L, Solvoll K. NORKOST 1997 Landsomfattende kostholdsundersøkelse blant menn og kvinner i alderen 16-79 år. (National dietary survey among men and women aged 16-79 years). 1999.
15.Rognså GH. Mat og kosthold for eldre Stavanger: NOFIMA. 2018 [Available from:
https://no].
16.Malvik S. Folat, jern og vitamin D – slik får du i deg nok [Internet]. Mat-helse.no.
2013 [Available from: http://mat-helse.no/2013/06/folat-jern-og-vitamin-d-slik-far-du-i-deg-nok/].
17.Hansen KV. Food and meals in caring institutions – a small dive into research.
International Journal of Health Care Quality Assurance. 2016;29(4):380-406.
18.Hansen KV. Still Learning 60+. The Qualitative Report. 2018;Under review.
19.Hansen KV. Generation G(old) – their interpretation of behaviour and future perspective regarding food and meals. The Qualitative Report. 2018;Under review.
20.Rognså GH. Mat og kosthold for eldre Stavanger: NOFIMA. 2018 [Available from:
https://nofima.no/nyhet/2018/11/mat-og-kosthold-for-eldre/].
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