Malnutrition among older adults in Canada is a serious and widespread issue with significant implications for their health and quality of life. An estimated 34% of senior citizens—or 4.1 million individuals—are at risk of malnutrition (Ramage-Morin & Garriguet, 2013), with up to two-thirds of residents in long-term care facilities affected. Despite its prevalence, the challenge of malnutrition can be overlooked, as warning signs such as sudden weight loss, reduced appetite, and muscle weakness can go unnoticed until severe consequences emerge. These include an increased risk of falls and fractures, longer and more frequent hospital stays, and higher mortality rates.
To address malnutrition, many long-term care homes have increasingly turned to oral nutritional supplements (ONS). While ONS can provide essential nutrients, it’s crucial to prioritize real food as the foundation of nutrition. Food offers a familiar, enjoyable, and holistic approach to nourishment that supports both physical and emotional well-being.
At apetito HFS, we believe nutrition can make a real difference. Our food-first approach prioritizes real, food-based solutions as the foundation for combating malnutrition, providing a sustainable and enjoyable alternative to supplementation. By focusing on increasing nutrient density and incorporating food fortification, healthcare providers can further enhance meals to support better health outcomes for older adults.
But what does a food-first strategy look like in practice?
A food-first approach involves fortifying and enriching meals to improve their nutritional value. This strategy aims to increase calories, protein, and essential micronutrients through simple adjustments to existing recipes. Examples include (Henderson, 2024):
- Incorporate full-fat dairy, skim milk powder, butter, or margarine, as well as Greek yogurt into oatmeal, smoothies, and milkshakes; use cottage cheese for added nutrition.
- Add cheese or oils to vegetables or use them as flavorful toppings.
- Utilize beans and lentils creatively, such as in lentil-based brownies.
- Include tofu in innovative "hidden nutrition" recipes.
- Enhance meals with nuts and seeds, including nut butters, by blending them into cookie dough, hot cereals, and desserts.
Focusing on comfort foods commonly consumed by residents and patients, such as hot cereals, beverages, soups, mashed potatoes, and desserts, ensures that these nutrient-rich adjustments are both accessible and enjoyable. Special attention should also be given to texture-modified foods, as research indicates that these menus are often lower in calories, protein, and micronutrients, and enhancing texture-modified meals with nutrient-dense ingredients is essential to closing this gap.
At apetito HFS, the food-first approach is demonstrated through the creation of our Appetite Assist line— our nutritional solution thoughtfully portioned to enhance the intake of essential calories and nutrients. These meals are designed for individuals who need more but want less. Below, we present a comparison of the nutritional facts of our Macaroni and Cheese from our Bulk Entrées and the Appetite Assist line. The Appetite Assist version provides 160 calories versus 115, with increased protein, carbohydrates, potassium, phosphorus, calcium , and iron. This side-by-side comparison highlights the value of intentional nutrient adjustments to support the health of individuals with specific nutritional challenges.
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Combating malnutrition through food-first approaches like fortification and nutrient-enrichment can help promote better health outcomes while maintaining enjoyment and dignity of meal-time. However, it is crucial to remember that malnutrition solutions are not one-size-fits-all. Success in combating malnutrition lies in adopting a person-centered approach as every individual has unique nutritional needs and preferences to be met. By combining these solutions with a commitment to individualized care, healthcare providers can ensure that every older adult receives the nutrition they need.
Resources
Henderson D. (2024). Managing malnutrition in long term care: Food first approach & effective menu planning [17-19]. Canadian Malnutrition Awareness Week 2024.https://cns-scn.ca/education-portal/view/managing-malnutrition-in-long-term-care-food-first-approach-effective-menu-planning
Ramage-Morin, P., & Garriguet, D. (2013, March 20). Nutritional risk among older Canadians. Government of Canada, Statistics Canada. https://www150.statcan.gc.ca/n1/pub/82-003-x/2013003/article/11773-eng.htm