In this study, we investigated the application of HACCP for a prepared side dish of sweet potato stems, within a free meal service system for the elderly in the Sungnam area. Total bacterial counts (TBC) and levels of coliforms and Esherichia coli (E.coli) were analyzed through an eight step cooking process. The TBCs of the raw samples ranged between 3.30 and 1.37${\times}10^4$ CFU/g per 100 cm$^2$ The trimmed, blanched, and drained sweet potato stems showed a mean TBC value of 1.37${\times}10^4$ CFU/g, and the level of coliforms was 1.48${\times}10^3$ CFU/g. Among the eight samples, however, after stir-frying and serving, the TBC decreased to a standard satisfactory level, and a coliforms and E. coli were not found. A five step process was used and samples were taken to check the microbial quality of the cook and cooking equipment. Here we tested for TBC, coliforms, Staphylococcus aureus (S. aureus), and Salmonella. Specifically, the TBC and number of coliforms were examined on the cook's hand's, cutting board, and knife, as they represented hazards for cross-contamination. The three inspection steps of preparation of the trimmed, rinsed, blanched, and drained sweet potato stems, cook's' hands, cutting board and knife were all considered CCPs, and a manual of cooking process management was established to improve the risk factors in this study. In conclusion, this study reinforces that microbiological analysis is as a valuable tool for checking what points and stages of the cooking process must be controlled.
This study is designed to assess the prevalence at risk of malnutrition according to the Mini Nutritional Assessment (MNA) and evaluate the factors influencing on the nutritional risk of the elderly. Three hundred and nine elderly (110 men and 199 women: mean age =74.1) who participated in meal service in the Chung-buk province were investigated. Mean MNA total score was 21.9 and women had significantly lower MNA scores than men (respectively, 21.5 and 22.8). In the mean time mean MNA-SF (Short Form) score was 10.7, respectively 10.6 for the women and 11.0 for the men, with the difference being statistically significant. The MNA classified 33% of the elderly as well-nourished, 61.7% as at risk of malnutrition and 5.3% as overt malnourished. However, MNA-SF categorized the examinees 40.2% as good and 59.8% at nutritional risk. Those who identified as malnourished elderly had significantly lower mean BMI, mid-arm and calf circumference, poorer functional abilities (ADL, IADL) , lower MAR and food habits scores, and higher number of nutrient $\leq$ 75% of RDA than those with at risk of malnutrition and well nourished. Also socioeconomic status such as educational level, self-rated economic status, poverty level, and marital status significantly influenced nutritional status. Similar effect was observed in self-rated nutritional status and health status, dental status, appetite change according to MNA score. Stepwise multiple regression analysis indicated that weight loss was the most predictive item in the total MNA and MNA-SF score. It was found that items such as mobility, living status (home vs institution) , mode of feeding, and pressure sores were inappropriate for assessment of the elderly who are able to participate meal service program. Also, some modifications of items in MNA are needed in order to apply to Korean elderly. Even though the MNA seems to be an useful tool to screen those old people at risk of malnourished, a lot of work is still to be done with this assessment tool to secure its reliability.
Objectives: This study was performed to investigate the effect of active nutrition care on feeding and nutritional status of elderly patients receiving long-term enteral tube feeding. Methods: Subjects included 77 elderly patients who had received enteral nutrition more than one week before admission. Nutrition care was provided to patients supplied less calories than required. Feeding intolerance was examined and managed every day and formula was adjusted to meet nutritional requirement during the first 3 months after admission. Patients were classified into under or over 80% of percent ideal body weight (PIBW) and medical records were used to compare changes in weight,, biochemical indices, and nutritional status during the study. Results: Weight, BMI, triglyceride and total cholesterol in blood, hemoglobin, and hematocrit levels were significantly lower in patients under 80% of the PIBW than in those over 80% of the PIBW at admission. The percentage of supply to required calories was also lower in patients under 80% of the PIBW. After 1 month of nutritional care, supplied volume of formula was significantly increased in patients under 80% of the PIBW. Weight, BMI, and PIBW were increased and there were no differences between groups after 6 months. In addition, the concentrations of triglyceride and total cholesterol in blood, hemoglobin, and hematocrit tended to increase in patients under 80% of the PIBW, leading to no difference between groups after 3 months. Conclusions: Personalized active nutrition care is effective to increase weight and improve feeding and nutritional status in underweight elderly patients receiving long-term enteral nutrition.
