Characterizing Canadian long-term care home consumed foods and their inflammatory potential: a secondary analysis
Abstract Background Nutrient dense food that supports health is a goal of food service in long-term care (LTC). The objective of this work was to characterize the “healthfulness” of foods in Canadian LTC and inflammatory potential of the LTC diet and how this varied by key covariates. Here, we defin...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-02-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-022-14934-8 |
| _version_ | 1811165710477426688 |
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| author | Kaylen J. Pfisterer Robert Amelard Heather H. Keller Alexander Wong |
| author_facet | Kaylen J. Pfisterer Robert Amelard Heather H. Keller Alexander Wong |
| author_sort | Kaylen J. Pfisterer |
| collection | DOAJ |
| description | Abstract Background Nutrient dense food that supports health is a goal of food service in long-term care (LTC). The objective of this work was to characterize the “healthfulness” of foods in Canadian LTC and inflammatory potential of the LTC diet and how this varied by key covariates. Here, we define foods to have higher “healthfulness” if the are in accordance with the evidence-based 2019 Canada’s Food Guide, or with comparatively lower inflammatory potential. Methods We conducted a secondary analysis of the Making the Most of Mealtimes dataset (32 LTC homes; four provinces). A novel computational algorithm categorized food items from 3-day weighed food records into 68 expert-informed categories and Canada’s Food Guide (CFG) food groups. The dietary inflammatory potential of these food sources was assessed using the Dietary Inflammatory Index (DII). Comparisons were made by sex, diet texture, and nutritional status. Results Consumption patterns using expert-informed categories indicated no single protein or vegetable source was among the top 5 most commonly consumed foods. In terms of CFG’s groups, protein food sources (i.e., foods with a high protein content) represented the highest proportion of daily calorie intake (33.4%; animal-based: 31.6%, plant-based: 1.8%), followed by other foods (31.3%) including juice (9.8%), grains (25.0%; refined: 15.0%, whole: 10.0%), and vegetables/fruits (10.3%; plain: 4.9%, with additions: 5.4%). The overall DII score (mean, IQR) was positive (0.93, 0.23 to 1.75) indicating foods consumed tend towards a pro-inflammatory response. DII was significantly associated with sex (female higher; p<0.0001), and diet (minced higher; p=0.036). Conclusions “Healthfulness” of Canadian LTC menus may be enhanced by lowering inflammatory potential to support chronic disease management through further shifts from refined to whole grains, incorporating more plant-based proteins, and moving towards serving plain vegetables and fruits. However, there are multiple layers of complexities to consider when optimising foods aligned with the CFG, and shifting to foods with anti-inflammatory potential for enhanced health benefits, while balancing nutrition and ensuring sufficient food and fluid intake to prevent or treat malnutrition. |
| first_indexed | 2024-04-10T15:41:05Z |
| format | Article |
| id | doaj.art-87279c481f7044f482f1e7870c1b198f |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-04-10T15:41:05Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-87279c481f7044f482f1e7870c1b198f2023-02-12T12:24:58ZengBMCBMC Public Health1471-24582023-02-0123111410.1186/s12889-022-14934-8Characterizing Canadian long-term care home consumed foods and their inflammatory potential: a secondary analysisKaylen J. Pfisterer0Robert Amelard1Heather H. Keller2Alexander Wong3Department of Systems Design Engineering, University of WaterlooSchlegel-University of Waterloo Research Institute for AgingSchlegel-University of Waterloo Research Institute for AgingDepartment of Systems Design Engineering, University of WaterlooAbstract Background Nutrient dense food that supports health is a goal of food service in long-term care (LTC). The objective of this work was to characterize the “healthfulness” of foods in Canadian LTC and inflammatory potential of the LTC diet and how this varied by key covariates. Here, we define foods to have higher “healthfulness” if the are in accordance with the evidence-based 2019 Canada’s Food Guide, or with comparatively lower inflammatory potential. Methods We conducted a secondary analysis of the Making the Most of Mealtimes dataset (32 LTC homes; four provinces). A novel computational algorithm categorized food items from 3-day weighed food records into 68 expert-informed categories and Canada’s Food Guide (CFG) food groups. The dietary inflammatory potential of these food sources was assessed using the Dietary Inflammatory Index (DII). Comparisons were made by sex, diet texture, and nutritional status. Results Consumption patterns using expert-informed categories indicated no single protein or vegetable source was among the top 5 most commonly consumed foods. In terms of CFG’s groups, protein food sources (i.e., foods with a high protein content) represented the highest proportion of daily calorie intake (33.4%; animal-based: 31.6%, plant-based: 1.8%), followed by other foods (31.3%) including juice (9.8%), grains (25.0%; refined: 15.0%, whole: 10.0%), and vegetables/fruits (10.3%; plain: 4.9%, with additions: 5.4%). The overall DII score (mean, IQR) was positive (0.93, 0.23 to 1.75) indicating foods consumed tend towards a pro-inflammatory response. DII was significantly associated with sex (female higher; p<0.0001), and diet (minced higher; p=0.036). Conclusions “Healthfulness” of Canadian LTC menus may be enhanced by lowering inflammatory potential to support chronic disease management through further shifts from refined to whole grains, incorporating more plant-based proteins, and moving towards serving plain vegetables and fruits. However, there are multiple layers of complexities to consider when optimising foods aligned with the CFG, and shifting to foods with anti-inflammatory potential for enhanced health benefits, while balancing nutrition and ensuring sufficient food and fluid intake to prevent or treat malnutrition.https://doi.org/10.1186/s12889-022-14934-8Long-term careFood intake patternsCanada’s Food GuideDietary Inflammatory IndexDietary intakeAging |
| spellingShingle | Kaylen J. Pfisterer Robert Amelard Heather H. Keller Alexander Wong Characterizing Canadian long-term care home consumed foods and their inflammatory potential: a secondary analysis BMC Public Health Long-term care Food intake patterns Canada’s Food Guide Dietary Inflammatory Index Dietary intake Aging |
| title | Characterizing Canadian long-term care home consumed foods and their inflammatory potential: a secondary analysis |
| title_full | Characterizing Canadian long-term care home consumed foods and their inflammatory potential: a secondary analysis |
| title_fullStr | Characterizing Canadian long-term care home consumed foods and their inflammatory potential: a secondary analysis |
| title_full_unstemmed | Characterizing Canadian long-term care home consumed foods and their inflammatory potential: a secondary analysis |
| title_short | Characterizing Canadian long-term care home consumed foods and their inflammatory potential: a secondary analysis |
| title_sort | characterizing canadian long term care home consumed foods and their inflammatory potential a secondary analysis |
| topic | Long-term care Food intake patterns Canada’s Food Guide Dietary Inflammatory Index Dietary intake Aging |
| url | https://doi.org/10.1186/s12889-022-14934-8 |
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