Evaluation of an Institute of Medicine approach to dietary planning in long‐term care

This study tested the effect of planning menus using the Institute of Medicine's (IOMs) Simple Nutrient Density Approach on micronutrient intakes and prevalence of inadequate intakes in long‐term care (LTC) residents. The regular menus were modified using conventional and fortified foods to meet intake goals for vitamin E, magnesium, zinc, vitamin D and calcium. Using a within‐subjects crossover design, three‐day weighed food intakes for 35 females were collected for both regular and modified menu versions. To estimate long‐term average intake and the proportion of residents with inadequate nutrient intakes, data were adjusted using PC‐SIDE (Iowa State University). Results revealed that menu modification significantly increased intakes of the target nutrients. Our goal to decrease the prevalence of inadequacies to <3% was met for zinc and vitamin E but not magnesium. The groups' mean usual intake from the modified menu met or exceeded the Adequate Intake (AI) for calcium but not vitamin D. Alternatively, it was determined that addition of a multivitamin and mineral (MVM) supplement to intakes of the regular menu would achieve intake goals for vitamin E, zinc and vitamin D but not calcium and magnesium. A combination of menu modification and MVM supplementation may be necessary to achieve a low prevalence of micronutrient inadequacies among LTC residents.