Malnutrition among Australia’s aged care residents is a widespread, and widely documented, issue. About 50 per cent are considered malnourished, a statistic that has — sadly — remained stagnant for decades . Now, an evidence-based program being rolled out at facilities across Queensland is showing the answer could lie in a legume more commonly used to feed Australia’s cattle — lupin.
Dr Cherie Hugo, a Bond University Adjunct Professor and Lantern Alliance founder, has studied the benefits of lupin flour for aged care residents for six years. She says the outcomes have the potential to help reverse malnutrition rates and improve the health of our elderly.
The benefits of lupin
Dr Hugo first researched the impact of integrating lupin flour into aged care residents’ diets as part of her PhD at Bond University in 2018. The study found a significant 34 per cent decrease in malnutrition in just three months. She’s since worked closely with 15 aged care facilities to establish the program long-term, with incredible results. Over several years, thousands of aged care residents have experienced health improvements from incorporating lupin into their diet.
“The homes we’re working with have recorded between a 25 and 50 per cent improvement in malnutrition,” says Dr Hugo.
“At the other end of the spectrum, there’s been just a six to eight per cent decline. So, across the board, we’re seeing significantly higher improvement and significantly less regression in malnutrition rates than the norm.” Dr Hugo says the figures compare to published research that shows just six per cent of residents in aged care typically see nutrition improvements, while 23 per cent experience a decline.
Reversing malnutrition
Importantly, the research proves you can turn the tide on malnutrition in aged care. “What we’ve shown is when we take a proactive approach, the person can improve,” says Dr Hugo.
“And, when we get an improvement, we see eight times less falls, three to 11 times less pressure injuries and significant drops in hospital readmissions. This translates to millions in savings to the healthcare system if it was adopted nationally, and better quality of life for residents.
"Malnutrition is preventable. It's been 50 per cent across the industry for decades but when we have an organisation that is engaged, we’ve shown we can reverse it.”
The benefits of lupin
Dr Hugo first researched the impact of integrating lupin flour into aged care residents’ diets as part of her PhD at Bond University in 2018. The study found a significant 34 per cent decrease in malnutrition in just three months. She’s since worked closely with 15 aged care facilities to establish the program long-term, with incredible results. Over several years, thousands of aged care residents have experienced health improvements from incorporating lupin into their diet.
“The homes we’re working with have recorded between a 25 and 50 per cent improvement in malnutrition,” says Dr Hugo.
“At the other end of the spectrum, there’s been just a six to eight per cent decline. So, across the board, we’re seeing significantly higher improvement and significantly less regression in malnutrition rates than the norm.” Dr Hugo says the figures compare to published research that shows just six per cent of residents in aged care typically see nutrition improvements, while 23 per cent experience a decline.
Reversing malnutrition
Importantly, the research proves you can turn the tide on malnutrition in aged care. “What we’ve shown is when we take a proactive approach, the person can improve,” says Dr Hugo.
“And, when we get an improvement, we see eight times less falls, three to 11 times less pressure injuries and significant drops in hospital readmissions. This translates to millions in savings to the healthcare system if it was adopted nationally, and better quality of life for residents.
"Malnutrition is preventable. It's been 50 per cent across the industry for decades but when we have an organisation that is engaged, we’ve shown we can reverse it.”
The lupin legume
About 85 per cent of the world’s lupin is grown in Australia, predominately in Western Australia, according to the Grains & Legumes Nutrition Council. A rich source of plant protein, dietary fibre and essential nutrients such as folate, calcium, magnesium and zinc, lupin is described as having a mild, nutty flavour. Dr Hugo says its benefits, particularly its high protein content, and its ability to be used in a variety of foods were especially relevant to the aged care sector.
“Our food first approach focuses on things people enjoy eating and lupin flour integrates well into cakes, biscuits, soups and casseroles—things that are commonly well received in the nursing home sector,” she says.
More commonly found on shelves in New South Wales and Western Australia, lupin flour is available in health food stores elsewhere. Dr Hugo says there’s potential for it to be available ‘to the masses’, in products like cereals, cake mixes and pastas.
Lupin education
Critical to getting more providers to integrate lupin is the development of resources, such as video tutorials and recipe books, which are in the works.
“Using lupin flour as a straight substitute for wheat flour doesn't consistently work,” says Dr Hugo. “We’re talking with more providers and trying to educate them on integrating lupin. It’s getting an Australian product out there and getting more fibre, protein and amino acids into aged care diets—all the good things.”
Dr Hugo says incorporating lupin can improve the quality of food served, while removing unnecessary spend—a win-win for providers and residents.
“There’s a return on investment when we get it right. Providers can keep food costs down and have better outcomes, with the nous and knowledge to procure smartly and prepare in a way that's tasty to residents so they eat more,” she says. “They've got more food going in bellies and less in bins.”
Lupin is beneficial to all aged care residents, except those with a peanut allergy.
Early intervention
While lupin is integrated into diets across the aged care facilities Dr Hugo is working with, her wider Nourish program also considers early intervention flags, so other appropriate food strategies can be put in place before a decline occurs.
“It’s often when the health consequences of malnutrition have already happened that dietitians are called in,” she says.
“The resident has poor skin integrity, is developing ulcers, may have had falls and is experiencing reduced immune function, going back and forth to hospital. We're trying to get in before that. We’re scanning for risk factors on a monthly basis, so when we identify a peak, we can put residents on Nourish, which includes additional lupin among other strategies.
“It's prevention rather than waiting for the downstream negative effects we see so commonly in aged care.”
Dr Cherie Hugo provides education on nutrition in aged care.
Dr Cherie Hugo provides education on nutrition in aged care.
Change on the horizon
The 2018 Royal Commission into Aged Care Quality and Safety named food and nutrition as the first of four immediate priorities for the sector. New defined standards officially come into effect from mid-2025.
Dr Hugo acknowledges the problem is complex, with her social enterprise Lantern Alliance established over a decade ago to open conversations and develop pragmatic strategies.
“It's an ongoing process,” she says.“With the new defined standards around food and nutrition, which I feel we’ve had a part in, it’s something the industry will have to demonstrate compliance with. I have high hopes for 2025.”
Published on 11 December, 2024
Original thinking direct to your inbox
Stories from Bond