Institutionalized elderly women have lower food intake than do those living more independently (Dutch Nutrition Surveillance System).

The habitual intake of energy and nutrients (assessed through dietary history) among elderly women (aged 65 and over) living in a nursing home (n = 54), elderly women living in service flats and receiving their dinners from the nursing home kitchen (n = 29), and elderly women living independently (n = 52) was evaluated within the framework of the Dutch Nutrition Surveillance System. Intake of energy and nutrients was lowest among women in the nursing home and highest among those living independently. Almost all differences in absolute intake found were significant, both unadjusted and adjusted for age. In the nursing home the intake of energy and nutrients was lower at higher age. In qualitative terms the differences among the groups of women were less striking. Mean daily intakes of iron, vitamin A, thiamin, vitamin B6 and vitamin C were below the Dutch recommended dietary allowances (RDAs) among the nursing home women. Several interrelationships among nutrient intakes were found, low intake levels clustering somewhat among elderly subjects. Our data indicate that these nutritional risks are due to a lower food intake resulting in a lower intake of energy and nutrients, and owing to differences in food choice resulting in a lower nutrient density. We conclude that it is difficult to design a diet containing all essential nutrients at the RDA level in a nursing home with residents who have a relatively low intake of energy, especially among those at higher age.     

Institutionalized elderly women have lower food intake than do those living more independently (Dutch Nutrition Surveillance System).

The habitual intake of energy and nutrients (assessed through dietary history) among elderly women (aged 65 and over) living in a nursing home (n = 54), elderly women living in service flats and receiving their dinners from the nursing home kitchen (n = 29), and elderly women living independently (n = 52) was evaluated within the framework of the Dutch Nutrition Surveillance System. Intake of energy and nutrients was lowest among women in the nursing home and highest among those living independently. Almost all differences in absolute intake found were significant, both unadjusted and adjusted for age. In the nursing home the intake of energy and nutrients was lower at higher age. In qualitative terms the differences among the groups of women were less striking. Mean daily intakes of iron, vitamin A, thiamin, vitamin B6 and vitamin C were below the Dutch recommended dietary allowances (RDAs) among the nursing home women. Several interrelationships among nutrient intakes were found, low intake levels clustering somewhat among elderly subjects. Our data indicate that these nutritional risks are due to a lower food intake resulting in a lower intake of energy and nutrients, and owing to differences in food choice resulting in a lower nutrient density. We conclude that it is difficult to design a diet containing all essential nutrients at the RDA level in a nursing home with residents who have a relatively low intake of energy, especially among those at higher age.     

Nutrient intake of low-income, black families in southwestern Mississippi

A dietary intake study for 250 low-income households in Claiborne County in southwestern Mississippi was conducted from June through August 1974. Data were obtained during daily home visits for seven days by trained college students. The adequacy of nutrient intake for individuals was evaluated by comparing the data with the 1974 Recommended Dietary Allowances by age and sex. The data was also compared with those of the Ten-State Nutrition Survey and HANES. Mean intakes of protein, vitamin A, thiamin, riboflavin, and ascorbic acid for all subjects were above the RDAS; those of energy, calcium, iron, and preformed niacin were below the allowances. Whereas calcium was the nutrient least adequately consumed by all persons, protein was most adequately consumed. Sixty per cent of children had calcium intakes below two-thirds of the allowance. By sex, 66.7 per cent of all males and 73.3 per cent of all females had calcium intakes below two-thirds of the standard. None of children received less than two-thirds of the allowance for protein. Nutrient intake was low for a substantial number of the subjects. Adolescents, ages eleven to eighteen years, of both sexes had the poorest diets for all nutrients. Regarding the sex difference, females had better nutrient intakes than did males for all nutrients except calcium and iron.     

2020年长沙市岳麓区居民膳食结构和营养素摄入状况分析

目的 了解长沙市岳麓区居民膳食结构和营养素摄入现况,为针对性开展营养健康教育提供参考依据。方法 调查长沙市岳麓区3岁及以上居民2020年食物消费状况,采用Kruskal-Wallis H检验分析各年龄组居民平均每标准人日膳食和营养素摄入量差异,并与2010—2013年中国居民营养与健康状况、中国居民膳食指南和膳食营养素参考摄入量进行比较。结果 共计392人纳入数据分析,其中男性192人、女性200人,平均年龄(37.39±19.93)岁。2020年岳麓区居民平均每标准人日谷类(341.9 g)、大豆(33.6 g)、蛋类(39.9 g)和鱼虾蟹贝类(47.3 g)摄入量基本达到膳食宝塔推荐量;但薯类(19.5 g)、水果(34.9 g)、乳及乳制品(58.9 g)的摄入严重不足,畜禽肉类(159.7 g)、食用油(44.5 g)和盐(6.4 g)的摄入量超标。平均每标准人日营养素摄入量中,蛋白质、B族维生素、维生素E、钠、磷、铁的摄入量达到了推荐摄入量(RNI)要求,碳水化合物和脂肪供能比分别为41.3%和45.0%,比2012年全国平均水平下降了13.7%和上升12.1%。不同年龄组...     