Park, Seoyun;Ahn, So Hyun;Kim, Jin Nam;Kim, Hye-Kyeong
The Korean Journal of Food And Nutrition
/
v.26
no.3
/
pp.459-469
/
2013
This study was performed to estimate the salt content and evaluate the nutritional quality of free lunch meals served by welfare facilities for the elderly. We collected food items from 8 welfare facilities in Gyeonggi-do, and calculated the total salt content from the salinity and weight of individual food items. The average salt content from lunch meals was 5.68 g, which was over the recommended daily salt intake by the WHO. The greatest contributor to the salt content among the menu groups was soup and stew (37.5%). Soup, stew, deep-fried foods, and sauces were major sources of salt, while the most salty dishes were sauces, deep-fried food, salt-fermented food, and kimchi. The nutrient content was sufficient, except for calcium in both men and women, which was equal to approximately 1/3 of the dietary recommended intakes (DRIs) for Korean adults of their mean age. In addition, the index of nutritional quality (INQ) and nutrient adequacy ratios (NAR) of most nutrients were satisfactory, except for those of calcium and sodium. The INQs of calcium and sodium were 0.64 and 4.41, respectively, while the mean adequacy ratio of a meal was 0.95. These results suggest that multilateral efforts to lower sodium intake be considered and calcium sources be added, in order to improve the quality of meals served to the elderly at welfare facilities.
Seo, Hui-Jae;Hong, Min-Ji;Jang, Yeong-Ae;Kim, Bok-Hui;Lee, Haeng-Sin;Kim, Cho-Il
Journal of the Korean Dietetic Association
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v.9
no.2
/
pp.114-127
/
2003
In the process of devising an efficient meal service system for the elderly, 478 elderly were interviewed at 6 different social centers with the elderly meal service program in Seoul area to monitor degree of satisfaction and/or needs of the beneficiaries regarding the program. The survey was conducted during the month of December 2002 by well-trained interviewers using self-developed questionnaire. Results were analyzed statistically using SAS package program. Most of the beneficiaries were low economic class and 76% of them had doctor diagnosed disease(s). Among the beneficiaries of congregate meal service, mean score of 12 aspects of satisfaction was 3.72 out of 5. For most of the questions, female elderly and healthy elderly responded with higher score than male elderly and unhealthy elderly, respectively (p<0.05, p<0.01). On the other hand, beneficiaries of the home-delivered meal service were little bit less satisfied with the service (3.54 out of 5). Compared to the beneficiaries of congregate meal service, larger portion of beneficiaries of home-delivered meal service wanted more meats (28.5 % vs. 17.1 %) and vegetables (23.2 % vs. 12.3 %) as side dishes. On the other hand, the most preferred type of cooking and/or seasoning was stewing for both cases. Based on these findings, it is suggested that more fresh foods should be used than processed foods in the preparation of meals for the elderly and, more fish-, meat- and vegetable- dishes should be served to come up to the needs of the elderly. Onto this, mainly Korean style meals with some intermittent Western, Japanese or Chinese style meals served at the right temperature would suffice most of the elderly needs.
This study was carried out to determine the depression symptoms and nutritional status of elderly females that ate congregate meals at lunch in rural Pocheon. The subjects were 18 elderly females aged over 65 ($75.7{\pm}4.6$ years) and information on smoking, subjective health status, depression symptoms and malnutrition risk were collected using a questionnaire administered with the help of trained research assistants. Measurements included mid-arm circumference and calf circumference. Food consumption for 3 days during breakfast and supper were determined by 24-hour recall and food consumption at lunch was determined as the difference between the amounts served and the plate waste. All data were compared between two age groups (${\leq}75$ and > 75). The subjects had the lowest nutrient adequacy ratio (NAR) for vitamin $B_6$ (0.523), followed by calcium and niacin and the lowest index of nutrient quality (INQ) for calcium (0.738). The older elderly had significantly lower NAR for vitamin $B_1$, vitamin $B_2$, vitamin $B_6$ and niacin as well as significantly lower mean adequacy ratio (MAR) compared to the young elderly. They also had significantly lower INQ for vitamin $B_1$ and vitamin C and significantly thinner arm circumference (28.3 cm vs. 31.3 cm). They consumed more than 40% of their daily intake for each nutrient at lunch. Higher proportions of nutrient intake from lunch provided evidence of the importance of congregate meals, suggesting that the government and society should support congregate meals to improve nutritional status.
