Bridging the nutrition gap in healthcare

A good appetite is something we may take for granted. However, people who are ill, recovering from injury or surgery, elderly or depressed may be unable or unwilling to eat enough for proper nourishment. Helping them obtain the calories, protein, vitamins and minerals they need is a major challenge for registered dietitians in healthcare.

While serving a good, balanced meal is the ideal, provided a patient is willing and able to eat it, in some cases a nutritionally fortified food product may better meet the individual’s immediate needs, dietitians say.

“If I can get a person to eat a plate of watermelon, blueberries, salmon and brown rice, then absolutely I am going for the real food first,” says Roberta Anding, RD, a registered dietitian and a spokesperson for the Academy of Nutrition and Dietetics. “But if a person can’t or won’t eat because they don’t feel good or are in too much pain, I have to come up with Plan B or Plan C to make sure that person’s nutritional needs are met.”

In her more than 30 years in clinical dietetics, Anding says that she has at times used fortified juices and soft drinks for supplemental feeding. Such products are part of a growing array of enhanced foods for the healthcare segment. They may be used if a person has difficulty eating because of a broken jaw, has greater nutritional needs because they are recovering from surgery, burns or wounds, is losing a significant amount of weight involuntarily or has lost appetite due to dementia or the effects of multiple medications. For cancer patients, chemotherapy and radiation also may put a damper on appetite.

“To me, this is where nutritionally fortified foods can fill a gap,” says Anding.

It is especially important for elderly people to maintain their appetite, because involuntary weight loss in this age group can augur serious health issues, Anding says.

That’s why staff members at Maria-Joseph Nursing and Rehabilitation Center in Dayton, Ohio, watch residents carefully for diminished appetite. “The longer it slips, the harder it is to get it turned around,” says Suzanne Cryst, RD, CSG, LD, director of nutrition services.

Serving a fortified food like nutrient-supplemented ice cream can reawaken interest in eating among those who have lost it, Cryst says.

“You look for things that tempt them,” says Cryst. “Ice cream is a comfort food. It doesn’t look like it is enhanced or has more calories. I don’t want to say it’s a fooler, but you don’t have to tell them what’s in it.”
Although it is common for dietary departments to fortify their own foods by blending in protein powder and other supplements, having a prepackaged fortified product like an ice cream cup also can come in handy.

“It is convenient, easy to serve and don’t look manipulated,” says Cryst. “It looks and tastes normal. And it makes the patient feel ‘I am normal. I am not different.’”

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