Study circles improve the precision in nutritional care in special accommodations

  • Albert Westergren
  • Carolina Axelsson
  • Petra Lilja-Andersson
  • Christina Lindholm
  • Karin Petersson
  • Kerstin Ulander
Keywords: education, malnutrition, undernutrition, overweight, special accommodation, quality improvement


Background: Disease-related malnutrition is a major health problem in the elderly population, but it has until
recently received very little attention, especially are management issues under-explored. By identifying
residents at the risk of undernutrition (UN), appropriate nutritional care can be provided.
Objective: To investigate if study circles and policy documents improve the precision in nutritional care and
decrease the prevalence of low or high body mass index (BMI).
Design: Pre and post-intervention study.
Setting: Special accommodations (nursing homes) within six municipalities were involved.
Participants: In 2005, 1,726 (90.4%) of 1,910 residents agreed to participate and in 2007, 1,526 (81.8%) of
1,866 residents participated.
Intervention: Study circles in one municipality, having a policy document in one municipality and no
intervention in four municipalities.
Measurements: Risk of UN was defined as involving any of: involuntary weight loss; low BMI; and/or eating
difficulties. Overweight was defined as high BMI.
Results: In 2005 and 2007, 64% and 66% of residents, respectively, were at the risk of UN. In 2007,
significantly more patients in the study circle municipality were accurately provided protein and energy
enriched food (PE-food) compared to the no intervention municipalities. There was a decrease between 2005
and 2007 in the prevalence of low BMI in the study circle municipality, but the prevalence of overweight
increased in the policy document municipality.
Conclusions: Study circles improve the provision of PE-food for residents at the risk of UN and can possibly
decrease the prevalence of low BMI. It is likely that a combination of study circles and implementation of a
policy document focusing on screening and on actions to take if the resident is at UN risk can give even better


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How to Cite
Westergren A., Axelsson C., Lilja-Andersson P., Lindholm C., Petersson K., & Ulander K. (2009). Study circles improve the precision in nutritional care in special accommodations. Food & Nutrition Research, 53. Retrieved from
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