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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/