Dietary and fluid intakes of older adults in care homes requiring a texture modified diet: the role of snacks

J Am Med Dir Assoc. 2011 Mar;12(3):234-9. doi: 10.1016/j.jamda.2010.06.001. Epub 2010 Oct 23.


Objective: To evaluate and compare energy, protein, non-starch polysaccharide, and fluid intakes of a care home population consuming a texture modified diet (TMD) with those on a standard diet and also to evaluate the role of snacks in individuals' diets.

Design: Cross-sectional study.

Setting: Care homes.

Participants: Thirty residents (n = 15 requiring standard diet: n = 15 requiring TMD).

Measurements: Dietary intakes were assessed using a 3-day weighed plate-wastage method. All snacks and drinks consumed were observed and recorded. Weights of standard portions and volumes were used to determine actual amounts consumed of these items. Estimated intakes were converted to energy and nutrient intakes using WinDiets Dietary analysis software.

Results: Residents on a TMD had significantly lower intakes of energy (1312 [326] kcal versus 1569 [260] kcal, P < .024), non-starch polysaccharide (6.3 [1.7] g versus 8.3 [2.7] g, P < .02) and fluid (1196 [288] mL versus 1611 [362] mL, P < .002) when compared with residents on a standard texture diet. Snacks provided significantly less energy (13% or 173 kcal versus 22% or 343 kcal, P = .001) and non-starch polysaccharide (P < .001) in those requiring the TMD.

Conclusions: These results suggest that dietary and fluid intakes of older adults in care homes requiring a TMD are significantly less than individuals on a standard texture diet. These are unlikely to be meeting individuals' dietary and nutritional needs. Strategies that maximize provision of appetizing energy and nutrient-dense foods (including snacks) and fluids of suitable textures require further investigation.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Diet*
  • Dietary Proteins / administration & dosage
  • Drinking
  • Energy Intake
  • Female
  • Geriatric Assessment
  • Humans
  • Male
  • Middle Aged
  • Nursing Homes*
  • Nutrition Assessment
  • Nutritional Requirements
  • Polysaccharides / administration & dosage
  • Scotland
  • Software


  • Dietary Proteins
  • Polysaccharides