Nutrition & Foodservice Edge Magazine - March/April 2022 - 18

Continued from page 17
TRADITIONAL FOOD
INTERVENTIONS are
typically the first line
of defense, however
sometimes additional
strategies are
necessary.
Other ideas include peanut butter mixed into oatmeal, avocados
added to smoothies, ricotta mixed into pasta, olive oil for
dipping bread, and nuts or seeds used in baked goods.
9. Embrace culinary creativity.
A Food in Health Care Working Group of the Canadian
Malnutrition Task Force (CMTF) developed guiding principles
in food service to prevent malnutrition, one of which is
" balancing clinical credibility with culinary quality. " As the
aging population grows and becomes increasingly diverse in
future years, the need for expanded culinary creativity from
different regional and cultural cuisines will be of growing
importance to encourage adequate intake.
10. Continuously reassess.
Just because a resident arrives without malnutrition, it
unfortunately doesn't mean they'll remain that way. Changes
in health (physical or mental) could trigger the pathway to
malnutrition. Karolin Saweres, RDN, LD, emphasizes that " the
nutrition care plan is a continuous process. Positive or negative
outcomes are monitored and revised as needed. "
In addition to assessing patient outcomes, don't forget to
also address patient satisfaction. Research suggests this is
underutilized in hospital and long-term care settings-but you
can often get impactful information from simple satisfaction
surveys or conversations with your residents.
11. Understand the value of oral nutrition
supplements.
Traditional food interventions are typically the first line of
defense, however sometimes additional strategies are necessary
(especially in the case of moderate to severe malnutrition). In
these cases, the doctor or dietitian may order oral nutrition
supplements.
Most research supports a positive impact of oral nutrition
supplements. For example, a meta-analysis in Clinical Nutrition
ESPEN found that oral (and enteral) nutrition support
interventions led to a 30 percent reduction in mortality among
malnourished non-critically ill patients compared to those not
receiving such interventions. Similarly, a study in Geriatric
nursing found that oral nutrition supplements improved intake
and increased weight among people with dementia.
High protein strategies and long-term interventions are thought
to be most beneficial. In addition, oral nutrition supplements are
18 NUTRITION & FOODSERVICE EDGE | March-April 2022
typically best served between meals (rather than a replacement
for a meal itself).
These supplements include drinks, bars, or even ice creams. In
fact, ice cream supplements were widely accepted and increased
caloric intake in a recent study. They may be particularly useful
among those suffering from a loss of taste and smell, as the cold
smooth texture and sweetness are welcomed.
12. Work collaboratively with other departments.
Many healthcare providers play a role in reducing the risk of
malnutrition:
* Nursing can report on feeding difficulties for patients eating
in their rooms.
* Dentists help with tooth issues or dentures, which affect the
ability to eat.
* Speech-language pathologists are useful for residents who are
having issues swallowing.
* Recreation directors encourage physical activity, which
preserves muscle mass and functional ability, and increases
appetite.
* Psychologists or therapists can help residents work through
depression or anxiety.
When it comes to malnutrition, a village is needed.
THE BOTTOM LINE
Malnutrition is a widespread problem in long-term care, perhaps
now more than ever because of the COVID-19 pandemic.
As a CDM, CFPP, you are in a unique role to creatively and
collaboratively reduce malnutrition risk. Don't be afraid to try
new strategies, like incorporating new nutrient-dense menu
items, working with the dietitian on fortified food strategies, or
voicing concerns about restrictive diets. E
REFERENCES: This Level III article contains a lengthy list of
References. If reading the digital Edge, click the following link
for these References. For print readers, type the following in
your browser: www.ANFPonline.org/docs/default-source/
edge/nc032022-references.pdf
https://www.anfponline.org/docs/default-source/edge/nc032022-references https://www.anfponline.org/docs/default-source/edge/nc032022-references
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