The contribution of foods from outside the home to the nutrient intake of young adolescents

Eating patterns in the UK are changing, not least of these changes is the increase in food availability and choice outside the home. Eating outside the home is not a new phenomenon; limited data are available for adults and for the population as a whole, but no such data exist for children. Information on food choices and purchasing is valuable in identifying relevant targets for effective change. This paper reports the dietary intake and the percentage of total intake from home and away from home (identifying as outside sources, school meals, other homes, school tuck-shops and shops or cafes for 379 11–12-year-old schoolchildren in 1990), as well as the nutrient density of intakes from each food source. Each child completed two 3-day dietary records between January and July 1990, and was interviewed after each 3-day record by one dietitian. The purpose of the interview was to verify and enlarge upon the information recorded in order to obtain a quantitative record of food intake and to determine the source of each food item. Food tables were used to calculate nutrient intake. Sources of food outside the home accounted for approximately 30% of their total energy intake. Food from home had the highest micronutrient density of all the sources. The nutrient density of school meals compared well with food from home; school meals were lower in non-milk extrinsic sugars although higher in fat and lower in protein, non-starch polysaccharides, iron and retinol equivalents. Foods purchased from shops/cafes or school tuck-shops were of poor nutrient quality for all nutrients measured. Children from ‘low’ social groups had intakes of a lower nutrient density from home than children from ‘high’ social groups and also obtained a greater proportion of their total diet from shops or cafes. Although the popularity of the different food sources outside the home varied with gender and social group, the quality of intake obtained did not, suggesting that children followed peer group food preferences outside the home rather than food habits taught at home.     

Evaluation of nutrient intakes of rural elders in eleven southern states based on sociodemographic and life style indicators

Nutrient intakes of 2893 rural free-living elderly persons aged 65 and older residing in 11 southern states were studied. Data being reported herein include food intake by a 24-hr recall, meal preparation settings and use of dietary supplements and socioeconomic variables. High percentages of monthly income were spent on food, particularly among black females and participation rates in community service programs, including senior centers and home delivered meals, were low. Caloric intakes by rural males were 1603 and 1365 kcal, respectively, for whites and blacks; 1270 and 1259 kcal for white and black females, respectively. Means for most of the nutrients equalled or exceeded the RDAs for this age group except energy and calcium. Age had little influence on nutrient intake. Race showed as a significant determinant on the nutrient intake index computed from 11 key nutrient intakes; however, the significant effect of race disappeared when either income or educational level was used as covariate. Thus, the disparities in intakes between the black and white elders were due partly to income rather than race. Of these rural elders, 46.5% consumed meals alone. Eating alone per se did not have a significant impact on nutrient consumption, but 35.2% of those eating alone indicated that they ate less, had fewer choices or ate more. Dietary supplements were used by 33.9% of rural elders, and their intakes of several nutrients were higher than by nonusers. More effort by community services to reach rural elders is needed, particularly those in the low socioeconomic spectrum.     

Nutrition of old people in sheltered housing

Two hundred and thirty-five sheltered housing tenants (59 men and 176 women) were investigated by using the 24-h dietary recall and checklist devised by the Nutrition Advisory Group on the Elderly (NAGE) to estimate their energy and nutrient intakes, and by measuring their body weight and demi-span to calculate ratios of weight to demi-span. Sixty seven per cent had energy intakes below the mean previously recorded in a national survey of old people living at home, but most had an adequate intake of protein, while, in 44%, the proportion of energy consumed as fat exceeded 35%. For most nutrients, few tenants had intakes below the lower recommended nutrient intake (LRNI). Exceptions were that there were 64% with pyridoxine intakes and 63% with vitamin D intakes below this level. Only 18% of men but 74% of women had weight to demi-span ratios below the means recorded in elderly people living at home in another recent survey. There was no correlation between these anthropometric ratios and energy intakes.     

