Evaluation of the dietary intake of homebound elderly and the feasibility of dietary supplementation.

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Abstract
The dietary intake of elderly subjects receiving home care services (n = 145) was studied to assess the adequacy of their intake, and their ability to maintain normal body weight. In a second part of the study, the feasibility of providing nutrient supplements to underweight subjects or those with important recent weight loss was evaluated. For the survey, three 24-hour recalls, height, weight and lifestyle habits were evaluated in a home interview and two follow-up telephone contacts. The effects of dietary supplementation of 14 subjects at risk of malnutrition (underweight or with substantial weight loss) over 12 weeks were evaluated. Mean energy intake for the entire group was low (males 1546 kcal; females 1152 kcal) and on average barely covered estimated resting energy expenditure. Recent weight loss was negatively correlated with energy intake among underweight subjects (R = −0.64; p < 0.001). Dietary supplementation resulted in an average increase in daily intake of 390 kcal with an average weight gain of 1.27 kg over the 12-week period. Weight change was directly associated with measures of functional status; hand-grip strength (r = 0.75; p = 0.002) and general well-being score (r = 0.46; p = 0.095). Homebound elderly were at high risk of inadequate protein and energy intake. Dietary supplementation in high risk individuals was well tolerated and led to modest weight gain and improvements in general well-being.