1. Meal Intake Percentage Priority Nutrition Care Dietetic Intern Kerry Barbera
Weight loss and malnutrition are common occurrences in the elderly population that can have a significant negative impact on their health. It is imperative that the health professionals working with the elderly recognize the potential for weight loss and malnutrition for early intervention.

2. Objectives Importance of recording meal intakes
Review percent of meal intake system
Introduce point system another way of documenting food intake

3. Introduction
Residents who consistently eat less than 75% of their meals puts them at risk of under-nutrition
Weight loss and malnutrition have a significant impact in the elderly
Accuracy is crucial in identifying at risk residents
Early nutritional intervention is key
Weight loss and malnutrition are common occurrences in the elderly population that can have a significant negative impact on their health.
It is imperative that the health professionals working with the elderly recognize the potential for weight loss and malnutrition for early intervention.
This is one of the nutrition screens for identifying patients at risk for malnutrition to promote early nutritional intervention and it is imperative that the documentation of the resident’s meal intakes are accurate
Resident meal intake recorded as 51-75% in actuality was less than 51% and should have ben recorded as 26-50%.
If this continues over time this could lead to malnutrition and maybe over looked.
It is important to recognize this early rather than later to intervene to add nutritional supplement.

4. Meal Intakes
OF THE 86 MEALS: 56% ACCURATE, 5 WERE NOT RECORDED AND 38% INACCURATE, 24 OVERREPORTED AND 9 UNDERREPORTED (33 TOTAL ). Data suggests this is a very common occurrence where most over estimating happening especially in lower level intakes

5. Food intake guide handout

6. Percent Meal Intake
76-100%- ¾ of all items eaten. All of three or more basic food groups
51-75%- ½ to ¾ of all items eaten. All of two basic food groups
26-50%- ¼ to ½ of all items eaten. All of one basic food group
0-25% -bites only. No basic food groups eaten
Refused-nothing eaten
Please refer to handout when reviewing slide
Basic food groups-protein, grain/starch, fruit, vegetables

7. Points System Tallies the amount of food eaten.
Beverage intake is documented separately per PE policy
Condiments, such as ketchup, mustard, and mayonnaise, do not count.
Butter counts with the bread.
All other food items are given 1 point.

8. Points System If the resident eats: All of a particular food=1 point
½ of a particular food item = ½ point
≤ to ¼ of a food item = 0 points.

9. Points System
Total points eaten-To simplify the process, record the tally of foods eaten as a fraction (ie, 2/7, 3/6, 4/9, etc).
Once you have determined the total points eaten, divide this number into the number of total items on the tray.
Example: 2/7=28.5% rounded to the nearest whole number equals 29%, 3/6=50%, 4/9=44%
This will give us all a good indication of how the patient is really eating.

10. Example All of the soup and crackers=2 points
½ of the cottage cheese/fruit plate=½ point
All of the orange Jell-O®=1 point
TOTAL to record=3.5/4    equals 87.5% or % 

11. Example All of his orange juice ½ of the Cheerios ¾ of the bacon
½ banana
None of the waffle with syrup
TOTAL to record=2/4 equals 50% or 26-50% not %

12. Examples ¼ of the steak All of the mashed potatoes
½ of the green beans
All of the salad with dressing
¾ of the vanilla pudding
TOTAL to record=3.5/5 equals 70% or 51-75%

13. Examples 1 ¾ of the mushroom chicken= _____
½ of the mashed potatoes with gravy=_____
None of the wax beans=_____
½ of the bread with butter=_____
¼ of the rice pudding =_____
All of the grapes=_____
½ of the vanilla cake                      
TOTAL to record=_____

14. Answer Example 1 ¾ of the mushroom chicken=1
½ of the mashed potatoes with gravy=½ 
None of the wax beans =0
½ of the bread with butter=½
¼ of the rice pudding=0
All of the grapes=1
½ of the vanilla cake=½
TOTAL to record: 3.5/7= 50% or 26-50%

15. Practice Example 2 Sips of the broth=_____
None of the tossed salad=_____
¾ of the enchilada casserole=_____
¼ of the spinach=_____
All of the roll=_____
All of the applesauce=_____
½ of the ice cream =_____
TOTAL to record=_____

16. Answer Example 2 Sips of the broth=0 None of the tossed salad=0
¾ of the enchilada casserole=1
¼ of the spinach=0
All of the roll=1
All of the applesauce=1
½ of the ice cream = 1
TOTAL to record: 4/7=57% or 51-75%

17. Practice Example 3 All of the vegetable soup=_____
All of the crackers=____
½ of the ham and cheese sandwich=____
¾ of the potato salad=____
All of the custard=_____
All of the ice cream=____
TOTAL to record=_____

18. Answer Example 3 All of the vegetable soup= 1 All of the crackers= 1
½ of the ham and cheese sandwich= ½
¾ of the potato salad= 1
All of the custard= 1
All of the ice cream= 1
TOTAL to record= 1
TOTAL to record: 5.5/6=92% or %

19. Practice Example 4 ½ of the chicken Kiev=____ ¼ of the brown rice=____
½ of the broccoli =____
All of the carrots =____
½ of the whole wheat roll=____
All of the rice pudding =____
None of the peaches =____
½ of the ice cream=____
TOTAL intake=

20. Answer Example 4 ½ of the chicken Kiev= ½ ¼ of the brown rice=0
½ of the broccoli = ½
¾ of the carrots = 1
¼ of the whole wheat roll=0
All of the rice pudding = 1
None of the peaches = 0
¾ of the ice cream= 1
TOTAL intake=4/8 = 50% or 26-50%

21. Summary
Weight loss and malnutrition have a significant negative impact in the elderly
Accuracy is crucial in identifying at risk residents early
Early nutritional intervention is key
Percent or Point system

22. You gave me your time-the most thoughtful gift of all.- Dan Zedra
Questions
You gave me your time-the most thoughtful gift of all.- Dan Zedra
Thank You!

23. Resources
Nutrition411.com. (2016). Meal Intake Guide (supported by Abbott Nutrition) | Nutrition411. Retrieved from nutrition. Accessed on February 14, 2015
Nutrition411.com. (2016). Point System Percentage Meal Intake: Adding Up the Points | Nutrition411. Retrieved from meal-intake-adding-points. Accessed on February 14, 2015
FS.Rot.CRD 1.1, 4.4, & 4.6.Barbera