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Billeret, Anne; Rousseau, Chloé; Thirion, Rémy; Baillard-Cosme, Béatrice; Charras, Kevin; Somme, Dominique; Thibault, Ronan
Nutrients, 01/2023, Volume: 15, Issue: 3Journal Article
Malnutrition is related to poor outcomes. Food intake semi-quantitative assessment is helpful for malnutrition screening. Aims: to assess maintenance over one month of one-day semi-quantitative assessment of food intake (primary aim) and its performance in diagnosing malnutrition (secondary aim) in older people living in a nursing home. Food portions consumed at lunch and dinner were measured during 20 days by the Simple Evaluation of Food Intake (SEFI) assisted by photography (SEFI -AP) in 70 residents. Nutritional status was assessed in each patient during the first week of food intake monitoring according to Global Leadership Initiative on Malnutrition criteria. Food intake was decreased, i.e., SEFI -AP < 7, in 39% (n = 27/73) of patients. According to the methods, 36 to 48% (n = 25 to 33/73) of patients had malnutrition, and 6 to 37% (n = 4 to 25/73) sarcopenia. According to a generalized linear model on ranks with repeated measures, the SEFI -AP medians of lunch ( = 0.11) and means of lunch and dinner ( = 0.15) did not vary over time. Day 3 SEFI -AP anticipated decreased food intake from days 4 to 20, with a sensitivity of 78% (95% confidence interval (CI), 62-94), a specificity of 30% 95%CI, 17-44 and positive and negative predictive values of 41% 95%CI, 28-55 and 68% 95%CI, 48-89. The performance of SEFI -AP for diagnosis of malnutrition using calf circumference <31 cm as a phenotypic criterion was correct: area under the curve = 0.71 95%CI, 0.59-0.83. SEFI -AP sensitivity was better if ≤9.5 than <7, and inversely for specificity. The food intake of older people living in nursing homes is stable over one month. One-day SEFI -AP correctly anticipates food intake during the following month and predicts diagnosis of malnutrition. Any decrease in food intake should lead to suspect malnutrition.
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