The prevalence and impact of 'atypical' days in 4-day food records

OBJECTIVE: To understand how days with atypical food intake affect estimates of usual nutrient intake from 4-day food records. PARTICIPANTS/SETTING: Secondary analyses of 4-day food records (4DFRs) (n = 2,560) collected from 1,090 women, aged 50 to 79 years, who participated in the Women's Trial Feasibility Study in Minority Populations, a randomized dietary intervention trial. DESIGN: Food records were classified as atypical if participants marked one or more day's food intake as "more than usual" or "less than usual." Total amounts and nutrient densities (percent of energy or grams per 1,000 kcal) were examined for all macronutrients, fiber, vitamin C, beta carotene, and calcium. STATISTICAL ANALYSIS: Contingency tables were used to examine associations of demographic characteristics with the likelihood of completing a 4DFR with atypical intake days. Analysis of variance was used to test whether nutrient intake differed among records with and without atypical days. Student t tests were used to identify any differences in total energy and percent energy from fat among typical and atypical intake days. RESULTS: Approximately 16% of records included at least 1 atypical day. Reporting less-than-usual intake was associated with younger age, higher income, and higher body mass index. Black women were less likely to report more-than-usual intake than whites and Hispanics. Records with less-than-usual intake had lower intakes of all nutrients analyzed except alcohol; however, there were no differences in nutrient densities. Records with more-than-usual intake had higher intakes of alcohol and all nutrients except beta carotene and vitamin C, with higher nutrient density measures of alcohol and decreased nutrient density measures of protein, vitamin C, and fiber. CONCLUSIONS: Atypical intake days are common in 4DFRs and they have a large effect on mean total intakes of most nutrients. APPLICATIONS: It is important for researchers to collect information on atypical intake days included in a 4-day food record. Strategies are needed to incorporate information on atypical intake days when analyzing and interpreting research results.     

Alcohol and nutrient intake of elderly men.

The effect of alcohol consumption on the intake of food nutrients was investigated in elderly residents in a Veterans Administration Domiciliary. When compared with a group of abstainers from the same institution, the imbibers ate fewer food calories (2,140 vs. 2,415 kcal per day) and had lower serum albumin levels (54 vs. 58 per cent total serum protein). The lower caloric intake extended to the three main energy sources (fat, protein, and carbohydrate) and occurred even though ample food was available. In view of the reduced nutrient intake and known impairment of the absorptive process by ethanol, institutionalized elderly alcoholics require special attention to maintain a satisfactory nutritional status.     

The implications of underreporting in dietary studies

Abstract: Dietary data from the Western Sydney Dietary Survey 1989-90 (n = 512) was used to investigate: 1. the prevalence and predictors of underreporting of energy intake, 2. the effects on results of excluding data from underreporters for analysis of mean nutrient intakes, and 3. the proportion of energy intake supplied by macronutrients and proportions of subjects who met dietary goals. The proportion whose measured energy intakes from a Food Frequency Questionnaire (FFQ) were below cut-points for biologic plausibility was 28.5 per cent; it was higher for subjects who had BMI > 25 and were female. Point estimates for mean intakes of energy and nutrients were all greater when data from underreporters were excluded, but nutrient intakes expressed as percentages of energy intake remained largely unchanged. Increases in estimated mean population intake for each nutrient ranged from 7 per cent to 14 per cent for males, and 12 per cent to 17 per cent for females. Estimates of the percentages of the sample who did not meet dietary goals were significantly lower for a number of nutrients when underreporters were excluded. We conclude that: 1. results expressed as a percentage of energy intake are not affected by the exclusion of energy underreporters, and 2. estimates of the proportion of populations meeting some nutrient goals and associations between diet and disease are likely to change meaningfully and significantly with the exclusion of data from underreporters.     

Dietary behaviours of volunteers for a nutrition education program,compared with a population sample

Abstract: The dietary behaviours of and recent dietary change by volunteers for a nutrition education program were compared with those of a more population-representative sample. The population sample was randomly selected from the electoral rolls of three Australian cities. Those selected received questionnaires which were to be completed and returned by mail. The sample of volunteers was recruited from the electoral rolls of suburbs of either high or low social status in one of these cities. Volunteers were posted a questionnaire, to be returned in person. A quantified food frequency questionnaire was used to estimate relative intake of 19 nutrients, plus energy intake. Occupation, age, sex, reported recent dietary change and diet-related beliefs were also assessed. The population sample was weighted to the age and occupational distribution of the education program sample. Compared to the 874 respondents in the population sample (70.4 per cent response rate), the 487 volunteers (24.2 per cent response rate) for the nutrition education program had healthier nutrient intakes and reported more dietary behaviour changes. Recruitment in the education program was greater in areas of higher social status (32 per cent) than in areas of lower social status (20 per cent). The potential effect of such a program on the whole population was demonstrated by the proportions that volunteered and the characteristics of these volunteers. The need to provide a range of opportunities for changing dietary behaviour, according to the health-related behaviours and beliefs of target groups and their socioeconomic circumstances, was highlighted.     

