Effects of a Texture-Modified, Enriched, and Reshaped Diet on Dietary Intake and Body Weight of Nursing Home Residents with Chewing and/or Swallowing Problems: An Enable Study

Abstract

This proof-of-concept study investigated the effects of an innovative nutrition concept, comprising texture modification, enrichment, and reshaping, on dietary intake and nutritional status of 16 nursing home residents with chewing and/or swallowing problems (mean age 86.5 ± 7.4 years) in a pre-test post-test design. During 6 weeks with usual texture-modified diet (P1) energy and protein intake were constant. After the implementation of the innovative diet, daily energy intake increased by 204.2 (median) [interquartile range 95.8–444.4] kcal (P = 0.011), and protein intake by 18.3 [9.9–26.3] g (P < 0.001) and remained constant during the following 6 weeks (P2). Body weight decreased during P1 (–0.5 [–1.4 to 0.2] kg), and increased during P2 (+1.1 [0.0 to 1.7] kg, P = 0.004). The present nutrition concept turned out to be a promising strategy for nutritional management of chewing and/or swallowing problems, however, the effects need to be confirmed in larger studies.

Keywords:

• Chewing/swallowing problems
• enable-cluster
• enrichment/fortification
• nursing home
• reshaped
• texture-modified diet

Acknowledgments

We would like to thank the nursing homes Max am Stadtpark and Max am Rennweg and all personnel and residents involved for participating, and the Federal Ministry of Education and Research for funding of the study.

This paper is submitted in partial fulfilment of the requirements for obtaining the degree Dr. rer. biol. hum. (PhD in Human Biology) for the primary author Angela Ott at Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Germany.

The preparation of this paper is part of the enable Cluster and is catalogued by the enable Steering Committee as enable013 (http://enable-cluster.de).

An abstract of these results has been submitted for the ESPEN Congress 2018.

Author contributions

D.V., C.S., T.L., M.S. and A.O. conceived and designed the study. Together with the nursing home staff, two housekeepers (Kirsten Edenhofner and Brigitta Sixt) M.S. and A.O. performed the study. Two master students (Maria Voigt and Alexander Gabber) and A.O. collected the data. A.O. analysed the data. A.O. and D.V. interpreted the data. A.O. drafted the manuscript and D.V., C.S., T.L., O.G. and M.S. revised it critically for important intellectual content. All authors approved the final version to be published and agree to be accountable for all aspects of the work. The funding sponsor had no role in the design of the study, used methods, subject recruitment, data collections, analysis and preparation of the paper.

Data availability statement

Study participants did not give their general consent to share data.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Federal Ministry of Education and Research [Grant 01EA1409C].