High Protein Foods and Age-Related Decline in Nutritional Status in Aged Care Residents

It is estimated that by 2057, 25% of the global population will be 65 years or older. Currently, 72% of adults in aged care facilities are at risk of malnutrition, which has been linked to poorer health outcomes and mortality. Thus, implementing practical, effective solutions to mitigate the burden of malnutrition in long-term care is critical, as the number of institutionalized adults is expected to increase with the aging population.

A cluster-randomized, controlled trial involving 60 aged care facilities (654 residents) in Australia assessed the impacts of increasing dietary protein intake by: 1) substituting snacks with dairy-based alternatives, 2) adding milk, cheese, or yogurt to meals, 3) fortifying foods with milk powder, 4) modifying recipes to increase the protein content with milk products. 

Overall, the intervention increased the daily servings of milk, cheese, or yogurt from 2 servings at baseline to 3.5 servings after 12 months and increase protein by 11 grams per day. The energy intake of both groups remained unchanged.

After 12 months, the intervention group’s nutritional status, measured by the mini-nutrition assessment (MNA), remained stable, while the control’s group scores decreased significantly. Hemoglobin, which has been found to be correlated with malnutrition, decreased in the control group, but did not change in the intervention group. Both groups had comparable decreases in albumin levels. Importantly, compliance to the food-based intervention was sustained for the 12 month duration of the study and was maintained for the 12-months following the end of the intervention.

Overall, increasing protein intake through supplementary dairy foods in the menu is a pragmatic approach to protecting the nutritional status of adults residing in long-term care facilities. The authors note that this intervention was simple to implement and was considered a palatable solution, an important factor in ensuring compliance. In contrast, oral protein supplements have lower long-term compliance. Moreover, milk products also contribute a wide range of other important nutrients, such as calcium, vitamins B2 and B12, zinc, and leucine. The authors conclude that high-protein foods, such as dairy, should be incorporated into food-based policies and guidelines for aged care homes.