Absence of nutritional or clinical consequences of decentralized bulk food portioning in elderly nursing home residents with dementia in Montreal

OBJECTIVES: To evaluate the nutritional and clinical consequences of changing from a centralized food delivery system to decentralized bulk food portioning; a system in which meal portioning occurs on residents' floors of a nursing home. DESIGN: A pilot study with a pre-post design SUBJECTS/SETTING: The study took place on one floor of a home for elderly persons with dementia. Of the 34 residents, 22 (1 man) participated in this study. Average age was 82 years (range = 55 to 94 years). Nutritional status was verified before introduction of the bulk food portioning system by 3 nonconsecutive days of observed food intakes, anthropometric measurements (height, weight, triceps skinfold thickness, mid-upper-arm circumference), and biochemical parameters (albumin, lymphocytes, glucose, sodium, potassium, transferrin, vitamin B-12, folate, hemoglobin). Trained dietitians collected the dietary and anthropometric data and validated the food intake estimates and anthropometric measurements. Data were also collected 10 weeks after implementation of the new food distribution system. STATISTICAL ANALYSES PERFORMED: Paired t tests adjusted by a Bonferroni correction assessed differences between values measured before and after introduction of the new food distribution system. RESULTS: Average food consumption increased substantially and significantly after introduction of the bulk food portioning system. Mean energy intakes rose from 1,555 to 1,924 kcal/day and most other nutrients also increased, many significantly, but there were no changes in anthropometric values or biochemical parameters, except for albumin level which decreased to the lower normal limit. APPLICATIONS: Portioning of food in the residents' dining room simulates a homelike atmosphere thereby encouraging increased food consumption. With well-trained and enthusiastic staff, this system could contribute to improved nutritional status in the very elderly, even those who have dementia. Dietitians have a key role to play in overseeing residents' nutritional needs and in training, supervising, and motivating foodservice personnel.     

Dietary Nutrient Profiles of Canadian Baffin Island Inuit differ by Food Source, Season, and Age

Objective To compare the effect of food source (traditional or market), season (six seasons), and age (five age groups) on dietary nutrient patterns of Inuit living in Baffin Island, Canada.Design Twenty-four-hour recall interviews of all residents who had lived ≥3 years in this one community in each of six seasons. Foods that were recalled were divided by source.Setting/subjects The study took place in the Inuit community of Qikiqtarjuaq, which harvests the highest quantity of wildlife per capita of all Baffin communities. Three hundred sixty-six residents contributed a total of 1,410 recalls: 401 from nonpregnant, nonlactating adult women, 74 from pregnant women, 301 from adult men, 451 from children aged 3 to 12 years, and 183 from teenagers aged 13 to 19 years. Participation was voluntary and averaged 65% to 75% of residents.Main outcome measures Energy, total dry weight of food, and dietary nutrients (ie, carbohydrate, protein, total fat, saturated fat, polyunsaturated fat, vitamin A, iron, copper, zinc, calcium, phosphorus, magnesium, and sodium) were measured by food source, season, and age. Nutrient density (nutrient per 1,000 kcal) was calculated in traditional and market food sources. Selected nutrients were computed in total diets, and compared with Recommended Dietary Allowances (RDAs).Statistical analyses performed Tests for normality of the distribution of nutrient intakes (ie, Shapiro-Wilk statistic) were performed followed by nonparametric analyses (ie, Wilcoxon paired-sample t test, Kruskal-Wallis analysis of variance, and adjustment for Bonferroni inequalities resulting from multiple comparisons).Results Most nutrient intakes were significantly different by food source (P<.05). Traditional food contributed more protein, phosphorus, iron, zinc, copper, magnesium, and vitamin A for several age groups. Market food contributed greater amounts of dry weight, energy, fat, carbohydrate, calcium, and sodium for most age groups. Seasonal variation (P<.05) existed for nutrients coming from traditional and market food. Of the 10 nutrients assessed for nutrient density, all except calcium and sodium were present in greater amounts in traditional food than in market food (P<.05). Calcium and vitamin A intakes fell below 66.6% of the RDAs for more than 60% of the population.Conclusions The comprehensive view of nutrient profiles, food source, and seasonality of Inuit diets will assist health professionals in developing nutrition promotion and education programs for all age groups of this population. Traditional food is an essential source of the total annual dietary nutrient intake of Inuit. Results indicated, however, that calcium and vitamin A intake must be improved. J Am Diet Assoc. 1996; 96:155–162.     

