Last updated on June 15th, 2023
If you’re about to sit down for a meal, what would you rather have? Buttery pancakes, fluffy mashed potatoes with gravy, and ice cream with chocolate sauce, or a canned supplement shake? Probably the first option, right?
Many senior living communities choose to tackle residents’ nutritional deficiencies with supplements instead of real food. However, oral supplements can be expensive, taste terrible, and often go unconsumed. Plus, there’s some debate over their effectiveness in a long-term care setting. Oral supplements have been shown to be only moderately successful in increasing calorie intake and have little impact on improving strength or function if not combined with resistance strength training. Yet in most communities, 60-80% of residents are prescribed dietary supplements.
What is the Food-first Method?
Today, food-first policies are becoming more prevalent as senior living communities focus on person-centered care.
Food-first means that residents are receiving real foods to increase caloric intake and nutritional value. There’s quite a case to make for a food-first approach to supplementation. The Centers for Medicare and Medicaid Services (CMS) states that “With any nutrition program, improving intake via wholesome foods is generally preferable to adding nutritional supplements.”
Fortified, liberalized diets can be a lower-cost way for your dining program to combat nutritional deficiencies while maintaining your residents’ good quality of life. Liberalized diets allow older adults to make decisions about their own nutrition. Therapeutic diets, on the other hand, are meant to manage chronic conditions like diabetes or hypertension and can often limit variety and options in daily meals, resulting in weight loss and a reduction in quality of life. When older adults can make choices about the foods they consume, they’ll eat better and enjoy life more. A liberalized diet approach is supported by both CMS and the Academy of Nutrition and Dietetics (AND).
What are Fortified Foods?
Fortified foods can replace commercial supplements by adding a calorie range to each meal through the use of enriched food, modification to a current menu item, or an additional item.
Fortified, food-first programs may all look a little different depending on the community. For some communities, this approach may mean that you increase meal and snack frequency. For others, it could mean that you serve more courses at each meal, or you infuse food with real ingredients to boost nutrition. A common way to fortify foods is with sauces or soups because you can add a variety of nutritious ingredients to them, like fish, fruits, and vegetables.
The Enhance Fortified Foods Premium Program
As we age, the need for nutritional support increases. Culinary Services Group believes that additional nutrients and calories should always come from whole foods first. That’s why we created the “Enhance” Premium Program to help senior living communities easily fortify foods residents already love. Our team developed recipes that can be incorporated into a liberalized diet approach creating optimal nutrition and enjoyment for older adults.
We fortify everyday meals with whole-food ingredients, reducing the need for costly supplements while increasing the nutritional value of our meals. We can also provide homemade smoothies, shakes, and puddings that offer similar calories, carbohydrates, proteins, and fats while providing better taste and more variety. Plus, our costs for these whole food products are comparable or even lower to commercially made products. We’ve found that with the Enhance Program, our additional cost Per Patient Day (PPD) is between $0.35 – $1.05. In fact, our costs are often lower than prescribing commercial supplements.
When senior living communities choose to participate in the Enhance Program, a Culinary Services Group Dietitian and Foodservice Director will work with the community’s dining team to determine the most appropriate fortified levels to use and develop a cycle menu pattern to fulfill the program. We also work with residents to understand which foods they like so we can incorporate those into their diets.
Some communities may be concerned about whether a food-first approach will require more staff resources. However, oral supplements may consume as much staff time as a food-first approach to deliver. A 2015 study determined that delivering oral supplements and giving verbal encouragement to consume averaged 11 minutes, while the time to deliver a food-first snack averaged 14 minutes. In this study, residents who consumed oral supplements took in 256 additional calories, while those who received the snack intervention took in 303 calories. The study concluded that snack-based nutritional intervention was more cost-effective than supplements based on staff time, resident refusal rates, caloric intake, and waste.
How Will You Continue to Support Your Residents’ Needs?
According to the Academy of Nutrition and Dietetics, the goal of food service should be to create a meal situation as natural and independent as possible. Meals should be comparable with eating at home, and diners should be able to make choices from a wide range of menu items tailored to their wants. Stringent diet restrictions limiting familiar foods and eliminating or modifying seasonings can contribute to poor appetite, decreased food intake, and an increased risk of illness, infection, and weight loss.
A food-first approach to nutrition supports a resident’s independence and is preferred to commercial oral supplements. Allowing residents to have a choice, accessibility, and individualization about the foods they eat supports a liberalized diet.
At Culinary Services Group, our goal is to meet nutritional goals for the residents we serve with foods we’d want to eat, too. For residents that need a little more help, we do this by fortifying foods they already love so they’ll eat more of it and look forward to mealtimes.
When communities select our Enhance program, Culinary Services Group makes sure that we provide a chef for your community who is passionate about fortified foods and nutrition. We also provide continued training at our corporate kitchen headquarters with our executive chef. By providing familiar foods, we set our goals to nourish your community and improve the quality of life for those we serve.
If you’d like to learn more about the Enhance Premium Program (or any of our other premium programs), feel free to contact us here.
