Malnutrition Toolkit by Sysco Canada

Nourished Aging Toolkit:

Malnutrition in Older Adults: Optimizing Food & Fluid Intake

Message From Sysco’s Nutrition Services Team

Older adults, living within senior living can be at increased risk of unintentional weight loss and malnutrition. Both have an impactful influence on individual's overall health and quality of life. This resource will focus on helpful tips to optimize the dietary intake of seniors to manage malnutrition and/or unintentional weight loss and feature topics such as: •

•

Also included are Fortified Recipes found in Synergy Tech Suite and product listings. Please reach out to your Sysco Sales Representative for more information.

Note: The information provided within this toolkit are suggestions and should be implemented in consultation with a Registered Dietitian or Nutrition Manager and in accordance with your home specific policies

- Sysco Canada’s Nutrition Services Team

The Food First Approach • High Protein High Energy Diet

Supporting Intake Beyond

Food

Table of Contents Senior Malnutrition & Page 3 Weight Loss Food First Approach Page 4 High Protein High Page 5 Energy (HPHE) Diet HPHE Recipe Ideas Page 7 Nutrition in Disguise Page 8 Recipe Ideas Page 9 Supporting Intake Page 11 Beyond Food Product Features Page 12 This toolkit has been developed in collaboration with our partner, Seasons Care Dietitian Network.

Senior Malnutrition & Weight Loss

Older adults are at risk of poor dietary/nutritional intake causing weight loss due to a variety of reasons including physical, cognitive or psychological changes, along with social factors:

Poor Intake

Physical Psychological

Dentition

Motor Control

Sensory Changes

Health Condition

Medication

Depression

Dementia

Unintentional weight loss and malnutrition are possible consequences of poor nutritional intake from food and fluids among older adults living in senior living settings.

Malnutrition is defined as the deficiencies, excesses or imbalances in an individual's intake of energy and/or nutrients.

Social

Social Isolation

3 Senior Malnutrition & Unintentional Weight Loss

Food First Approach

The Food First Approach is a practice used to help manage poor dietary intake and the consequence of unintentional weight loss using everyday nourishing foods and beverages.

The majority of resident's nutritional needs should be met by the menu. Further individual nutritional needs should be met by nutrient-dense foods and beverage interventions.

Achieving a Food First Approach

Optimize the Main Menu

• Adapt menu to meet resident

• preferences and cultural needs

• Incorporate familiar foods and dishes

• Incorporate ongoing resident feedback from resident council, resident surveys & plate waste audits

• Create opportunities for resident’s to be active in mealtime

o Resident choice days

o Incorporate resident recipes

Assess Individual Needs

Understand individual food preferences upon admission through individual or family interview. Include ongoing assessment and follow up.

• If resident assessment identifies the need for additional nutrition, consider a High Protein High Energy intervention that uses nutrient dense foods.

• If High Protein High Energy food items are not tolerated or not effective, consider usage of nutritional supplements to complement the Food First Approach

4 Senior Malnutrition & Unintentional Weight Loss

High Protein High Energy Diet

A High Protein High Energy (HPHE) intervention focuses on increasing protein and energy intake through foods, beverages or supplements, without increasing the volume of food consumed.

Food and beverages can be fortified with high protein and/or high energy options.

Here are some tips to fortify foods & beverages to increase protein and energy intake.

Added Protein Added Fat

• Add extra meat/fish or eggs to meals like pasta, salads, soups, stews, etc.

• Add plant-based options such as tofu, tempeh and legumes to meals

• Add spreads like hummus to sandwiches or snacks

• Add cheese to sandwiches and snack options

• Grate cheese over vegetables or rice/pasta dishes

• Add skim milk powder to soups, smoothies, puddings and other desserts

• Add butter or oil to vegetables, rice, pasta or potatoes

• Add butter to bread and crackers

• Use extra cream in cold or hot cereals, soups and sauces

5 Senior Malnutrition & Unintentional Weight Loss

Protein Options

Loss of muscle mass, strength & function are common parts of aging. Adequate protein intake has been shown to positively influence immune status, wound healing, blood pressure & bone health – while helping to prevent unintentional weight loss.

Synergy Tech Suite includes a variety of recipes including different protein options. Visit www.sysco.ca/synergy for more information.

