Lan S J, Justice C L
Department of Foods and Nutrition, Purdue University, West Lafayette, IN 47906.
J Am Diet Assoc. 1991 Jan;91(1):46-51.
Randomly chosen medical charts of 212 elderly subjects in 11 nursing homes were reviewed to determine which characteristics of the subjects were most closely associated with their diet prescriptions. The chart reviews indicated that 104 (49.0%) of the 212 subjects had some type of nutrient-modified diet prescription. Eight patients who were tube fed were not included in subsequent analyses. Sodium restriction was the most common modification (60 [29.4%] of the remaining 204 patients) and calorie-controlled diets were also common (52 [25.5%] of the patients). Of the 55 patients with hypertension, 31 (56.4%) had no sodium restriction. Only 10% of all low-sodium diets limited sodium to 2 g per day. Of the 38 patients with diabetes, 7 (18.4%) had no prescription for calorie control, and there was no indication that increased dietary fiber was encouraged for diabetic patients. Only one of the 121 subjects with a diagnosis of coronary heart disease or atherosclerosis had a prescription for a cholesterol-lowering diet. Characteristics of the subjects not specifically related to diet or diagnosis, such as age, sex, duration of stay, and level of care, had no significant relationship to diet prescription. These findings suggest that the practitioners in our sample were not convinced of the efficacy of modified diets to control disease for most nursing home residents.
对11家养老院中随机挑选的212名老年受试者的病历进行了审查，以确定受试者的哪些特征与他们的饮食处方最密切相关。病历审查表明，212名受试者中有104名（49.0%）有某种类型的营养改良饮食处方。8名通过鼻饲管进食的患者未纳入后续分析。限钠是最常见的改良措施（其余204名患者中有60名[29.4%]），热量控制饮食也很常见（52名患者[25.5%]）。在55名高血压患者中，31名（56.4%）没有限钠措施。在所有低钠饮食中，只有10%将钠限制在每天2克。在38名糖尿病患者中，7名（18.4%）没有热量控制处方，而且没有迹象表明鼓励糖尿病患者增加膳食纤维摄入。在121名诊断为冠心病或动脉粥样硬化的受试者中，只有1名有降胆固醇饮食处方。受试者的年龄、性别、住院时间和护理级别等与饮食或诊断无特定关系的特征，与饮食处方无显著关系。这些发现表明，我们样本中的从业者并不相信改良饮食对大多数养老院居民控制疾病的有效性。
