improving nutrition & food palatability in older...
TRANSCRIPT
Improving nutrition & food palatability in older people
Senses and beyond the senses
Food matters live
November 24th 2016
The Center for Food and Hospitality Research
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The sciences dedicated to the understanding of the pleasure of meals, worldwide
http://recherche.institutpaulbocuse.com/
Prevalence of malnutrition in institutions: 15 to 38% HAS, 2007
- Physiological, psychological and sociological changes Ferry, et al. 2007 - Inadequate food intake Chen, et al. 2001
Promote food intake through meal pleasure
Elderly living in geriatric institutions
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Elderly in geriatric institutions - Average age around 85 years old KPMG, 2013
- A majority of women DRESS, 2006
- “Frail” elderly
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• Nutrients - Food selection/ enrichment
• Adequate quantities - Portion size
NUTRIONAL REQUIREMENTS
• Physical access – Food/ Packaging adaptation
• Chewing & Swallowing troubles - Modified texture
FOOD ACCESSIBILITY
•Willingness to eat •Food pleasure
FOOD ATTRACTIVENESS
French guidelines: PNNS, 2006 ; HAS, 2007 ; ANAP, 2011
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The food – sensory
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The influence of COLOUR variety
Homogeneity: Finger foods in one vs. two layers Each participant receives a plate with 2 versions of a same dish.
4 days with a different dish tested for each factor
Pouyet V., Giboreau, A., Benattar, L., & Cuvelier, G. (2014). Attractiveness and consumption of finger foods in elderly Alzheimer’s disease patients. Food Quality and Preference, 34, 62-69
Protocol
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Participants 114 participants 26 males, 88 females, age : 86 ±6,7 years old) with Alzheimer’s disease able to feed themselves high dependency (GIR≤2) With and without chewing and swallowing difficulties
Paired comparison test in a real situation of mealtime
(lunch)
Assessment by caregivers: - 1st choice
- finger foods consumption
Results
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At lunch, Alzheimer patients significantly chose more and consumed more 2-layer finger foods (Vs all pureed in 1)
THE INFLUENCE OF FLAVOUR VARIETY
Products
Soft bread toasts with an aubergine purée. Same appearance, same texture REF : bland purée F+ : flavour enhanced purée with salt, pepper, lemon juice, garlic
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F+ REF
Pouyet V., Cuvelier G., Benattar L., & Giboreau, A., Influence of flavour enhancement on food liking and consumption in older adults with poor, moderate or high cognitive status. Food Quality and Preference, 44, 119–129
Protocol
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Participants 104 elderly subjects, aged m= 89 +/- 5 Clustered in 3 MMS groups Low, Medium and High cognitive status (MMS) Experimental design tasting sessions before lunch
Measure of food intake Count of the number of remaining toasts. Comparison to served amount (8)
Results
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Positive effect of flavour enhancement on food consumption
No significant difference between the different cognitive status
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Beyond the food – the context
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Control Experimental
DISH DRESSING
Navarro D.A., Boaz M., Krause I., Elis A., Chernov K., Giabra M., Levy M., Giboreau A., Kosak S., Mouhieddine M. & Singer P. (2015) Improved meal presentation increases food intake and decreases readmission rate in hospitalized patients Clinical Nutrition, 1-6.
N= 100 in each group.
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Dish dressing accordingly to gastronomy standards increased liking and consumption
Control Experimental
The foodservice system
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KITCHEN
DINING ROOM
The waiter
The chef
The client
Foo
d s
up
ply
Tab
le a
rt s
up
ply
What means are available to provide « good food »?
Plate and cutlery
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Piqueras-Fiszman B., Giboreau A., Spence C. 2013 Assessing the influence of the color of the plate on the perception of a complex food in a restaurant setting, Flavour, 2:24
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Table dressing
Saulais. L. et al (2015) Measuring residents’ perceptions and expectations for the design of retirement homes restaurants ambiences. Menu
• Effect on declarative willingness to eat
1 1
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Comme à la maison Fleurie
Cosy
The ATMOSPHERICS , physical environment, table dressing
• Social and interactional dimensions at meal service in the institution
• Evaluating training programs for nursing auxiliary staff
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The SERVICE
Space arrangement (tray)
Personal interest (staff)
Management (institution)
Bouima S., Paryse F., Ticca A.C, Michaud M., Giboreau A., Combret D. & Nicod-Franc S. Lutter contre la dénutrition à l’hôpital par la formation des aides-soignantes aux bonnes pratiques de service de repas en unité de soin : apports et limites d’une approche ascendante.
Tomorrow’s question…
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Liking is a driver of food intake
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0%
20%
40%
60%
80%
100%
0 1 2 3 4 5 6
Foo
d In
take
(%
)
Food Liking (5 points scale)
Regression of food intake by food liking (R²=0,232)
Food Liking Low MMS (N=116)
Medium MMS (N=125)
High MMS (N=101)
Pearson Coefficient 0,454 0,440 0,469
*** *** ***
Low MMS group (low cognitive abilities)
Medium MMS group (medium cognitive abilities)
High MMS group (high cognitive abilities)
Pouyet et al. 2015
The kitchen
The individual
The dining
room and service
A universal triad …
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FOOD
EATER
CONTEXT
… to increase pleasure & well being
Thank you for your listening
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Welcome to Lyon, France 2017 Events
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. Food choice environments to promote healthy and sustainable eating behaviours 2nd 3rd February
. Healthy and Tasty snacking 9th March
. The role of proteins within a nutritious, healthy and sustainable diet 30th / 31st March
. Cooking as a ritual. Cuisine and culture in the globalized XXIst Century World 28th/ 29th June
. Social and cognitive factors influencing food perception and behavior in young children 27th/28th September
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