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Abstract
Purpose
This study assessed the food intake and nutritional status of the elderly in long-term care facilities in order to provide adequate food services and improve the nutritional status.
Methods
The survey was carried out from August 2019 to October 2019 for the elderly in long-term care facilities located in Gwangju Metropolitan City. The survey was conducted to collect data from 199 elderly persons (34 males and 165 females) aged over 65 years old. The food intake was assessed using a 1-day 24-hour recall method.
Results
More than 90% of the subjects were over 75 years old. Forty five percent of the subjects were active, 44.2% of the subjects perceived themselves as not being healthy. Dementia and Parkinson's disease were the most common diseases, followed by hypertension, musculoskeletal disease, diabetes, and stroke. Only 25.6% of the subjects had most of their teeth intact, and 44.7% of the subjects had difficulty in chewing and swallowing. The total food intake was 1,127 g in males and 1,078 g in females. The most frequently consumed foods were kimchi, cooked rice with multi-grains, soybean soup, cooked rice with white rice, yogurt, pumpkin porridge, soy milk, and duck soup. The average energy intake of the subjects was 1,564.9 kcal in males and 1,535.5 kcal in females. The overall nutritional status of the elderly in the long-term care facilities was poor. In particular, the intake of vitamin D and calcium, vitamin C, riboflavin, and potassium were very low. The intake of vitamin D was 5 µg, and 86.4% of the elderly were below the estimated average requirement, while the intake of sodium was high.
References
1. Ministry of Health and Welfare. 2019 The status of welfare facilities for the elderly. Sejong: Ministry of Health and Welfare;2018.
2. Ministry of Health and Welfare. 2019 Guidelines for elderly health welfare business. Sejong: Ministry of Health and Welfare;2019.
3. Statistics Korea. 2018 Elderly statistics. Daejeon: Statistics Korea;2018.
4. Ministry of Health and Welfare. 2016 National health statistics. Sejong: Ministry of Health and Welfare;2017.
5. Ministry of Health and Welfare. The elderly welfare act [Internet]. Sejong: Ministry of Health and Welfare;2019. [cited 2019 Jul 1]. Available from:. http://www.law.go.kr.
6. Ministry of Food and Drug Safety. Guidelines for healthy meals for the elderly. Cheongju: Ministry of Food and Drug Safety;2015.
7. Korea Institute for Health and Social Affairs. Analysis and policy implications of longterm care facilities for the elderly. Sejong: Korea Institute for Health and Social Affairs;2015.
8. Kwon JS, Lee SH, Lee MK, Lee YN. Study on energy and nutrient intake and food preference of the elderly in care facilities. Korean J Community Nutr. 2016; 21(2):200–217.
9. Hyun EY, Oh JJ. Malnutritional status and it's related factors of demented elderly in longterm care facilities. J Korea Contents Assoc. 2017; 17(9):426–436.
10. Won JB, Ha JY. The subjective oral health status, dependence of eating behavior and nutritional status of the elderly in nursing facilities according to dysphagia. Asia Pac J Multimed Serv Converg Art Humanit Sociol. 2018; 8(12):711–720.
11. Kwak KS, Bae YJ, Kim MH. Nutritional status and dietary quality in the low-income elderly residing at home or in health care facilities. J Korean Diet Assoc. 2008; 14(4):337–350.
12. Lee MS. Nutritional status of the oldest-elderly population in Sunchang county. Korean J Community Nutr. 2009; 14(3):255–265.
13. Kwak CS, Cho JH, Yon M, Park SC. Anthropometric index, dietary habits and nutrient intake of the oldest-old population aged 95 and over living in Seoul. Korean J Community Nutr. 2012; 17(5):603–622.
14. The Korean Nutrition Society. 2015 CAN-Pro 5.0. Seoul: The Korean Nutrition Society;2015.
15. The Korean Nutrition Society. 2015 Dietary reference intakes for Koreans, 1st revision. Seoul: The Korean Nutrition Society;2015.
16. Han G, Yang E. Status of foodservice operations in longterm care facilities for the elderly-focus on the Gwangju Metropolitan City-. J East Asian Soc Diet Life. 2018; 28(5):337–344.
17. Korea Institute for Health and Social Affairs. 2017 Survey of the elderly status. Sejong: Korea Institute for Health and Social Affairs;2017.
18. Chang YJ. Status and improving the quality of foodservice in longterm care facilities for the elderly. Seoul: National Assembly Research Service;2013.
