The findings published in Appetite suggested that a poor appetite in older adults could be an important factor of reduced food intake and undernutrition. The findings could therefore lead to effective strategies to reduce such risks among the ‘vulnerable group’, it said.
The researchers added that among other findings, the preference for non-dairy foods products and a variation for high protein foods were more pronounced for older adults in a poor appetite group than older adults with a good appetite. "They also preferred non-dairy high-fibre foods and solid texture...[and] some combinations over others such as high protein [diets] with variation and high fiber with sauce,” said Dr Barbara Meij, the lead author of the study.
Increasing the variety of food offered to such individuals could therefore be an effective strategy to stimulate food intake. “The provision of adapted meals and snacks with high variation and colour variation could help,” added Meij.
Structure of foods
With regard to the structure of foods, the authors said that they had expected older adults to prefer a liquid texture as they required less chewing and were easier to swallow. But results suggested that the participants preferred a solid texture, particularly for foods with high carbohydrate content.
A possible explanation for this could be because subjects who had difficulties chewing or swallowing had been excluded from the study. “Chewing and swallowing difficulties are generally highly prevalent in older institutionalised persons, so this is probably a limitation of the generalisability of our findings to this specific population,” said the team.
High protein diets
Previous experiments in healthy adults showed that after an imposed protein deficit, food intake appeared to change toward high protein foods in order to compensate for the protein shortage. In this study of older adults with a poor appetite, 44% were considered undernourished and therefore probably had a protein deficit. “The observed preference for foods with variation and high protein content in older adults with a poor appetite supports these findings,” added Meij.
The preference for non-dairy foods products was consistent for older adults with a poor and a good appetite but was slightly more pronounced in the poor appetite group. And since dairy foods are an important source of protein, calcium and B-vitamins, the finding that the participants did not like them was a cause for concern.
The necessary protein and calcium could therefore be consumed through other food, said the team. Offering a large variety of high protein foods or replacing meat with easier to chew high-quality protein sources like eggs, seafood, and poultry could be an alternative. “As we did not observe a preference for animal protein, vegetarian protein sources such as legumes or soy products are also an option.
“Interestingly, studies have shown that increasing variety by offering more types of foods is an effective strategy to increase short term food intake in older adults in general and in older adults at risk of undernutrition,” said the researchers.
The study
The team studied 349 older adults of 65 to 101 years in nursing, residential care homes, hospitals or at home receiving home care. The study used a computer-based assessment with a variety of food images to determine the food preferences.
Future studies should be conducted to confirm the identified food preferences in older adults with a poor appetite using actual food intake data, the researchers concluded.
Source: Appetite
Vol: Volume 90, 1 July 2015, Pages 168–175, doi: 10.1016/j.appet.2015.03.011
‘Specific food preferences of older adults with a poor appetite. A forced-choice test conducted in various care settings’
Authors: B. S. van der Meij, et al