Aug 02, 2019

Eating more protein halts malnutrition


Increasing the amount of protein eaten daily prevents aged care residents from becoming more malnourished, according to new research.

Sandra Iuliano, senior research fellow, University of Melbourne, told HelloCare that focusing on nutrition in aged care has enormous benefits to residents’ health, and is also likely to have cost benefits too.

Food should be at the centre of aged care

“We need to look at nutrition and get that right systematically across Australia,” she said.

People concentrate on clinical health but without good nutrition, every other aspect of their health will be affected, she said, “they’re more frail, and they’ll have more comorbidities”.

Dr Iuliano said there are likely to be cost benefits of ensuring good nutrition in aged care because when residents eat well, they don’t go to hospital as often, they don’t stay there as long, their care needs may not be as high because they don’t become frail so quickly, and they don’t fall as often.

68% of aged care residents are malnourished

In her previous research, Dr Iuliano and her co-researchers found 68 per cent of aged care residents were malnourished or at risk of malnutrition. Their research found a major contributor to malnutrition was inadequate protein intake.

In her latest research, Dr Iuliano set out to determine if providing residents with four servings of dairy a day – milk, yoghurt, cheese – would reduce fractures?

Dairy was chosen, rather than meat, because of its calcium component, which is good for bones. Daily is also more versatile, as it can be used in both sweet and savoury food, and it’s softer and easier for older people to eat than meat.

The researchers recruited 60 aged care facilities for the study, ranging in size from 50 to 200 beds, and in regional and metropolitan centres.

Researchers added more dairy into menus

A team of dieticians who specialise in food service went into the study group’s homes and altered their menus, while a control group had no modifications to their menu. 

The researchers added dairy to menus using four strategies:

  • modification, e.g. made cheesecake from scratch so that one slice contained one full serve of dairy
  • substitution, e.g. they replaced gravy with cheese sauce
  • modifications, e.g. they fortified food, say by adding skim milk powder to milk to double the dairy value for the same volume, and 
  • adding, e.g. they might add cheese to a platter that might have previously not had dairy.

On average, those in the study group ate an additional 10-15 grams of protein per day.

Rates of malnutrition stabilised

For the facilities that served extra dairy, rates of malnutrition stabilised. 

By comparison, in the control facilities where there was no change to diets, residents became more malnourished over the two-year study period.

Fracture data being analysed

The fracture data is still being analysed, but Dr Iuliano said she is “very excited” about the results. 

“Hopefully we can see some good outcomes that will make a real difference to lives in residential aged care,” she said.

Change starts in the kitchen

The royal commission and research such as that being undertaken by Dr Iuliano has highlighted the importance of food to the conversation about aged care – not only from a clinical perspective, but also for residents’ quality of life.

Change in aged care must start in the kitchen, Dr Iuliano said.

“If you get the food right, the health of the person hopefully falls into place too.”

“Food is very, very important in people’s lives for nutrition, but also for cultural, social, and psychological reasons – all those other benefits. If they’re happier, then we’ve already done something.”

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