4.0 Article

A culinary twist of a two-course meals-on-wheels menu in a cluster-randomized controlled trial influencing health-related quality of life in nursing home residents

Journal

CLINICAL NUTRITION ESPEN
Volume 43, Issue -, Pages 137-147

Publisher

ELSEVIER
DOI: 10.1016/j.clnesp.2021.02.002

Keywords

Meals-on-wheels; Culinary improvement; Rehabilitation; Quality of life; Compliance

Funding

  1. Innovation Fund Denmark [4105-000 09B]

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An intervention study aimed at improving the health-related quality of life for nursing home residents receiving meals-on-wheels showed a significant decrease in the intervention group compared to the control group. The older adults in the intervention group may have been too unfamiliar with the culinary twist added to the intervention menu, leading to a decrease in satisfaction with their food-related life.
Background and aims: Meals-on-wheels in nursing homes are sensory diminished because of the packaging and reheating of the food, which creates less appetite stimulation and an impaired meal experience for nursing home residents. This background is crucial since nursing home residents are a frail and often malnourished group that is physiologically affected by sensory, physical and mental alterations. The study aimed to increase health-related quality of life in nursing home residents receiving meals-on-wheels using an intervention menu with favourite meals that added a culinary twist and were sensory improved by chefs. Methods: A double-blinded cluster-randomized controlled trial with two arms, one group receives an intervention menu, and the other group receives a non-optimized menu. The intervention menu included popular meals-on-wheels (a main meal for dinner and a starter/dessert before or after dinner with culinary improvements). The participants received the same meals without culinary improvements in the control group. Health-related quality of life (EQ5D3L) was the primary outcome of the study. Secondary outcomes were mental and nutritional status and muscle strength. The measurements were assessed at a baseline and end visit (12 weeks after baseline visit). Results: Fifty-two nursing home residents were included in the study (There are 20 in the intervention group and 32 in the control group). Following the principle of intention-to-treat, a significant decreasing effect (p-value 0.026) was found between the groups on health-related quality of life. The treated group experienced the largest decrease from the baseline to the end visit. The intervention group had a significant decrease in the second item on Satisfaction With Food-related Life (SWFL2) (I am very pleased with my food). No changes were found either within or between the groups, on the rest of the measured parameters. Conclusions: Nursing home residents are a target group experiencing natural aggravation, why the health-related quality of life might be difficult to improve using a culinary meal intervention. The decreasing effect of Satisfaction With Food-related Life found in the intervention group could be related to these older adults being too unfamiliar with the culinary twist added to the intervention menu. (C) 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

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