Abstract
Background: Constipation is a prevalent issue among older adults. For those living in care, laxative use is a common approach to treat constipation. However, laxatives do not always provide full relief from constipation or alleviate other digestive symptoms such as bloating. Dietary fibre can effectively treat constipation and is considered a first-line treatment. International guidelines recommend 25 grams of dietary fibre a day to promote laxation. Currently this is limited literature regarding the amount of dietary fibre provided and consumed by older adults living in care.
Aim: To assess the adequacy of dietary fibre provision and consumption among older adults living in residential care.
Summary: A systematic review and meta-analysis was conducted. The review followed the guidelines of Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA). The following databases were searched; Ovid, Embase, Scopus and CHINAH. 28 studies were included for analysis, representing 15 countries and 4817 residents living across 114 residential care facilities (mean age 81.8 years, 64.9% women). The total random effect estimate for dietary fibre provision was 21.4 grams (SE 1.2, 95% CI 18.8 to 24.2). The total random effect estimate for dietary fibre consumption was 15.8 grams (SE 0.6, 95% CI 14.7 to 16.9, p<0.001). The mean difference between males and females was only 1.92 grams (95% CI 1.1, 2.7 p<0.005). There was high heterogeneity amount the studies, as measured by the 12 statistic (p<0.001,12 98.53%). Low dietary fibre was reported across gender, for all ages, living settings and for residents both with a low BMI or within the normal BMI range. Dietary fibre consumption was the lowest for residents on modified diets and those requiring higher levels of care.
Discussion: The findings from this meta-analysis indicates that residents living in care are provided with inadequate amounts of dietary fibre and consume even less.