25th August 2017

Poor appetite and food intake

Poor appetite is an important problem and is associated with an increased risk of malnutrition.

Older people with poorer appetites are more likely not only to have lower energy (calorie) intakes, but also have less variety in their diets and a lower dietary quality. We know that malnutrition is linked with adverse clinical outcomes and reduced quality of life, and so a greater understanding of effective strategies to increase food intake in service users with poor appetites is important.

Research in effective management of poor appetite is still limited

Common approaches to improve appetite and food intake in older adults have included reducing portion sizes or increasing meal frequency (‘small but often’) as well as protected meal times and improved meal ambience. However, the evidence supporting improved outcomes with such measures is still limited and new research in this area is welcome.

Recently a team of researchers examined the differences in food intake (using a food frequency questionnaire) among around 2500 older adults aged 70 – 79 years with different appetite levels. The study from van der Meij et al. was published in the Journal of the American Geriatrics Society.

Older adults with poor appetites reported to have lower fruit and vegetable, wholegrain and protein intake

Compared to participants with very good appetites, the researchers reported that older adults with poorer appetites (self-described as moderate, poor or very poor) ate less protein and dietary fibre. They also ate fewer wholegrains and fruit and vegetables. However, people with poor appetite in this study were reported to have a greater intake of dairy foods.

The poor appetite group were on average older, had poorer health status, more often experienced unintentional weight loss and depression. It is likely that such general and health characteristics may confound the associations reported in this study. Nonetheless, in agreement with other studies, older adults with a poor appetite had a lower intake (in this case some 10-20% less) of protein-rich foods, fruits, and vegetables than those with a very good appetite. This could be clinically relevant, particularly if poor appetite and lower dietary intake are long-lasting.

Understanding of individual food preferences is useful

Understanding food preferences particularly in those with poor appetites can be used to refine nutrition interventions that aim to improve dietary intake and diet quality in older adults. For example, if certain nutrient–rich foods like dairy are enjoyed they could be increased to improve intake.

*All information is correct at the time of publishing

Ayela Spiro

Nutrition Science Manager, British Nutrition Foundation

Ayela is a nutrition scientist at the British Nutrition Foundation, where her role involves providing expert advice on nutrition and health issues to a number of key audiences including consumers, health professionals, charities, the media and the food industry. At the heart of her work is the communication of nutrition science that promotes understanding of nutrition and health and contributes to the improved wellbeing of all.

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