臺灣飲食質地備餐指引在長照機構餐點介入之探討

The Intervention of the Texure-modified Diet in Long-term Care Facilities Based on the Guidelines for the Preparation of Dietary Texure in Taiwan

目的：探討臺灣飲食質地分級餐介入長照機構之飲食後，是否能夠提升高齡者熱量攝取量、營養狀況及達到三大營養素均衡攝取。方法：研究對象為21位長照機構住民，實驗時間為期8週，第1－2週為介入前，分別進行營養狀態評估、質地適宜度評估及攝食量秤量，同時衛教廚務人員臺灣飲食質地製備指引草案之內容。第3－4週為機構供餐-1，由機構供應質地分級餐給受試者食用，並且秤量攝食量。第5－6週為研究單位供餐，使用真空包裝質地分級餐送餐至機構內復熱，並且秤量攝食量，第7－8週為機構供餐-2，由機構供應質地分級餐給受試者食用，並且秤量攝食量，同時對於機構製備質地分級餐進行食品品評調查及營養狀況評估。數據以成對樣本t檢定分析介入前、機構製備質地分級餐前後與研究單位供餐的營養狀況，p＜0.05代表有顯著意義。結果：介入前與介入後的營養評估皆未達顯著差異。在容易咬普通食與牙齦碎軟質食中，研究單位供餐熱量與醣類攝取量顯著較高。質地分級餐介入後的脂質顯著下降。結論：飲食質地分級餐介入後發現，在容易咬普通食與牙齦碎軟質食中的熱量攝取有明顯上升，且質地分級介入後三大營養素攝取皆達到均衡。

Objective: To explore whether older adults' calorie intake, nutritional status, and balance of intake of three major nutrients could be improved through an intervention in long-term care institutions based on Taiwan's dietary texture guidelines. Method: A total of 21 residents of long-term care institutions were recruited as research participants for an 8-week experiment. In weeks 1-2 - before the intervention - the participants' nutritional status was determined. Texture suitability analysis and intake measurement were performed, and the contents of the Guidelines for the Preparation of Dietary Texture in Taiwan were taught to kitchen staff. In weeks 3-4, the institutions supplied meals classified by texture to the research participants, and their intake was measured. In weeks 5-6, the researchers supplied meals, which were vacuum packed, according to texture, and these were reheated at the institutions; intake was measured again. In weeks 7-8, the institutions supplied meals classified by texture, and the participants' intake was measured. For the meals classified by texture prepared by the institutions, a food evaluation questionnaire and nutritional status assessment were administered to the participants. Paired-sample t tests were performed on the data to analyze the participants' nutritional status before and after the institutions prepared the meals classified by texture and vacuum packed them for delivery; P<0.05 represented statistical significance. Results: The nutritional assessment did not reveal significant differences after the intervention. The easy-to-bite ordinary diet and gum-crushed soft diet delivered by the researchers contained significantly more calories and carbohydrates. Moreover, after the dietary texture intervention, the participants' lipid levels were significantly lower. Conclusion: This study found that through nutritional intervention to provide easy-to-bite ordinary food and gum-crushed soft food, participants' calorie intake significantly increased. Additionally, after the intervention, balanced intake of the three major nutrients was achieved.