© Borgis - New Medicine 1/2004, s. 5-7
Wojciech Chalcarz, Ewelina Spochacz-Przygocka
Assessment of Daily Food Rations in Care Homes for Older People in Poznań and the Vicinity
Department of Food and Nutrition, University School of Physical Education, Poznań, Poland
Head of Department: Prof. Wojciech Chalcarz, MD, PhD
Aim. The aim of this study was to assess and compare daily food rations in care homes for older people in Poznań and the vicinity.
Material and method. Daily rations from 5 care homes for older people in Poznań and the vicinity were analysed and included 2 menus for weekdays and one for a weekend day. By means of the Dieta 2.0 computer programme, energy value and chemical composition of meals and daily rations were calculated. Statistical analysis was carried out by means of the SPSS 11.5 PL for Windows computer programme.
Results. The results showed a significant differentiation in daily rations, in the number of kitchen staff per resident and in the educational status of the dieticians. A strong differentiation in chemical composition and nutritional value of meals was noticed. Total daily rations did not differ significantly.
Conclusion. The results show that the daily food rations in the care homes were not in line with the principles of nutrition in the elderly. The main errors included an excessive energy supply for women, too high a percentage of energy from fat, too much protein, fat, cholesterol and phosphorus, and insufficient amounts of calcium, zinc and iron.
It has been noticed that during recent decades there has been an ongoing increase in the population of the elderly (1, 2, 3, 4). The studies among this group of people are focused on their dietary habits (1, 2, 5, 6, 7, 8), food preferences (9) and nutritional status (2, 8). However, there has been no research on assessment of the daily food rations in Polish care homes for older people, which house in total as many as 81,000 residents. Although nutrition of those residents is regulated by law (10, 11), there is no information about its practical application.
The aim of this study was to assess and compare daily food rations in care homes for older people in Poznań and the vicinity.
3. MATERIAL AND METHOD
The analysis involved daily food rations prepared in 5 care homes for older people in Poznań and the vicinity during the period between the end of March and the beginning of April, 2003. Number and locations of care homes for older people were as follows: No 1 – Poznań, Bukowska Street, No 2 – Lisówki, No 3 – Psarskie, No 4 – Poznań, Ugory Street, No 5 – Łężeczki.
From every care home 3 randomly-chosen menus were obtained – 2 for weekdays and 1 for a weekend day.
By means of the Dieta 2 computer programme, composition of food rations and compliance with dietary norms for both males and females were calculated. Statistical analysis was performed by means of the SPSS 11.5 PL for Windows computer programme.
4.1. Characteristics of the analysed care homes
General information related to the care homes is presented in Table 1.
Table 1. Characteristics of the care homes.
|Parameters||Care Home* |
|Total number of residents||155||100||120||166||135|
|Cost of a daily ration||6.40||6.50||5.82||7.50||7.00|
|Dieticians´ educational status||High school||University||University||High school||High school|
|Catering staff||7||9||5 + trainees||12||8|
|Kitchen staff per resident||0.05||0.09||0.04||0.07||0.06|
|Menu schedule||10 days||10 days||10 days||10 days ||10 days|
The population varied from 100 in care home No 2 to 166 in care home No 4. The daily cost of rations varied from 5.82 zl in care home No 3 to 7.50 zl in care home No 4. These differences were caused by different levels of contributions from local authorities, and different pensions among the elderly subjects, which are regulated by Polish law (11).
The dieticians in care homes No 2 and 3 had a university education. In the remaining homes the dieticians had only secondary education.
The kitchen staffing levels were varied and independent of the number of residents. The highest staffing level was in care home No 4, but the highest kitchen staff/resident ratio was in care home No 2.
In all care homes a 10-day menu schedule was used.
4.2. Differences in chemical composition of daily rations
The legislation (11) divides daily rations in care homes for older people into three main meals: breakfast, dinner and supper.
The statistical differentiation of main meals and daily rations by location is presented in Table 2. The statistically significant differences varied from 5 for a daily food ration to 31 for supper alone.
Table 2. Significant differences in chemical composition of daily rations by meal.
|Meal||Number of significant differences*|
|Total food ration||5|
Daily rations varied in their content of vitamin A, b-carotene and fatty acids 18:4, 20:5, and 22:5. Suppers varied in their content of potassium, magnesium, iron, copper, manganese, b-carotene, vitamin E, thiamine, vitamin B6, vitamin C, vitamin D, fatty acids 14:0, fatty acids 14:1, fatty acids 15:1, fatty acids 22:6, water, total protein, animal protein, cysteine, arginine, plant protein, alanine, asparaginic acid, glycine, proline, serine, starch, dietary fibre, folic acid, and total carbohydrates.
