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NutritionandSupplementationInAgedCare
©FoodSolutions2017
Overview
• Supplementsandpurposeofuse
• Typesofsupplements
• Effectiveuseofsupplements
• Monitorconsumption
• Makeyourownnutritionalsupplement
AimandObjectives
Aim:• Toincreasegeneralknowledgeofhowtousenutritional
supplementsinagedcare
Objectives:• Toidentifyreasonsforcommencingsupplements• Toidentifytypesofsupplements• Todiscussstrategiesforhowtoeffectivelyusesupplements
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WhatareSupplements?
• Specialfoodproductsorpowdersusedinadditiontodailyfoodintake
• Addextraenergy,protein,vitaminsandminerals• Assistinstabilisingweightandweightgain• Helpmaintainnutritionalstatus• Someare“nutritionallycomplete”
Whyusethem?
Supplementsarehelpfulforpeoplewho:• havelostweightwithouttrying• havedifficultymaintainingtheirweightie.lowbodyweight• arenotmeetingnutritionalrequirementsfromfoodalone• haveincreasednutritionalrequirementsforan
illness/conditioneg.COPD,Parkinson’s,PressureInjuryandpostsurgery
Whattypesarethere?
• Powdered• Readytodrinkliquids• PuddingsandJellies• Desserts• Cookies• SpecialisedSupplements
NB:somewillbelactosefreeand/orglutenfree,high/lowfibre
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Powdered
• plainorflavourede.g..neutralvsvanilla• useneutralpowdersforacidicandsavouryfoods(1-2scoops
permeal)• madeonmilkorwater• useasadrinkorinsteadofmilk,e.g.oncerealorincoffee• mixedathigherconcentrationifrequired• sprinkleoverbreakfastcerealsanddesserts
Readytodrinkliquids
• availableas“juice”or“milky”drinks• varietyofflavours• packaged,oftenwithastraw• differentsizesbutusually200mlto250ml
Juicetype:eg.ResourceFruit,FortijuiceorEnliveMilktype:eg.Sustagen,Ensure,Fortisip,ResourcePlus
PuddingsandJellies
• Analternativetexturetodrinks• Canbehelpfulfortexturemodifieddiets,howevernotejelly
isnotsafeforthoserequiringthickenedfluids• Packagedas
– readytomixpowders– justaddmilkorwatereg.boostjelly,sustagenpudding
– readymadeinindividualserveseg prolemon-lime,forticreme,ensurepudding
– fruit,cream,ice-creamcanbeadded
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Desserts
• custards,cheesecakes,fruitydesserts,nomelticecreams,usuallyservedinindividualportions
• maybepreferredbythosewhoenjoydesserts/sweets• serveatsupperormidmeals• halfatlunch,halfatdinner• serveifnoteatingdessertonmenu• serveifrefusingmeals
Cookies
• SavouryandSweet• Usedasasnackwithtea/coffee• Cancrumblesweetcookiesoverdesserts,savouryoversoups• Suitableforresidentswithdementiawhowanderorpace,can
carrypacketandeatonthego• Fullmealreplacement
Specialised Supplements
Designedtobeusedfordifferentmedical/diseasestates,howeverconsultyourdietitianasastandard2cal/mlsupplementmayalsosuffice
• Woundhealing– containsArginine,Vit C,Zincetc
• Diabetes– lowGI,somehavelowerenergyperserve
• Renaldisease– variedproteinfordialysisandmodifiedfor
electrolyteimbalanceseg PO4,Ca+,K+,Mg,Na
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EnergyPowders(containonlycarbohydrate)
• addenergywithoutchangingthetaste• sprinkleoverbreakfastcereals• mixintoallbeveragesandsoups• addtocasseroles,mashedvegetables,cannedorstewedfruit,
dessertsExample:Polyjoule,CarbPlus
Proteinpowders(foraddingextraprotein)
• useforincreasedproteinneedseg.dialysis,pressureinjury• sprinkleoverbreakfastcereals• mixintomilkdrinks,andcreamysoups• addtocasseroles,mashedvegetablesandmilkydesserts
Whentousesupplements
• betweenmeals
• aspartofameal
• anytimedesiringtoeatordrink
• duringmedrounds
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Improvingsupplementconsumption
• Temperature– servechilled,atroomtemperature,semi-
frozenorwarmedasperresident’spreference
• Texture– makejuicesintojelly,usethickener,addfreshfruit
andblendintomilkshake
• Presentation– serveinglass,offerjuicesonice
• Flavour– rotateflavours,findoutsavoury/sweetpreferences
• Delivery– useanumberofmodestodeliver,suchasinfood
andasdrinks,usemedpass
MedPass
• Usesa2cal/mlbeveragesupplementduringmedicationround• Promotesweightgainforhighriskresidents• Cancomplimentstandardnutritionalsupplementation• prescribedbytheGPorDietitian• morelikelytoconsumeas“medicine”• studiesshowbettercompliance
BenefitsofMedPass
• Easilyaddsneedednutritiontodailyintake• Idealforservingsmallervolumese.g.60-80mlTDS• Reducesflavourfatigue• Doesnotinterferewithappetiteasmuch
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MonitorConsumption
• Supplementscanbeexpensive
• Ascertaincausesfornon-consumptioneg.taste,loosebowels,nausea,presentation,temperatureetc.
• Foodandfluidchartscanassistinrecordingconsumption
• Oncehealthyweightisregained,abletodecreaseorceaseoralsupplementsandreturntoabalanceddiet
Makeyourown
Summary
Bytheendofthissession,haveyouachievedthefollowing..
Increased generalknowledgeofhowtousenutritionalsupplementsinagedcare?
Identifiedreasonsforcommencingsupplements?
Identifiedtypesofsupplements?
Abletodiscussstrategiesforhowtoeffectivelyusesupplements?
Pleaserefertothequizquestionstoreviewyourknowledgeofthiscourse.
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References
1. DietitiansAssociationofAustralia(2009).Evidencebasedpracticeguidelinesforthenutritionalmanagementofmalnutritioninadultpatientsacrossthecontinuumofcare.NutritionandDietetics66(Suppl.3):S1-34.
2. QueenslandGovernment,QueenslandHealth(2013).NEMOFactsheet:Makingthemostofnutritionsupplements.Accessibleatwww.health.qld.gov.au
3. MedicalNutritionInternationalIndustry(2012).Oralnutritionalsupplementstotacklemalnutrition:asummaryoftheevidencebase.MNI,Brussels,Belgium.
4. VolkertDetal.(2006)ESPENGuidelinesonenteralnutrition:geriatrics.ClinicalNutrition25;330-360.
5. Nutritioncompanywebsites:www.sustagen.com.auwww.abbottnutrition.com.au
www.nestlehealthscience.com.au/www.flavourcreations.com.au/www.nutricia.com.au/