The purpose of this study was to evaluate food safety practices and knowledge of foodservice workers at senior welfare centers. A self-administrated questionnaire was administered to 1200 foodservice workers at senior welfare centers in Seoul, Incheon and Gyeonggi province. Two hundred five responses were returned, with 181 usable for analysis. Statistical analyses were conducted using SPSS for Windows(ver.14.0). Volunteers of respondents comprised 64.1% while chefs and employees comprised 20.9%. Food safety practices were assessed using a 5-point scale(1: strongly disagree - 5: strongly agree), and the average score of food safety practices was 4.27. For specific practices, 'personal hygiene (4.46)' scored the highest, followed by 'cleaning and sanitizing(4.43)', 'separate handing(4.40)', 'cooking process(4.11)', and 'receiving and storing(4.05)'. There were significant differences in the practice average score by age(p<0.01) and experience of food safety education(p<0.01). The total score for food safety knowledge was 14.43 out of 20 points. In the category of food knowledge, 'equipment and facility(80.5%)' had the highest correct answer rate, followed by 'personnel hygiene(75.9%)', 'cooking process(70.4%)', and 'cleaning sanitizing(65.8%)'. There were significant differences in the knowledge total score by job type(p<0.05), age(p<0.05), working experience(p<0.05), chef certification (p<0.01), and frequency of food safety education(p<0.01). The knowledge and practice scores were significantly correlated(p<0.01). This study suggests that food safety education for foodservice workers should be conducted continuously and repetitively, and the development of proper education materials is needed to improve the effectiveness of food safety education for chefs, employees and volunteers at senior welfare centers.
The purposes of this research were 1) to investigate the characteristics of the meal service participants; 2) to evaluate the food service utilization of the elderly; 3) to identify major factors that affect food service satisfaction of the participants in Chungchongbuk-Do. For doing this, 309 subjects were selected and the survey research method was adopted. The characteristics of the meal service participants were similar to the characteristics of general elderly population in Korea. The public assistant recipients were under representative in this sample, that is, most of elderly people who participated in meal service consisted of non public assistant recipients. It meant that meal service was not provided to low-income elderly people. The health status of the elderly people was stable to be able to attend to the meal service organizations. The most important reason to use a meal service was to see their friends. It showed that meal services played an important role to provide support systems to the elderly people in community. Thus, meal services should be provided to the elderly people with social services. In order to analyze the factors influencing food service satisfaction, multiple regression analysis was employed. The results showed that physical activity, contact with friends who met in meal service program, and the number of social services were the important variables to predict meal service satisfaction in this study. These findings contributed to a better understanding of developing a meal service planning. Several improvement strategies were recommended to provide effective meal services. First, socio-economical characteristics of the elderly should be considered to provide appropriate services. Second, meal services should be provided to the elderly people with social services. Third, home delivery meal services should be available to the home-bound elderly.
Elderly with dementia in geriatric hospitals (EDGH) are highly dependent on hospital meals. This study evaluated the foodservices satisfaction and food preference of the EDGH. The survey was conducted on 104 elderly with dementia (21 males and 83 females) in 4 geriatric hospitals in Seoul and Incheon in November, 2016. Data were collected from interviews using a questionnaire that consisted of 6 questions for foodservice satisfaction and 24 questions (10 categories) for food preference. The data were analyzed using SPSS ver. 20.0. The satisfaction with taste, saltiness, texture, and variety in foodservices was good, but the satisfaction with the amount was not, and the reason for leaving food was its large serving size. The subjects preferred soft boiled rice, noodles, porridges, meats, fish, seafood, vegetables, and fruits. Among them, they preferred more janchiguksu, red bean porridge, beef, croaker, oyster, spinach, and banana. Regarding the cooking methods, they preferred soup, grill, and boiling, but not frying. The also preferred Chinese cabbage kimchi, but they did not prefer hard kkakdugi. They did not prefer milk because of diarrhea, but they preferred yogurt. Therefore, to provide a satisfying meal for EDGH, it is necessary to develop a friendly diet considering their food preferences.
The purpose of this study was to investigate the effects of a nutrition education and personalized lunch service program in a senior welfare center. A total of 30 elderly (14 males, 16 females) aged 62~89 years participated in this study. Nutrition education lessons (2 hour/lesson/week) were provided for 4 weeks. Also, ten weeks from week 3rd to week 12th, personalized lunch providing 1/3 personal needed energy was served 5 times for a week. After the nutrition intervention program, we compared anthropometric characteristics, blood biochemical characteristics, nutrition knowledge, dietary attitude and dietary intake using 24 hr recall with those before the intervention. The body weight (p < 0.001) and body mass index (BMI) (p < 0.001) were decreased. There were significant increases in score of nutrition knowledge (p < 0.01) and consumption of milk & milk products for snacks. There was a positive effect on fasting blood sugar (FBS) showing significant decreases in portion of impaired fasting glucose and diabetes mellitus (p < 0.05). Also, serum triglyceride (TG) was significantly decreased (p < 0.05). In evaluation of nutrient intake by Dietary Reference Intakes for Koreans (KDRIs), riboflavin (p < 0.01), vitamin C (p < 0.001), calcium (p < 0.05) were positively improved. The index of nutritional quality (INQ) and intakes of vitamin C (p < 0.001), riboflavin (p < 0.05), Ca (p < 0.01) and Fe (p < 0.05) were increased. In conclusion, this nutrition education and lunch service program providing 1/3 personal needed energy can be used to develop and implement a tailored nutritional intervention programs in the setting of a community senior welfare center to improve health and nutritional status of Korean elderly.
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