Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany.
Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Germany.
J Am Med Dir Assoc. 2021 Mar;22(3):636-641.e1. doi: 10.1016/j.jamda.2020.11.012. Epub 2020 Dec 11.
BACKGROUND/OBJECTIVES: Plate diagrams (PDs) are commonly used to monitor dietary intake in nursing homes (NHs). PD intake estimation of texture-modified diet (TMD) is reliable, but only if the offered portion is determined by weighing records (WRs). Offered portion size is usually individualized in NHs and WRs are impractical for NH routine. Thus, an estimation of offered portion size by PDs seems to be appropriate but its validity is unknown. Further, validity of PDs for intake estimation based on estimated offer (instead of WRs) is unknown.
Main meal dietary offer and intake were assessed via PDs and WRs.
Seventeen NH residents receiving TMD regularly.
Offered portion size and intake of breakfast, lunch, and dinner at 42 days were estimated by nursing personnel via PDs (answer options offered portion size: >standard, standard, ¾, ½, ¼, nothing, I do not know; answer options intake: all plus second helping, all, ¾, ½, ¼, nothing, I do not know). In parallel, scientific personnel weighed all offered food items and leftovers. PD estimation of offered portion size was multiplied by energy and protein content of predefined standard portions. Afterward, PD estimation of intake was multiplied by PD determined energy and protein offer to determine the estimated energy and protein intake. PD determined offer and intake were compared with weighed offer and intake.
Seventeen residents (14 female) with a mean [±standard deviation (SD)] age of 87.1 (±7.5) years participated in the study. Nursing personnel overestimated offer and intake. Mean daily differences (±SD) between WR and PD determined offer were -349.0 (±315.7) kcal, P < .001, (-36.3% of mean weighed energy offer) and -15.0 (±12.8) g protein, P < .001, (-42.2% of mean weighed protein offer). Mean daily differences (±SD) between WR and PD determined intake were -283.0 (±299.8) kcal, P < .001, (-35.1% of mean weighed energy intake) and -12.6 (±12.7)g protein, P < .001, (-43.1% of mean weighed protein intake).
PD estimation of individualized offered portion size of TMD by nursing staff is not valid and can, thus, not be recommended. The mistake in estimation of offered portion size is continued on intake estimation but does not become larger, which supports the use of PDs for intake estimation but just in case of a WR determined offer.
背景/目的： 图谱（PDs）常用于监测养老院（NHs）的饮食摄入量。 经称重记录（WRs）确定的质地改良饮食（TMD）的 PD 摄入量估计是可靠的，但前提是提供的部分必须通过称重记录确定。在 NH 中，提供的部分大小通常是个性化的，WRs 不适合 NH 常规使用。因此，通过 PD 对提供的部分大小进行估计似乎是合适的，但其有效性尚不清楚。此外，基于估计的供应量（而不是 WRs）通过 PD 进行摄入量估计的有效性尚不清楚。
通过 PDs 和 WRs 评估主餐的饮食供应和摄入量。
17 名定期接受 TMD 的 NH 居民。
护理人员通过 PD（提供部分大小的答案选项：>标准、标准、¾、½、¼、无、我不知道；摄入量的答案选项：全部加第二份、全部、¾、½、¼、无、我不知道）在 42 天内估计早餐、午餐和晚餐的提供部分大小和摄入量。同时，科学人员对所有提供的食物和剩余食物进行称重。PD 对提供部分大小的估计乘以预定义标准部分的能量和蛋白质含量。之后，PD 对摄入量的估计乘以 PD 确定的能量和蛋白质供应，以确定估计的能量和蛋白质摄入量。将 PD 确定的供应和摄入量与称重的供应和摄入量进行比较。
17 名居民（14 名女性）参加了这项研究，他们的平均年龄为 87.1（±7.5）岁。护理人员高估了供应量和摄入量。WR 和 PD 确定的供应量之间的平均每日差异（±SD）为-349.0（±315.7）kcal，P<.001，（相当于平均称重能量供应量的-36.3%）和-15.0（±12.8）g 蛋白质，P<.001，（相当于平均称重蛋白质供应量的-42.2%）。WR 和 PD 确定的摄入量之间的平均每日差异（±SD）为-283.0（±299.8）kcal，P<.001，（相当于平均称重能量摄入量的-35.1%）和-12.6（±12.7）g 蛋白质，P<.001，（相当于平均称重蛋白质摄入量的-43.1%）。
护理人员对 TMD 个体化提供部分大小的 PD 估计是无效的，因此不能推荐使用。在估计提供部分大小时的错误会继续在摄入量估计中出现，但不会变得更大，这支持了使用 PD 进行摄入量估计，但仅在 WR 确定的供应量的情况下使用。