Food habits and nutrient intakes of Filipino women in Los Angeles.

Food habits, dietary changes, and nutrient intakes of forty-seven college-educated, empolyed Filpino women who have moveed from the Philippines to Los Angeles were studied. One-third started drinking mikk in the United STAtes. They said that they were eating more meat, vegetables, frit and less starchy food since they left the Philippines. Eighy per cent continued to eat ricedaily, and seafood was eaten frequently. Daily intakes of protein, niacin, and thiaminment 100 per cent of the 1974 u.s. Recommended Dietary Allowances for almost all subjects, but intakes of calcium and vitamin A were less than two-thrids of the allowances fo 61 and 22 per cent, respectively. The daily caloric intake was higher, with twice as amny calories coming from protein and three times as many from fat as was reported for diets in Philippines.     

Designing snacks to address micronutrient deficiencies in rural Kenyan schoolchildren

Three snacks were designed to improve nutrient intakes among school-age children living in rural Kenya. Snacks containing animal-source foods (milk and meat) provided more nutrients than an equicaloric vegetarian snack. The vegetarian snack provided extra vitamin A (primarily from fortified cooking fat; the milk snack was rich in calcium, vitamin A, and vitamin B-12; and the meat snack supplied vitamin B-12, iron, and zinc. When changes in intakes from baseline to the feeding period were compared across the 4 groups, total energy intake increased the most for children in the meat group and the least for children in the control group. Differences in energy intakes across the 3 feeding groups were primarily caused by decreases in home intake for the vegetarian and milk snack groups. It is important to evaluate the change in home intakes as well as intakes from the foods provided by the study when evaluating the effect of feeding programs on nutrient adequacy.     

Trends in fatty acid intakes of 10-year-old children, 1973 to 1982

Diets of four groups of 10-year-old children (no. = 871, 30% black, 70% white) were examined over 10 years with 24-hour dietary recalls to study temporal trends in cholesterol, fat, and fatty acid intakes in a community. Boys had higher intakes per day and per kilogram body weight than girls for all nutrients (p less than .0001), but there were no sex differences in nutrients per 1,000 kcal. The only racial difference detected was a higher myristic acid intake in whites (p less than .02). There was a 16% decline in dietary cholesterol intake between 1978 and 1982. Three shifts in fatty acid intake increased the P:S ratio from 0.29 in 1973 to 0.45 in 1978: (a) a 5% decline in oleic acid, coupled with a 5% rise in linoleic acid; (b) a quadrupling of linolenic acid; and (c) less stearic and more myristic acid, with palmitic acid unchanged. Total fat intake provided 38% of the calories in each survey, but the changes in proportions of fatty acids paralleled trends in food consumption patterns and nutrient sources. Despite the changes, few children met prudent diet recommendations, and serum total cholesterol and very-low-density-lipoprotein cholesterol levels did not change over time.     

Associations Between Nutritional Status,Frailty and Health-Related Quality of Life Among Older Long-Term Care Residents in Helsinki

The aim of this study was to examine how nutritional status modifies the association between frailty and health-related quality of life (HRQoL) among older nursing home residents. We also investigated how residents’ energy intake is linked to frailty score. A total of 486 older (> 65 years of age) nursing home residents living in Helsinki, Finland were included to this cross-sectional study. We collected data on the residents’ background information, HRQoL by 15D, nutritional status by Mini Nutritional Assessment (MNA), frailty status (Fried’s phenotype criteria; pre-frail: 1–2 criteria and frail: 3–5) and energy intake (one- or two-day food records). The frail residents were more often malnourished and had lower HRQoL than those in the prefrail group. Energy and protein intakes were significantly lower among frail women than prefrail women. Energy intake was linearly associated with frailty points. When residents in the frail and prefrail groups were divided according to their nutritional status, both nutritional status and frailty were associated with HRQoL, but there was no interaction. Both nutritional status and frailty were associated with HRQoL, and lower energy intake indicated a higher frailty score. An adequate energy intake may promote residents’ HRQoL and prevent frailty in long-term care.     

