Older adults living in long-term care (LTC) are nutritionally vulnerable. The purpose of this study was to determine diet quality of Canadian LTC residents and its association with malnutrition and low calf circumference. A cross-sectional study was undertaken in 32 LTC homes across four Canadian provinces. Nutrient adequacy ratios (NARs) were calculated for seventeen nutrients; mean adequacy ratio (MAR) was calculated to describe overall diet quality. Malnutrition risk was assessed with the Mini Nutritional Assessment-Short Form (MNA-SF) and diagnosis of protein/energy malnutrition with the Patient-Generated Subjective Global Assessment (PG-SGA). Calf circumference (CC) was also assessed. Linear and logistic regressions for these outcomes with diet quality as the predictor were conducted adjusting for covariates. Average MNA-SF score was 10.7 ± 2.5. Residents (43.5%) had mild/moderate to severe malnutrition based on the PG-SGA and 32.6% had a CC of < 31 cm. Mean MAR score was 0.79 ± 0.09 with significant differences between those requiring eating assistance (0.77 ± 0.11) and those that did not require assistance (0.80 ± 0.07) (p < .05). MAR score was significantly associated with malnutrition in fully adjusted models: MNA-SF scores [β = 5.34, 95% Confidence interval (CI) (2.81, 7.85)] and PG-SGA [Odds ratio (OR) = 0.49, 95% CI (0.38, 0.64)]. Those who had better diet quality were more likely to be well nourished or not at risk. Although several individual nutrients were associated with low CC (< 31 cm), there was no association between overall diet quality (MAR) and low CC. Diet quality is associated with malnutrition and individual nutrients (NARs) with a low CC. In addition to calories and protein, nutrient dense diets that promote adequate micronutrient intake are required in LTC.

中文翻译：

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饮食质量与加拿大长期护理居民的营养不良和小腿围低有关

生活在长期护理 (LTC) 中的老年人在营养方面很脆弱。本研究的目的是确定加拿大 LTC 居民的饮食质量及其与营养不良和小腿围低的关系。在加拿大四个省的 32 个 LTC 家庭中进行了一项横断面研究。计算了 17 种营养素的营养素充足率 (NAR)；计算平均充足率（MAR）来描述整体饮食质量。营养不良风险采用小型营养评估-简表 (MNA-SF) 进行评估，蛋白质/能量营养不良的诊断采用患者生成的主观整体评估 (PG-SGA)。还评估了小腿周长 (CC)。以饮食质量为预测因子对这些结果进行线性和逻辑回归，并对协变量进行了调整。平均 MNA-SF 评分为 10.7 ± 2。5. 根据 PG-SGA，居民 (43.5%) 患有轻度/中度至重度营养不良，32.6% 的居民 CC < 31 cm。平均 MAR 得分为 0.79 ± 0.09，需要进食帮助的人 (0.77 ± 0.11) 和不需要帮助的人 (0.80 ± 0.07) 之间存在显着差异 (p < .05)。在完全调整的模型中，MAR 评分与营养不良显着相关：MNA-SF 评分 [β = 5.34, 95% 置信区间 (CI) (2.81, 7.85)] 和 PG-SGA [优势比 (OR) = 0.49, 95% CI (0.38, 0.64)]。饮食质量更好的人更有可能营养良好或没有风险。尽管几种单独的营养素与低 CC (< 31 cm) 相关，但总体饮食质量 (MAR) 与低 CC 之间没有关联。饮食质量与低 CC 的营养不良和个体营养素 (NAR) 相关。