Protein intake in aged care residents before and after the Royal Commission into Aged Care Quality and Safety: A review of historical data compared to contemporary intakes

AIM: Malnutrition is prevalent among aged care residents and is exacerbated by inadequate provision and intake of protein. High rates of malnutrition and inadequate provision of protein were two issues raised by the Royal Commission into Aged Care Quality and Safety that prompted the Federal government to provide financial support to the sector to improve nutrition in residents. We aimed to determine if protein provision to, and intake in, residents has improved and meets requirements following the Royal Commission. METHODS: Protein intakes from 12 Pre-Royal Commission studies were identified from a literature search (n = 2378 residents, 85.9 years, 72.3% female). Post-Royal Commission intakes of 78 residents (84.3 years, 84.6% female) were documented. Protein intakes were measured using weighed intake or visual plate waste assessment over 1-3 days. Intakes (±95% confidence interval) for protein (g), relative protein (g/kg body weight), high-protein foods and energy (kJ/kg body weight) were calculated. Differences occurred if the 95% confidence interval between Pre- and Post-Royal Commission intakes did not overlap. RESULTS: Mean relative protein (0.9 g/kg body weight; 95% confidence interval: 0.8-0.9) and energy (98 kJ/kg body weight; 95% confidence interval: 97-100) intakes of residents pre-Royal Commission did not differ to post-Royal Commission residents (protein: 0.9 g/kg body weight; 95% confidence interval: 0.8-1.0, energy: 96 kJ/kg body weight; 95% confidence interval: 88-104). Provision and intakes of high-protein foods remained below recommended levels. CONCLUSIONS: Protein intake of residents and provision of high-protein foods were inadequate prior to and remain below recommendations since the Royal Commission. Regulatory changes such as minimal national nutritional standards for food provision are required to ensure nutritional adequacy of aged care residents.