Proof is in pudding: Aged care residents eat more when served larger portions

As Australia’s aged care sector continues to be scrutinised, researchers at the University of South Australia show that plain solutions are often the best, with a new study finding that aged care residents can improve their nutrition intake simply by increasing their meal sizes.

Assessing the effectiveness of environmental cues within an aged-care home – music, fragrance and other health information – researchers discovered that if residents were offered larger meals, they would eat more, thereby increasing energy and nutrition levels.

The study found that for each kilojoule increase in served energy there was a 0.73 kilojoule increase in consumed energy.

UniSA researcher Hei Tong Lau, says that the portion size effect was a manipulation to test the true effects of extrinsic food-cues.

“Our research is focussed on improving the nutrition and health status of older Australians living in a residential aged care facility,” Lau says.

“In Australia, up to 70 per cent of elderly people living in aged care facilities are suffering from malnutrition, the primary reason for which is inadequate food intake.

“To improve this, we must find ways to encourage older people to eat more. And while there has been a justified focus on the food itself – including look, taste and texture ­- we have been concentrating on other factors that can improve the food experience, within a real-world aged care facility.

“While exploring environmental factors that could improve the dining atmosphere, we found that portion size was highly correlated with the amount of food that residents consumed.

“And, that both music and fragrance could positively influence food consumption, but secondary to portion size, as we did see variances among each individual.”

According to the Aged Care Quality and Safety Commission (ACQSC) and under the Aged Care Quality Standards (effective 2019), aged care service providers in Australia are required to ensure appropriate nutrition and energy intake for all residents.

The study examined the presence of the portion size effect – the act of eating more food when served a more significant portion – in an Adelaide-based residential care facility. Over a seven-week period, the food intake of 31 residents was recorded once a week, both under a control and a cue-enhanced setting.

Lau says the findings provide valuable insights for aged care caterers and providers.

“With an ageing population and high levels of malnutrition among aged care residents, there is a clear need to better understand factors that can influence residents’ food intake,” Lau says.

“Increasing serving sizes may seem like a small step, but for residents who need the nutrition, it’s massive move forward.”

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