Unidentified under-nutrition: Dietary intake and anthropometric indices in a residential care home population

Background: Research investigating the nutritional status of older people in residential care homes is scant. Objective: To determine the anthropometric measures and dietary intakes of older people in this setting as a basis for future intervention studies. Methods: Dietary intake was assessed using 3-day-weighed food records, nutritional status was evaluated using anthropometric measurements (knee height to predict standing height, and body weight). Catering provision was assessed using a computer-based menu assessment tool (CORA). Results: Mean body mass index (BMI) for the 34 participants was 22.2 kg m² (range 14.5-34.4). Six participants (17.6%) had a BMI ≤ 18.5 kg m² with a further seven identified as having a BMI > 18.5 but <20 kg m². Only two subjects with BMI <18.5 kg m² were prescribed oral supplements. In both men and women, recorded mean energy intakes were below current estimated average requirements by 24% and 22% respectively. Conclusion: Despite adequate food provision, under-nutrition was prevalent and, in the majority of cases, unidentified and untreated. A larger study is warranted to investigate whether improved nutritional intake is achievable through dietary modification. These data indicate that a sample size of around 60, with 90% power and at the 5% significance level, is required to detect a difference of 1674 kJ between groups of residents in an intervention study following a cluster randomized design.