Abstract
Objective
This study aimed to clarify the association between texture-modified diets and poor
appetite in older adults, as it is not fully understood.
Design
Cross-sectional study.
Setting and Participants
We included 208 inpatients who were aged ≥65 years (mean age 78.9 ± 7.6 years, 57.7%
female) and admitted to a rehabilitation unit with stroke, musculoskeletal disease,
or hospital-associated deconditioning covered by the Japanese insurance system, between
January 2019 and January 2020.
Methods
Participants were divided into 2 groups according to their food texture level: International
Dysphagia Diet Standardization Initiative (IDDSI) levels 3 to 5 for the texture-modified
diet group and levels 6 and 7 for the normal diet group. Appetite was assessed using
the Simplified Nutritional Appetite Questionnaire for the Japanese elderly, and a
score ≤14 was defined as poor appetite. The relationship between IDDSI levels and
poor appetite was analyzed using the Cochrane-Armitage trend test. Logistic regression
analysis was used to investigate the relationship between the consumption of texture-modified
diets and poor appetite. Statistical significance was set at P < .05.
Results
The numbers of participants on modified diets according to the IDDSI framework were
as follows: 4, 11, 41, 76, and 76 in levels 3, 4, 5, 6, and 7, respectively. In total,
152 and 56 patients were classified into the regular diet group and texture-modified
diet group, respectively. A significantly higher prevalence of poor appetite was observed
with the consumption of texture-modified diets (P < .001 for trend). Logistic regression analysis showed that poor appetite was independently
associated with the consumption of texture-modified diets (odds ratio 3.443, P = .011).
Conclusions and Implications
These findings indicate that the consumption of texture-modified diets is associated
with poor appetite. Further studies are required to verify whether a multimodal approach
involving improvement in the appearance, taste, flavor, and nutrients of the food
can improve poor appetite.
Keywords
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Article info
Publication history
Published online: June 14, 2021
Footnotes
This research was supported by the Research Funding of Longevity Sciences (grant no.: 20-57) from the Ministry of Health, Labour and Welfare of Japan (K.M.) and the Nakatani Suzuyo Memorial Fund For Nutrition and Dietetics (A.S.).
The authors declare no conflicts of interest.
Identification
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© 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
