Diagnóstico da assistência alimentar e do estado nutricional de idosos em instituições de longa permanência de Belo Horizonte

Abstract

The current study had the goal of evaluating the assistance and the nutritional status of elderly people living in long-term care facilities in the city of Belo Horizonte, MG. One hundred and eleven elderly were included, in four different institutions, chosen by convenience. Food assistance evaluation encompassed the quality assessment of the menu throughout a period of six months by using the method Qualitative Analysis of the Menus Preparation. Food intake was evaluated by the direct food weighing method as well as the analysis of the individual intake by comparing it with the reference values determined by the "Dietary Reference Intakes" - DRIs. Acceptance tests based on the National School Feeding Program - PNAE, were carried out with the purpose of verifying the adequacy and acceptance of the lunch offered. Also, received food donations were qualitatively evaluated (FNDE, 2009). The nutritional diagnosis was carried out by the mini nutritional assessment (MNA) and the subjective global assessment (SGA). Anthropometric indicators such as weight, height, body mass index (BMI), arm circumference (CB), triciptal skin fold (DCS), subscapular skinfold (DCS), arm muscle circumference (CMB) and calf circumference (CP) were measured. The Katz scale was adopted to assess the degree of dependency for Activities of Daily Living (ADL). None of the included institutions had a dietitian regularly working there. The Qualitative Analysis of the Preparation of menus pointed to the inadequacy of salads and vegetables (below recommended) and fatty meats (higher than indicated). The overall intake of all nutrients, in particularly, vitamins D and B6, pantothenic acid, calcium, magnesium, and zinc were inadequate for more than 80.0% of the elderly. Acceptability test evaluation indicated the need to modify he menus and the preparations. Donated food was of low nutritional quality, especially high in sugar and sodium contents. According to MNA, the risk of malnutrition was 76.6%, malnourished elderly represented 15.3%, while those with adequate nutritional status were 8.1%. The prevalence of malnutrition according to SGA was 49.5%, with severe malnutrition seen in 6.3% of the elderly. Therefore, we may conclude that its highly recommended that adequate policies should be adopted to improve better nutritional care to this group of vulnerable individuals, of which the presence of dietitians would most likely help in regards to nutritional quality, individual attention and care.