19. Korea Agro-Fisheries and Food Trade Corporation. Status of 2016 processed food market by category: elder friendly foods. Naju: Korea Agro-Fisheries and Food Trade Corporation;2016.
20. Ministry of Food and Drug Safety. 2019 Guiding the recipe for those who difficulty in chew or swallow. Cheongju: Ministry of Food and Drug Safety;2019.
21. Han G, Yang E. Evaluation of dietary habit and nutritional intake of Korean elderly: data from Korea National Health and Nutrition Examination Survey 2013∼2015. J East Asian Soc Diet Life. 2018; 28(4):258–271.
22. Adrogué HJ, Madias NE. Sodium and potassium in the pathogenesis of hypertension. N Engl J Med. 2007; 356(19):1966–1978.
23. Chobanian AV, Hill M. National heart, lung, and blood institute workshop on sodium and blood pressure: a critical review of current scientific evidence. Hypertension. 2000; 35(4):858–863.
24. Tsugane S. Salt, salted food intake, and risk of gastric cancer: epidemiologic evidence. Cancer Sci. 2005; 96(1):1–6.
25. Yang EJ, Bang HM. Nutritional status and health risks of low income elderly women in Gwangju area. J Nutr Health. 2008; 41(1):65–76.
Table 1.
General characteristics of the elderly in long-term care facilities
| Characteristics | Total (n = 199) | Male (n = 34) | Female (n = 165) | p-value2) |
|---|---|---|---|---|
| Age (yrs) | 0.062 | |||
| 65–74 | 19 (9.5) | 7 (20.6) | 12 (7.3) | |
| 75–84 | 86 (43.2) | 16 (47.1) | 70 (42.4) | |
| ≥ 85 | 94 (47.3) | 11 (32.4) | 83 (50.3) | |
| Education level | < 0.0001 | |||
| Elementary school or lo | wer 166 (83.5) | 18 (53.0) | 148 (89.7) | |
| Middle school | 18 (9.0) | 7 (20.6) | 11 (6.7) | |
| High school | 11 (5.5) | 6 (17.6) | 5 (3.0) | |
| College or higher | 4 (2.0) | 3 (8.8) | 1 (0.6) | |
| Length of residence1) (yrs) | 0.065 | |||
| < 1 | 64 (32.5) | 11 (32.4) | 53 (32.5) | |
| ≥ 1 and < 3 | 75 (38.1) | 13 (38.2) | 62 (38.0) | |
| ≥ 3 and < 5 | 28 (14.2) | 3 (8.8) | 25 (15.3) | |
| ≥ 5 and < 10 | 20 (10.2) | 2 (5.9) | 18 (11.0) | |
| ≥ 10 | 10 (5.1) | 5 (14.7) | 5 (3.1) | |
| Drinking & smoking | < 0.0001 | |||
| Neither | 164 (82.5) | 20 (58.8) | 144 (87.3) | |
| Drinking | 18 (9.0) | 5 (14.7) | 13 (7.9) | |
| Smoking | 2 (1.0) | 1 (2.9) | 1 (0.6) | |
| Both | 15 (7.5) | 8 (23.5) | 7 (4.2) | |
| Physical activity | 0.226 | |||
| Usually in bed or chair | 108 (54.3) | 14 (41.2) | 94 (57.0) | |
| Active | 91 (45.7) | 20 (58.8) | 71 (43.0) | |
| No. of exercises | 0.636 | |||
| Almost everyday | 81 (40.7) | 15 (44.1) | 66 (40.0) | |
| 2–4 times/week | 35 (17.6) | 6 (17.6) | 29 (17.6) | |
| 1 time/week | 26 (13.1) | 6 (17.6) | 20 (12.1) | |
| No exercise | 57 (28.6) | 7 (20.6) | 50 (30.3) |
Table 2.