Animal Based Protein Source Animal Product Protein Source Protein Serving Calories Protein Protein Serving Calories Protein Egg Milk, 2% Yogurt Greek Yogurt Cheese, Cheddar 1 Each 125 mL 125 mL 125 mL 50 g 67.5 Kcal 64.4 Kcal 110 Kcal 77.30 Kcal 200 Kcal 6.7 g 4.25 g 2.96 g 13.3 g 11.6 g Chicken Breast 90 g 135 Kcal 18 g Turkey Breast 90 g 126 Kcal 18 g Pork Chop 90 g 110 Kcal 18.9 g Beef, Ground 90 g 171 Kcal 17.6 g Veal, Ground 90 g 155 Kcal 22 g Plant Based Protein Sources Protein Serving Calories Protein Lamb, Diced 90 g 167 Kcal 25 g Tofu Beans, Black Lentils Peanut Butter Quinoa 150 g 150 g 150 g 30 mL 125 mL 105 Kcal 198 Kcal 155 Kcal 193 Kcal 110 Kcal 12 g 13.2 g 8.2 g 5.6 g 4.24 g Salmon Fillet 90 g 189 Kcal 18 g Cod Fillet 90 g 72 Kcal 17 g Tuna, Canned 90 g 98 Kcal 21 g Shrimp, 90 g 63 Kcal 13.5 g Pieces Edamame 125 mL 198 Kcal 17.4 g 6 Senior Malnutrition & Unintentional Weight Loss

High Protein High Energy Recipe Ideas

Breakfast Lunch

• Flax Fruit Oatmeal: Add 1 Tbsp of flax meal to 180mL of oatmeal prepared with whole milk or cream

• PB & Banana Smoothie: Blend banana, whole milk, peanut butter and high fat, high protein yogurt

• Cheese & Ham Omelette: Add cooked ham and cottage cheese. Top with shredded cheese and serve with buttered toast

Dinner

• Pasta & Meat Sauce: Add ground beef or pork to tomato sauce. Top with added shredded cheese

• Lentil Beef Stew: Add lentils and diced potatoes to the stew. Serve with buttered bread

• Potato Fish Cakes: Add mashed potatoes to fish cake mix. Serve with high fat mayonnaise tartar sauce.

• Turkey Taco Soup

Add extra beans like black & pinto for added protein. Top with a high fat sour cream

• Chicken Salad Sandwich: Mix chicken with high fat mayonnaise and top with avocado & tomato slices

• Cobb Side Salad: Elevate a side salad by adding elements of a cobb salad like boiled eggs, diced chicken or feta cheese. Top with ranch dressing

Snack

• Yogurt Fruit Bowl: 125mL of higher fat, high protein yogurt with fruit of choice. Top with peanut butter, granola or honey.

• Hummus with Crackers: Serve crackers, hummus spread and cucumber slices

• Carrot Loaf & Cream Cheese Icing: Top carrot loaf with a cream cheese icing made up of high fat cream cheese, cream, butter, icing sugar & vanilla

7 Senior Malnutrition & Unintentional Weight Loss

Nutrition in Disguise

Nutrition in Disguise (NiD) is a research project completed at the Research Institute for Aging focusing on creating nutrient dense recipes by adding healthy ingredients to common foods that older adults enjoy

Most older adults are not consuming enough key nutrients to stay healthy and are at risk of micronutrient deficiencies.

While protein/energy intake are often a central focus when considering senior’s health and risk of malnutrition – it is important to consider micronutrient intake and the influence of micronutrient deficiency on overall health.

NiD create recipes that focused on micronutrients that are important to adult health. Ingredients that contain key micronutrients were incorporated into recipes.

All Nutrition in Disguise recipes are available in Synergy Tech Suite!

Oatmeal Cookie

Berry Parfait

Includes raspberries – a great source of fibre & vitamin C

Spinach & Cheese Quiche

Includes spinach – a source of vitamin K, vitamin A & folate

For more information on Nutrition in Disguise or the Research Institute for Aging click here

8 Senior Malnutrition & Unintentional Weight Loss

Supplement/Fortified Recipes

Supplement/Fortified Recipes Available in Synergy Tech Suite!

Find these recipes and more in Synergy Tech Suite, Sysco Canada’s end-to-end software & hardware foodservice management solution designed for the healthcare and senior living industry.

