Abstract
Objectives
Nursing home (NH) residents receiving texture-modified diet (TMD) are at risk of inadequate
nutritional intake and subsequent malnutrition. It is essential to monitor dietary
intake to take corrective actions, if necessary. Plate diagrams (PDs) are widely used
to assess dietary intake in institutions but little is known about their validity
for TMD.
Design
Dietary intake at main meals was assessed by nursing personnel via PDs and scientific
personnel via weighing records (WRs).
Setting and Participants
17 NH residents receiving TMD on a regular basis.
Methods
Intake from main meals (breakfast, lunch, and dinner) at 48 days was estimated by
nursing personnel in quarters of the offered amount [nothing, ¼, ½, ¾, all, all plus
second helping (), or I do not know] and by scientific personnel via WRs. PD estimation was multiplied
by the energy and protein content of the offered meal determined by WR and compared
to WR intake results. Sums of daily PD quarters were drawn against WR intake results.
Results
Energy and protein intake from main meals separately and in total per day were highly
correlated (r > 0.854, all P < .001). Paired statistics showed no significant differences between assessment methods
(P > .05). Mean differences [±standard deviation (SD)] between PD and WR were 13.9 (±68.6)
kcal, which is 1.7% of the mean weighed caloric intake, and 0.2 (±3.3) g protein,
which is 0.5% of the mean weighed protein intake per day. Daily energy and protein
intake from main meals determined by WR varies widely within each category of summed
daily intake quarters; for example, a sum of PD quarters of 12 (ie, “all eaten at
all meals”) showed corresponding WR intake levels from 394.6 to 1368.9 kcal and 16.3
to 63.0 g protein.
Conclusions and Implications
Energy and protein intake from TMD estimated by PD corresponds very well to WR-determined
intake, if the energy and protein content of the offered meals is known.
Keywords
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Article info
Publication history
Published online: January 27, 2020
Footnotes
This work was supported by the German Ministry for Education and Research (Grant 01EA1409C). The funding sponsor had no role in the design of the study, used methods, subject recruitment, data collections, analysis and preparation of the paper.
The authors declare no conflicts of interest.
Identification
Copyright
© 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
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