Health status of the elderly in long-term care facilities
| Health status | Total (n = 199) | Male (n = 34) | Female (n = 165) | p-value2) |
|---|---|---|---|---|
| Health consciousness | 0.097 | |||
| Good | 61 (30.6) | 17 (50.0) | 44 (26.7) | |
| Moderate | 50 (25.1) | 5 (14.7) | 45 (27.3) | |
| Poor | 88 (44.2) | 12 (35.3) | 76 (56.0) | |
| Disease1) | – | |||
| Dementia & Parkinson's | 120 (27.1) | 22 (28.9) | 98 (26.6) | |
| Hypertension | 100 (22.6) | 15 (19.7) | 85 (23.1) | |
| Arthritis & musculoskeletal | 65 (14.7) | 8 (10.5) | 57 (15.5) | |
| Diabetes | 39 (8.8) | 7 (9.2) | 32 (8.7) | |
| Stroke | 34 (7.7) | 5 (6.6) | 29 (7.9) | |
| Chronic renal failure | 12 (2.7) | 0 (0.0) | 12 (3.3) | |
| Others | 73 (16.5) | 19 (25.0) | 55 (14.9) | |
| No. of medications | 0.119 | |||
| < 1 | 21 (10.5) | 5 (14.7) | 13 (7.9) | |
| 2 | 31 (15.6) | 7 (20.6) | 24 (14.5) | |
| 3 | 57 (28.6) | 4 (11.8) | 53 (32.1) | |
| ≥ 4 | 90 (45.3) | 18 (52.9) | 72 (43.6) | |
| Nutritional & health supplement | 0.163 | |||
| Yes | 29 (14.6) | 3 (8.8) | 26 (15.8) | |
| Occasionally | 9 (9.5) | 1 (2.9) | 18 (10.9) | |
| No | 151 (75.9) | 30 (88.2) | 121 (73.3) |
Table 3.
Chewing & swallowing function of the elderly in long-term care facilities
| Characteristics | Total (n = 199) | Male (n = 34) | Female (n = 165) | p-value1) |
|---|---|---|---|---|
| Teeth condition | 0.541 | |||
| Have most teeth intact | 51 (25.6) | 10 (29.4) | 41 (24.8) | |
| Have only a few teeth | 39 (19.6) | 7 (20.6) | 32 (19.4) | |
| Have no teeth | 12 (6.0) | 2 (5.9) | 10 (6.1) | |
| A partial denture | 39 (19.6) | 9 (26.5) | 30 (18.2) | |
| A full denture | 58 (29.1) | 6 (17.6) | 52 (31.5) | |
| Difficulty of chewing & swallowing | 0.648 | |||
| Yes | 89 (44.7) | 14 (41.2) | 75 (45.5) | |
| No | 110 (55.3) | 20 (58.8) | 90 (54.5) | |
| A way to eat food when it is difficult to chew and swallow | 0.694 | |||
| Cut finely | 50 (25.1) | 10 (29.4) | 40 (24.2) | |
| Chop finely | 34 (17.1) | 3 (8.8) | 31 (18.8) | |
| Ground finely | 7 (3.5) | 1 (2.9) | 6 (3.6) | |
| Dilute | 7 (3.5) | 1 (2.9) | 6 (3.6) |
Table 4.
Daily food intake of the elderly in long-term care facilities
| Food groups (g) | Total (n = 199) | Male (n = 34) | Female (n = 165) | p-value1) |
|---|---|---|---|---|
| Total food | 1,086.5 ± 305.3 | 1,126.8 ± 238.8 | 1,078.2 ± 317.2 | 0.399 |
| Cereals | 206.4 ± 88.5 | 230.4 ± 130.1 | 201.4 ± 76.8 | 0.082 |
| Potatoes & starches | 40.3 ± 46.5 | 62.4 ± 57.1 | 35.7 ± 42.8 | 0.002 |
| Sugars & sweet | 8.2 ± 5.6 | 7.5 ± 6.5 | 8.4 ± 5.5 | 0.397 |
| Legumes | 94.8 ± 98.9 | 93.1 ± 102.2 | 95.2 ± 98.5 | 0.914 |
| Seeds & nuts | 5.3 ± 22.0 | 5.6 ± 24.1 | 5.6 ± 24.1 | 0.940 |
| Vegetables | 393.9 ± 140.5 | 423.3 ± 141.5 | 387.8 ± 140.0 | 0.180 |
| Mushrooms | 16.6 ± 18.5 | 18.2 ± 21.8 | 16.3 ± 17.8 | 0.593 |
| Fruits | 28.5 ± 46.0 | 28.4 ± 51.9 | 28.6 ± 44.9 | 0.984 |
| Meat & poultry | 67.9 ± 50.1 | 60.8 ± 57.6 | 69.3 ± 48.4 | 0.368 |
| Eggs | 12.9 ± 19.8 | 7.9 ± 14.3 | 14.0 ± 20.7 | 0.101 |
| Fishes & shellfishes | 70.4 ± 39.0 | 80.3 ± 42.4 | 68.4 ± 38.1 | 0.105 |
| Seaweeds | 4.5 ± 6.5 | 4.0 ± 5.9 | 4.6 ± 6.6 | 0.630 |
| Milk & dairy products | 73.9 ± 92.1 | 39.7 ± 80.5 | 80.9 ± 93.0 | 0.017 |
| Beverages & alcohol | 3.4 ± 12.3 | 1.9 ± 2.8 | 3.7 ± 13.5 | 0.443 |
| Condiment | 47.0 ± 21.1 | 51.4 ± 21.3 | 46.1 ± 21.1 | 0.179 |
| Oil | 11.3 ± 5.5 | 10.9 ± 2.8 | 11.4 ± 5.2 | 0.621 |
| Others | 1.2 ± 2.2 | 1.1 ± 2.2 | 1.2 ± 2.2 | 0.742 |
Table 5.
