19 Aug Partner Perspective: Food fortification – making every mouthful count for better health outcomes
It is estimated that up to as many as 89% of individuals residing in residential aged care or rehabilitation settings are at risk of malnutrition or are in fact malnourished (1).
It is therefore important that every mouthful of food that a resident consumes is packed full of the key essential nutrients required for better health outcomes. This is where food fortification may improve the daily lives of residents by adding ingredients making real foods more nutrient dense (2,3,4).
Inadequate nutrition is the leading cause of malnutrition in older adults and may result in a loss of muscle mass, causing a decrease in strength which may impair mobility and the ability to self-care. Left untreated, inadequate nutrition can have an enormous impact on quality of life and may lead to a loss of independence, and death (5,6).
It is often difficult to deliver adequate levels of nutrition to many residents as they are unable to eat large meals due to several physiological changes that occur with ageing that can impair appetite (5,6).
This highlights the importance of nutrient dense foods and beverages being offered at all times in residential aged care.
The importance of Protein
After water, protein is the main component of cells and is essential to life. Protein is used to build and maintain muscle, collagen, bone, hormones and enzymes.
Higher intake of protein helps to reduce muscle loss associated with ageing and therefore helping to maintain muscle mass and function. The amount of protein required in one day jumps from 0.8g/kg body weight in those aged between 19-70 to 1-1.2g/kg body weight in those aged over 70 (1,2).
Solutions for malnutrition
The objective of any aged care resident who is at risk of or is malnourished with a history of weight loss is to increase their food intake to boost nutrition and prevent further weight loss and in particular muscle mass wasting (6,7,3).
The ‘food first’ approach should always be advocated and introduced first which encourages eating frequent, small, high energy and protein meals and snacks (7,2).Unfortunately, it has been documented that an average of only 50% of meals are consumed in full in these facilities, with wastage being an ongoing concern (8,7).
Food fortification includes adding ingredients to make foods more nutrient dense, without increasing the volume of food on offer (2,3,4). Food fortification presents an opportunity to add energy, protein, calcium and other key nutrients into the diet whether it be in the food or as additional dairy based supplement drink (2,3,4).
In a systematic review (9) looking at residents in aged care that were provided fortified oral nutrition supplements (high energy, high protein and key micronutrients), it was associated with:
- Reduced hospitalisations
- Reduced mortality risk
- Improved quality of life
- Reduced infection risk
- Reduced falls and functional limitations
The use of oral nutrition supplementation for 3 months resulted in a medium cost saving of 9.2% compared to those who did not receive supplementation (9).
The objective for food fortification should be to use ingredients that contain key essential nutrients – protein, energy, calcium and vitamin D, to ensure that every mouthful the resident is consuming is full of valuable nutrition.
SUSTAGEN® Hospital Formula Active Neutral Flavour
SUSTAGEN® Hospital Formula Active Neutral Flavour is a nutritionally complete supplement that can be used to easily and simply fortify food and drinks for residents. It is high in protein for muscle health and has essential vitamins and minerals, including vitamin D and 50% of the daily calcium requirements to support bone health. Adding SUSTAGEN® Hospital Formula Neutral Flavour to food or taking it as a drink can help boost energy, protein, calcium, vitamin D and essential micronutrients in a quick and convenient way to make every mouthful count.
Available in 840g can and Bulk 3kg bag.
For how to use SUSTAGEN® to fortify meals, check out the SoupedUp Recipe section. For more information about SUSTAGEN® Hospital Formula Neutral Flavour or the rest of the SUSTAGEN® range or for more recipe ideas, visit www.sustagen.com.au
Nutritional supplements can only be of assistance where dietary intake is inadequate. Please seek advice on your individual dietary needs from an Accredited Practising Dietitian or your healthcare professional. SUSTAGEN® Hospital Formula Active is a formulated meal replacement and cannot be used as total diet replacements. Consume as part of a varied and balanced diet and healthy lifestyle.
Information for healthcare professional use only
®Reg. Trademark of Société des Produits Nestlé S.A. Nestlé Healthcare Nutrition, a division of Nestlé Australia Ltd, 8 Nexus Court, Mulgrave VIC 3170, Australia. For more information call 1800 671 628.
- Luliano S et al. Dairy food supplementation may reduce malnutrition risk in institutionalised elderly, Br J Nutr. 2017 Jan 14; 117(1): 142–147
- Tieland M et al. Protein supplementation improves physical performance in frail elderly people: a randomized, double-blind, placebo-controlled trial, J Am Med Dir Assoc, 2012 Oct;13(8):720-6.
- Milne AC et al. Meta-analysis: protein and energy supplementation in older people. Ann Intern Med.,2006, 144, 37–48.
- Iuliano-Burns S et al. A dairy-based protein, calcium and vitamin D supplement reduces falls and femoral neck bone loss in aged care residents: a cluster randomised trial. J Aging Res Clin Pract, 2012, 2, 141–146.4 Meijers JM et al. Estimating the costs associated with malnutrition in Dutch nursing homes. Clin Nutr, 2012;31:65–68
- Pilgrim A et al. An overview of appetite decline in older people, Nurs Old People, 2015; 27(5):29-35
- Scott D, Blizzard L, Fell J, Giles G, Jones G. Associations between dietary nutrient intake and muscle mass and strength in community-dwelling older adults: the Tasmanian Older Adult Cohort Study. J Am Geriatr Soc 2010; 58:2129-2134.
- Dunne JL, Dahl WJ. A novel solution is needed to correct low nutrient intakes in elderly long-term care residents. Nutr Rev 2007;65(3):135-8
- Houston DK, Nicklas BJ, Ding J, et al. Dietary protein intake is associated with lean mass change in older, community-dwelling adults: the Health, Aging, and Body Composition (Health ABC) Study. Am J Clin Nutr 2008; 87: 150-155.
- Elia M et al. A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in community a care home settings, Clinical Nutrition, 2016;35:125-137