Food For Thought

Proper internal food cooking temperatures are being looked at by surveyors and county health departments. Make sure your health care communities are aware of the correct minimum internal cooking temperatures for whole meats, fish, eggs, ground meats, and pureed foods. Monitor their practices for checking temperatures after cooking and before serving. Refer to policy and procedure manual policy #524.

Nutricopia Summer Cycle Menus

New menus have been shipped to our menu clients which are to start on June 6, 2011. Make sure you sign off on the menu approval form and review them with the Dietary Manager for any changes.

Anorexia of Aging

 Anorexia can be a troublesome development, particularly in those residents that are the most frail and compromised. Unfortunately, the evolutionary cards appear to be stacked against the elderly in such a way that this population may simply be at higher risk. Some theories suggest that as evolution is concerned, once we are past the reproductive years, we are considered "useless." In times of food scarcity, feeding a "useless" person would have been considered a waste. Concomitantly, age related changes in appetite may be due to systems that cause feedback triggering the brain to eat less. Evolution notwithstanding, we, as RD's can help identify some of the problems that may be associated with age related anorexia and fix them. Physical changes that may contribute to anorexia include:

• Diminished GI transit (peristalsis)
• Increased incidence of GERD 
• Blunted taste acuity. Elderly may need up to 11x the amount of salt, 6x the amount of sweet for food to taste good. 
• Reduced sense of smell
• Reduced sense of mouth feel, particularly if the inside of the mouth is covered in dentures
• Food aversions may develop if medications are routinely disguised in favorite foods. 

Some interventions to consider: 

• For residents that are not sensitive to it or need to be on sodium restricted diets, the use of Monosodium glutamate (MSG) may be useful in small amounts to amplify the existing flavors of the food to help promote intake.
• Use of food colorings to enhance the colors of the food can give the perception of more flavor in the food.
• Juice preloading. There is some evidence that a small serving (4 oz) of fruit juice 1 hr before meals may be helpful in increasing PO intake up to 20-30%.
• Preparing residents to eat by exposure to food odors within 30 minutes of mealtime may help stimulate appetite.
• Smaller more frequent meals may be easier on the resident suffering from GERD or GI transit issues.
• Consider requesting a pharmacy review if you note Polypharmacy (resident on >9 medications) to see if some can be D/C'd.
• Avoid serving supplements with meals.
• Avoid mixing medications into favorite foods such as chocolate pudding, etc.  

RD Tip