Food intake frequency of the elderly in long-term care facilities
Table 6.
Daily nutrient intakes of the elderly in long-term care facilities
| Nutrient | Total (n = 199) | Male (n = 34) | Female (n = 165) | p-value4) | |||
|---|---|---|---|---|---|---|---|
| Intake1) | Proportion of below reference intakes (%)2) | Intake1) | Proportion of below reference intakes (%) | Intake1) | Proportion of below reference intakes (%) | ||
| Energy (kcal) | 1,538.9 ± 199.0 | 54.3 | 1,564.9 ± 444.1 | 85.3 | 1,533.5 ± 433.4 | 47.9 | 0.702 |
| Carbohydrate (g) | 235.2 ± 60.7 | – | 244.9 ± 55.3 | – | 233.2 ± 61.7 | – | 0.310 |
| Fat (g) | 37.5 ± 15.8 | – | 35.6 ± 18.1 | – | 37.9 ± 15.4 | – | 0.437 |
| Protein (g) | 64.7 ± 20.4 | 13.1 | 65.9 ± 21.0 | 11.8 | 64.4 ± 20.3 | 13.3 | 0.699 |
| Fiber (g) | 27.7 ± 10.0 | 22.6 | 30.3 ± 9.7 | 11.8 | 27.1 ± 10.0 | 24.8 | 0.090 |
| Vitamin A (µgRE) | 648.8 ± 365.2 | 27.1 | 717.2 ± 490.1 | 26.5 | 634.7 ± 333.9 | 27.3 | 0.231 |
| Thiamine (mg) | 1.5 ± 0.5 | 24.6 | 1.5 ± 0.5 | 23.5 | 1.5 ± 0.5 | 24.8 | 0.743 |
| Riboflavin (mg) | 1.1 ± 0.4 | 39.7 | 1.1 ± 0.4 | 41.2 | 1.1 ± 0.4 | 39.4 | 0.938 |
| Niacin (mg) | 12.7 ± 4.1 | 31.7 | 12.3 ± 4.5 | 38.2 | 12.8 ± 4.0 | 30.3 | 0.483 |
| Vitamin C (mg) | 93.0 ± 56.0 | 47.2 | 94.6 ± 55.8 | 47.1 | 92.7 ± 56.2 | 47.3 | 0.854 |
| Vitamin D (µg) | 5.1 ± 5.5 | 86.4 | 5.1 ± 5.4 | 85.3 | 5.2 ± 5.5 | 86.7 | 0.940 |
| Ca (mg) | 566.1 ± 233.7 | 43.2 | 529.4 ± 185.4 | 55.9 | 573.7 ± 240.8 | 40.6 | 0.316 |
| Na (mg) | 4,126.5 ± 1,436.8 | 90.53) | 3,935.1 ± 1,593.5 | 88.2 | 4,166.0 ± 1,404.3 | 3 90.9 | 0.395 |
| K (mg) | 3,000.2 ± 997.0 | 65.3 | 2,883.4 ± 1,024.7 | 64.7 | 3,024.3 ± 992.7 | 65.5 | 0.454 |
| Fe (mg) | 16.7 ± 6.0 | 3.5 | 16.2 ± 6.4 | 2.9 | 16.8 ± 5.9 | 3.6 | 0.546 |
| Energy contribution | |||||||
| Carbohydrate (%) | 61.9 ± 5.6 | – | 64.0 ± 6.8 | – | 61.4 ± 5.3 | – | 0.014 |
| Protein (%) | 16.7 ± 2.1 | – | 16.6 ± 2.2 | – | 16.7 ± 2.1 | – | 0.778 |
| Fat (%) | 21.3 ± 5.0 | – | 19.2 ± 5.7 | – | 21.7 ± 4.7 | – | 0.007 |
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