Select Recipes>Recipes Listing> Filter Recipe Box to Supplement/Fortified Recipes and Nutrition in Disguise

Beef

Barley Soup Power Hot Cocoa

Lentil Brownie

Power

Potato with Cheese

Recipe courtesy of Nutrition in Disguise & available in Synergy Tech Suite

9 Senior Malnutrition & Unintentional Weight Loss

Supporting Intake Beyond Food

Ensure all meal components are accessible & within reach

• Where appropriate, open all packaging including condiments, cutlery and straws

• Assist with preparing items for consumption including:

o Spreading margarine & jams on bread

o Preparing beverages like coffee and tea

o Cutting up proteins, vegetables and bread

• Ensure cutlery, napkins and beverages are within reach and where individual’s prefer

Practice different methods to create a positive mealtime

• Encourage socialization during mealtime:

o Pair residents with close friends at their table

o Encourage team members to interact with residents during meal service

• Create a welcoming and relaxed dining environment:

o Create a calm ambience with warm lighting

o Play soft music in dining rooms or personal rooms

o Add a flare to table settings with coloured napkins and placemats and beautiful center pieces

o Reduce loud noises like dish scraping or kitchen noise

Ensure residents are regularly assessed by a registered dietitian to ensure they receive appropriate diet order based on their needs

10 Senior Malnutrition & Unintentional Weight Loss

For more information & resources, contact your Sysco representative or visit www.sysco.ca/healthcare

For more information about Malnutrition visit the Canadian Malnutrition Task Force website here

Malnutrition in Adults Living With Dysphagia: Strategies for Prevention, Detection and Management

Presented by Heather Keller RD, PhD, FDC, FCAH

Dysphagia increases the risk of malnutrition, aspiration, and respiratory infections. Malnutrition causes longer hospital stays, higher re-admission rates, higher in-hospital mortality rates and accounts for $2 billion in health care costs in Canada.

Join us to learn more on how to prevent, detect and manage malnutrition in adults living with dysphagia.

DATE/TIME

Tuesday May 9th, 2023 12:15-1:15pm ET

REGISTRATION

To secure your spot for this Live Webinar register by Monday April 17th, 2023.

This webinar is complimentary and is funded by Nestlé Health Science.

LEARNING OBJECTIVES

• To have a better understanding of the risks of developing malnutrition in patients living with dysphagia

• Be familiar with the methods used to detect malnutrition in people who may be at risk

• Feel empowered to support families and patients with dysphagia with practical tips on how to manage mealtimes

• Learn more about the tools and resources available to assist families and patients with dysphagia who are malnourished.

UPCOMING LIVE WEBINAR: MAY 9, 2023

LOCATION Virtual Education Event

Almost

Please

BOOST®

180

https://www.dietitians.ca/DietitiansOfCanada/media/Documents/Resources/2019-Best-Practices-for-Nutrition,-Food-Service-and-Dining-in-LongTerm-Care-LTC-Homes.pdf Accessed Feb 21,2023. 2. Keller H, Vucea V, Slaughter SE, Jager-Wittenaar H, Lengyel C, Ottery FD, Carrier N. Prevalence of Malnutrition or Risk in Residents in Long Term Care: Comparison of Four Tools. J Nutr Gerontol Geriatr. 2019 Oct-Dec;38(4):329-344. All trademarks are owned by Société des Produits Nestlé S.A., Vevey, Switzerland and used under license. ©2023 Nestlé. All rights reserved. S10-5915

Nourished!

Stay Hydrated &

DID YOU KNOW?

half of long term care residents may experience dehydration.1 In addition, malnutrition is prevalent in long term care.2

Fruit Flavoured Beverage is a delicious and refreshing way to help improve hydration while also providing protein, energy and micronutrients. BOOST® Fruit Flavoured Beverage (24 x 237 ml) Peach Wildberry Orange Nestlé Product Code 12460256 12460255 12460257 Sysco Product Code 5538220 5538214 5541970

BOOST®

contact your Nestlé Health Science Sales Representative or call Nestlé Health Science Customer Service at 1 800 565-1871 for any questions.

use under the guidance of a healthcare professional. ®

For

Fruit Flavoured Beverage is nutritionally complete and provides a non-creamy alternative to traditional supplements.

every 237 ml serving, enjoy:

g of whey protein

vitamins and minerals

calories, 0.5 g fat

refreshing flavours.

Available in 3

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