The greatest difference between nutrient content in daily rations and breakfasts was found in care home No 2. Dinners and suppers were most differentiated in care home No 5.
Statistically significant differences in the chemical composition of breakfasts were found for calcium, phosphorus, copper, riboflavin, vitamin C, fatty acids 20:5 and 22:5, animal protein, lysine, tryptophan, valine, proline, sucrose, vitamin B12, and lactose. Dinners differed in their content of ash, sodium, magnesium, total energy, fatty acids 19:0, 20:0, 14:1, 15:1, 17:1, 18:3, 18:4, 20:5, 22:5, and 22:6, total fat and total carbohydrates.
Powyżej zamieściliśmy fragment artykułu, do którego możesz uzyskać pełny dostęp.
1. Pietruszka B., Brzozowska A., Puzio-Dębska A.: Ocena sposobu żywienia osób dorosłych w trzech wybranych wsiach województw warszawskiego, radomskiego i bielskopodlaskiego. Roczn. PZH, 1998; 49, 219-229. 2. Roszkowski W., Brzozowska A.: Ocena sposobu żywienia i stanu odżywienia ludzi starszych w Europie – projekt badawczy SENECA. Cz. II. Ocena sposobu żywienia. Żywienie Człowieka i Metabolizm, 1994; 21(1),35-48. 3. Ziemlański Ś., Budzyńska-Topolowska J.: Żywienie a starość. Cz. I. Rola czynnika żywieniowego (energia, białko, tłuszcze, węglowodany) w procesie starzenia się organizmu. Żywienie Człowieka i Metabolizm, 1994; 21(3),25-268. 4. Hryniewiecki L.: Żywienie ludzi w wieku podeszłym i star-czym. Nowiny Lekarskie 1993; 62(30),81-84. 5. Gertig H.: Ocena sposobu odżywiania się ludzi starszych z regionu Wielkopolska. Ars Senescendi 1994; 1,103-111. 6. Jeszka J., Olejnik D., Krejpcio Z.: Ocena wyżywienia osób starszych w wybranych Domach Pomocy Społecznej miasta Poznania. Ars Senescendi 1994; 1,116-124. 7. Myszkowska-Ryciak J., Bujko J., Malesza M.: Ocena sposobu żywienia kobiet w podeszłym wieku zrzeszonych w Uniwersytecie Trzeciego Wieku w Warszawie. Żywienie Człowieka i Metabolizm, 30,1/2, 2003; 357-361. 8. Wierzbicka E., Brzozowska A., Roszkowski W.: Sposób żywienia oraz stan odżywienia ludzi starszych w Polsce w świetle danych z piśmiennictwa z lat 1980-1996. Roczn. PZH, 1997; 48(1),87-102. 9. Gawęcki J., Kostrzewa-Tarnowska A., Zielke M., Wichłacz E.: Ocena preferencji pokarmowych osób starszych i ich wrażliwości smakowej. Ars Senescendi 1995; 2,85-95. 10. Ustawa o pomocy społecznej z dnia 29 grudnia 2001 roku. Dz. U. 64 z 1998 r., poz. 414; ze zmianami Dz. U. 106 z 1998 r., poz. 668; 117, poz. 756; 162, poz. 1118 i 1126; Dz. U. 20 z 1999 r., poz. 170; 79, poz. 885; 90, poz. 1001; Dz. U. 12 z 2000 r., poz. 136; 19, poz. 238; Dz. U. 72 z 2001 r., poz. 748; 88, poz. 961; 89, poz. 973; 111, poz. 1194; 122, poz. 1349; 154, poz. 1792. 11. Rozporządzenie Ministra Pracy i Polityki Społecznej z dnia 15 września 2000 roku w sprawie domów pomocy społecznej. Dz. U. 64 z 1998 r., poz. 414; 106, poz. 668; 117, poz. 756; 162, poz. 1118 i 1126; Dz. U. Z 20 z 1999 r., poz. 170; 79, poz. 885; 90, poz. 1001; Dz. U. 12 z 2000 r., poz. 136; 19, poz. 238. 12. Ziemlański Ś.(Red): Normy żywienia człowieka. Fizjologiczne podstawy. PZWL, War-szawa 2001.