Food matters live Improving nutrition & food palatability in older people Senses and beyond the senses
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1 Food matters live Improving nutrition & food palatability in older people Senses and beyond the senses November 24 th 2016
2 The Center for Food and Hospitality Research The sciences dedicated to the understanding of the pleasure of meals, worldwide 2
3 Elderly living in geriatric institutions Elderly in geriatric institutions - Average age around 85 years old KPMG, A majority of women DRESS, Frail elderly Prevalence of malnutrition in institutions: 15 to 38% HAS, Physiological, psychological and sociological changes Ferry, et al Inadequate food intake Chen, et al Promote food intake through meal pleasure 3
4 NUTRIONAL REQUIREMENTS Nutrients - Food selection/ enrichment Adequate quantities - Portion size FOOD ACCESSIBILITY Physical access Food/ Packaging adaptation Chewing & Swallowing troubles - Modified texture FOOD ATTRACTIVENESS Willingness to eat Food pleasure French guidelines: PNNS, 2006 ; HAS, 2007 ; ANAP,
5 The food sensory 5
6 The influence of COLOUR variety Homogeneity: Finger foods in one vs. two layers Each participant receives a plate with 2 versions of a same dish. 4 days with a different dish tested for each factor Pouyet V., Giboreau, A., Benattar, L., & Cuvelier, G. (2014). Attractiveness and consumption of finger foods in elderly Alzheimer s disease patients. Food Quality and Preference, 34,
7 Protocol Participants 114 participants 26 males, 88 females, age : 86 ±6,7 years old) with Alzheimer s disease able to feed themselves high dependency (GIR 2) With and without chewing and swallowing difficulties Paired comparison test in a real situation of mealtime (lunch) Assessment by caregivers: - 1st choice - finger foods consumption 7
8 Results At lunch, Alzheimer patients significantly chose more and consumed more 2-layer finger foods (Vs all pureed in 1) 8
9 THE INFLUENCE OF FLAVOUR VARIETY Products Soft bread toasts with an aubergine purée. Same appearance, same texture REF : bland purée F+ : flavour enhanced purée with salt, pepper, lemon juice, garlic REF F+ Pouyet V., Cuvelier G., Benattar L., & Giboreau, A., Influence of flavour enhancement on food liking and consumption in older adults with poor, moderate or high cognitive status. Food Quality and Preference, 44,
10 Protocol Participants 104 elderly subjects, aged m= 89 +/- 5 Clustered in 3 MMS groups Low, Medium and High cognitive status (MMS) Experimental design tasting sessions before lunch Measure of food intake Count of the number of remaining toasts. Comparison to served amount (8) 10
11 Results Positive effect of flavour enhancement on food consumption No significant difference between the different cognitive status 11
12 Beyond the food the context 12
13 DISH DRESSING Control Experimental N= 100 in each group. Navarro D.A., Boaz M., Krause I., Elis A., Chernov K., Giabra M., Levy M., Giboreau A., Kosak S., Mouhieddine M. & Singer P. (2015) Improved meal presentation increases food intake and decreases readmission rate in hospitalized patients Clinical Nutrition,
14 14
15 Control Experimental Dish dressing accordingly to gastronomy standards increased liking and consumption 15
16 Food supply Table art supply What means are available to provide «good food»? The foodservice system KITCHEN DINING ROOM The chef The waiter The client 16
17 Plate and cutlery Piqueras-Fiszman B., Giboreau A., Spence C Assessing the influence of the color of the plate on the perception of a complex food in a restaurant setting, Flavour, 2:24 17
18 The ATMOSPHERICS, physical environment, table dressing Effect on declarative willingness to eat Table dressing 1 1 Comme à la maison Fleurie 2 Cosy Saulais. L. et al (2015) Measuring residents perceptions and expectations for the design of retirement homes restaurants ambiences. Menu 18
19 The SERVICE Social and interactional dimensions at meal service in the institution Evaluating training programs for nursing auxiliary staff Space arrangement (tray) Personal interest (staff) Management (institution) Bouima S., Paryse F., Ticca A.C, Michaud M., Giboreau A., Combret D. & Nicod-Franc S. Lutter contre la dénutrition à l hôpital par la formation des aides-soignantes aux bonnes pratiques de service de repas en unité de soin : apports et limites d une approche ascendante. 19
20 Tomorrow s question 20
21 Food Intake (%) Liking is a driver of food intake 100% Regression of food intake by food liking (R²=0,232) 80% 60% 40% Low MMS group (low cognitive abilities) Medium MMS group (medium cognitive abilities) 20% 0% Food Liking (5 points scale) High MMS group (high cognitive abilities) Food Liking Low MMS (N=116) Medium MMS (N=125) High MMS (N=101) Pearson Coefficient 0,454 0,440 0,469 *** *** *** Pouyet et al
22 A universal triad FOOD The kitchen The individual EATER CONTEXT The dining room and service to increase pleasure & well being 22
23 Thank you for your listening 23
24 Welcome to Lyon, France 2017 Events International Multidisciplinary Research Symposia. Food choice environments to promote healthy and sustainable eating behaviours 2nd 3rd February. Healthy and Tasty snacking 9th March. The role of proteins within a nutritious, healthy and sustainable diet 30th / 31st March. Cooking as a ritual. Cuisine and culture in the globalized XXIst Century World 28th/ 29th June. Social and cognitive factors influencing food perception and behavior in young children 27th/28th September Information and registration : symposium@institutpaulbocuse.com 24
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