Comparison of Nutritional Intake of Free Living Adults Aged ≥75 Years Receiving Home Delivered Meals with Dietary Reference Values

Abstract

Background: House-bound older adults are at risk of malnutrition Sharkley [1]. However there is limited knowledge of dietary intake in this population in the UK. The 'meals on wheels' (MOW) service delivers meals to this population to help meet their nutritional requirements. This study aimed to compare the nutritional intake of older adults receiving MOW with dietary reference values (DRVs) and to consider the contribution that MOW provides to the daily intake. Methods: The study recruited people aged ≥75 years, free from cognitive impairment to ensure consent was obtained, receiving MOW either as lunch service (LS) or lunch and tea service (LTS). Participants completed a 3-day un-weighed food and drink diary to reflect intake variation and participant burden. Data were analysed using descriptive statistics and were compared with population DRVs Department of Health [2]. Ethical approval was obtained from the University of Hertfordshire. Results: Thirteen people agreed to participate and completed diaries were provided by five men and six women. Eight of these participants received LS and three received LTS Discussion: Participants did not rely on MOW as their main food source and had good intakes of calcium, folate and vitamin C, which is in contrast to a recent study in Ireland O'Dwyer et al. [3] but similar to the findings of the National Diet and Nutrition Survey (NDNS) for adults >65 years Bates et al. [4]. Despite the regular use of vitamin D fortification within MOW deserts, nine participants had poor intakes; a finding consistent with both these published studies. MOW provided foods rich in folate and vitamin C. MOW contribution to calcium and energy intake improved when both lunch and tea service were provided suggesting that foods served at tea provided a good source of calcium. Mean energy intakes were comparable to the NDNS and exceeded EAR when participants had both lunch and tea service, although the limitations of using the EAR need to be considered. Despite these findings, this study attracted the most able and cognitively well people within this vulnerable population. Conclusions: The intake of most participants met DRV, except for vitamin D and energy, and was better amongst those consuming LTS than those with lunch alone. Contribution from MOW to the overall dietary intake varied between nutrients.