Patterns of vitamin C intake from food and supplements: survey of an adult population in Alameda County, California

Use of vitamin C in food and pills and its association with health habits and health status were investigated in a random sample of 3,119 adults in Alameda County, California. Vitamin C intakes of nearly 80 per cent of respondents met or exceeded Recommended Daily Dietary Allowances. Fourteen per cent or fewer appeared to have inadequate vitamin C intake. Vitamin C supplements were taken daily by 29 per cent, occasionally by 21 per cent. Most respondents obtained 100 mg or less of vitamin C daily; 2 per cent had more than 2000 mg. Proportionately, more women than men took vitamin C pills daily. Men aged 16 to 44 were the most likely to have neither vitamin C foods nor pills. Persons 45 years and older tended to take vitamin C pills daily, younger persons to take them occasionally. Respondents who did not eat breakfast or who smoked cigarettes had lower vitamin C intakes. People in poor health took more vitamin C than those in good health. Health status may have influenced vitamin C intake rather than vitamin C intake influencing health status.     

Fortified Foods Are Major Contributors to Nutrient Intakes in Diets of US Children and Adolescents

BackgroundEven in an era of obesity and dietary excess, numerous shortfall micronutrients have been identified in the diets of US children and adolescents. To help tailor strategies for meeting recommendations, it is important to know what foods contribute greatly to micronutrient intakes. Data are lacking on specific contributions made by added nutrients.ObjectiveOur aims were to examine the impact of fortification on nutrient adequacy and excess among US children and adolescents and to rank food sources of added nutrient intake and compare rankings with those based on total nutrient intake from foods.Design and statistical analysesData were from 7,250 respondents 2 to 18 years old in the National Health and Nutrition Examination Survey 2003-2006. Datasets were developed that distinguished nutrient sources: intrinsic nutrients in foods; added nutrients in foods; foods (intrinsic plus added nutrients); and total diet (foods plus supplements). The National Cancer Institute method was used to determine usual intakes of micronutrients by source. The impact of fortification on the percentages of children having intakes less than the Estimated Average Requirement and more than the Upper Tolerable Intake Level was assessed by comparing intakes from intrinsic nutrients to intakes from intrinsic plus added nutrients. Specific food sources of micronutrients were determined as sample-weighted mean intakes of total and added nutrients contributed from 56 food groupings. The percentage of intake from each grouping was determined separately for total and added nutrients.ResultsWithout added nutrients, a high percentage of all children/adolescents had inadequate intakes of numerous micronutrients, with the greatest inadequacy among older girls. Fortification reduced the percentage less than the Estimated Average Requirement for many, although not all, micronutrients without resulting in excessive intakes. Data demonstrated the powerful influence of fortification on food-source rankings.ConclusionsKnowledge about nutrient intakes and sources can help put dietary advice into a practical context. Continued monitoring of top food sources of nutrients and nutrient contributions from fortification will be important.     

Observations on the nutrient intakes of eating-dependent nursing home residents: underutilization of micronutrient supplements.

To estimate the intakes of essential nutrients by eating-dependent nursing home residents (EDR).

This study was done in a 190 bed VA nursing home. Thirty-four EDR were selected for the study. Clinical data base which included age, sex, primary diagnosis, body mass index, albumin, hematocrit, activities of daily living status, decubitus ulcer medications and use of multivitamin/trace mineral supplement were recorded from the medical records. Caloric and essential nutrient intakes were determined over a 3-day period by a registered dietitian.

Seventy percent (24/34) residents in the study group were underweight (body mass index < 23 kg/m2), 26% were hypoalbuminemic (serum level < 3.5 g/dl), 50% were anemic (hematocrit < 37%); and 38% had pressure ulcers. In 88% EDR, the dietary intakes of three or more essential nutrients were below 50% of the RDA. Most frequent and severely deficient were zinc, copper, and vitamin B6. Despite the inadequate essential micronutrient intakes in the majority of EDR, only 35% received a multivitamin supplement and only 3% received a trace mineral supplement. A survey of 30 other VA nursing homes indicated generally similar findings to those in the Milwaukee facility with regard to the high frequency for eating-dependence, and the low frequency for administration of multivitamin and trace mineral supplements.

Despite eating supervision and assistance, the majority of EDR have inadequate intakes of numerous essential macro- and micronutrients. The deficient micronutrient intakes could be normalized by administration of a multivitamin/trace mineral supplement daily. Nevertheless, only a minority of EDR in VA nursing homes currently receive such a supplement.