Opinion: Managing malnutrition and dysphagia in aged care

In this guest post, Food innovator and entrepreneur, Vitish Guddoy, discusses the role of Molecular Gastronomy in helping improve the nutrition and well-being of aged care residents. A West London University graduate in Hospitality Management and MBA student at Heriot-Watt University, Vitishg brings 15 years of international expertise as a chef and hospitality specialist.

Dysphagia is recognised as a key cause of malnutrition in the aged care industry, but not all malnutrition is caused by dysphagia. Malnutrition increases the risk of falls and pressure injuries, increases hospital admissions, and has adverse outcomes on mortality. Malnutrition drives costs across the aged care sector of the healthcare system.

Dysphagia is a growing problem in our ageing population. This physiological difficulty in swallowing restricts what sufferers can consume. It limits diet to a certain restricted repertoire of food and recipes. Quite often, foods need to be pureed and modified to certain diet guidelines and, as a result, the food loses its appeal.

One common approach to addressing malnutrition in aged care facilities is to increase nutritional intake by administering clinical nutritional supplements. These are often expensive and do not reflect real foods. Using clinical nutritional supplements further removes the resident from the cultural and social enjoyment of eating good food. It can result in an increasing dependence on the supplement.

Prevention and management of malnutrition in care recipients requires a tiered approach, recognising and responding to the needs, preferences, and cultural requirements of each care recipient.  Best practice requires a “Food First Approach” in the aged care industry

Most people will think of fine dining restaurants or a celebrity chef when the term “Molecular Gastronomy” is used. Could molecular gastronomy be used as a method of culinary practice in Aged Care?

As opposed to blending foods into purees with a uniform flavour and texture, molecular gastronomy could be the new standard for sensory-appealing texture-modified foods. This is a major step up from using food moulds. 

Molecular Gastronomy makes use of the transformation of ingredients that occur in food preparation and cooking, thereby providing a completely different texture. It is a subdiscipline of food science that seeks to investigate the physical and chemical transformations of ingredients that occur in cooking, addressing the social, artistic and technical aspects of food.

In 2012, I worked on a research study to investigate the acceptability and consumption of Molecular Gastronomy in aged care. We did a plate waste study (pre-post design) to compare the food intake of commonly texture-modified mid-meal snacks with new snacks based on the molecular gastronomy concept. The results showed that the new snacks were very acceptable. Moreover, residents consumed significantly more energy and protein during morning/afternoon tea with these new menu items.

In recent years, I have been working on developing products specifically to address malnutrition and dysphagia in age and healthcare facilities using molecular gastronomy techniques.

We have developed an ice-cream-like nutrient-designed fortified food called Food Imperative. We worked with nutritionists from the industry to design the product to help manage and prevent nutrition in aged care institutions.

The Food Imperative Frozen Dessert has a unique blend of protein based on scientific evidence. Studies have indicated that a blend of whey, caseinate and soy in the right ratio is superior in terms of laying down lean muscle mass and maintaining muscle mass than any of the individual proteins or combinations of any two of the proteins.

Using Molecular Gastronomy, we have developed the product in a slow melt form making it easy to eat, even for slow eaters. We want people in aged care facilities to connect with a time in their youth when they enjoyed their food.

And what do they enjoy eating?

Anything that looks like ice cream or gelato!

It is a real “food first” solution that connects them to the social and cultural joy of food.

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