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Open AccessConcept Paper

Triple Adaptation of the Mediterranean Diet: Design of A Meal Plan for Older People with Oropharyngeal Dysphagia Based on Home Cooking

1
Gastrointestinal Physiology Laboratory, CIBERehd CSdM-UAB, Hospital de Mataró, 08304 Barcelona, Spain
2
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, 08304 Barcelona, Spain
3
Department of Dietetics and Nutrition, Hospital de Mataró, 08304 Barcelona, Spain
4
Fundació Alicia, San Fruitós del Bages, 08272 Barcelona, Spain
5
Fundació de Recerca en Gastroenterologia, 08304 Barcelona, Spain
*
Authors to whom correspondence should be addressed.
Nutrients 2019, 11(2), 425; https://doi.org/10.3390/nu11020425
Received: 15 January 2019 / Revised: 8 February 2019 / Accepted: 12 February 2019 / Published: 18 February 2019
(This article belongs to the Special Issue Older Individuals' Nutrition)
Background: Oropharyngeal dysphagia (OD) and malnutrition are highly prevalent in older patients that are discharged from general hospitals (47% and 30%, respectively). Aims: To develop a nutritional plan for these patients involving a triple adaptation of their traditional diet: (a) rheological adaptation (texture and viscosity) for safe deglutition, (b) nutritional adaptation (water, calories, and proteins), and (c) organoleptic adaptation to improve compliance. Methods: Two fluid viscosities (250 and 800 mPa·s) were selected according to previous studies on optimal viscosities in older patients. The British Dietetic Association food texture classification based on common clinical practice selected two food textures (thick purée and fork-mashable. Two levels of calorie protein enrichment were selected according to previous studies using the Mini Nutritional Assessment (MNA®). Results: The daily caloric-protein and hydric needs were established at 1750 kcal, 70 g protein, and 1750 mL water in patients with MNA® ≥ 17; and, 2037 kcal, 90 g protein, and 2000 mL water/day in malnourished patients. Sixteen weekly menus (296 recipes) were developed while using two textures, two levels of viscosity, two nutritional phenotypes (normal/at-risk vs. malnourished), and two seasons of the year (spring/summer-autumn/winter) based on Mediterranean cuisine. Conclusion: This concept paper demonstrates that traditional Mediterranean cooking can be adapted to meet the rheological, nutritional, and hydration needs of older patients with OD. The recipes that we have developed meet the needs of patients with varying degrees of OD and malnutrition are reproducible in patient’s homes and they could have a major impact on the clinical outcomes of these patients. View Full-Text
Keywords: oropharyngeal dysphagia; malnutrition; older; viscosity; texture; caloric; protein and organoleptic adaptation oropharyngeal dysphagia; malnutrition; older; viscosity; texture; caloric; protein and organoleptic adaptation
MDPI and ACS Style

Costa, A.; Carrión, S.; Puig-Pey, M.; Juárez, F.; Clavé, P. Triple Adaptation of the Mediterranean Diet: Design of A Meal Plan for Older People with Oropharyngeal Dysphagia Based on Home Cooking. Nutrients 2019, 11, 425.

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