Mealtime Partners, Inc.

The primary purpose of eating is to provide our bodies with nutrition and calories for energy and growth. Also, eating is often a social occasion when family and friends spend time together. However, within this framework it should be remembered that eating, and to an even greater extent, feeding oneself, requires energy to be expended (i.e., calories are both being acquired and being used by the same activity). For that reason, we should always be aware of the level of effort that is being put into eating so that the activity does not burn too many calories and thus reduce the benefit of the total calories consumed. If someone is using a lot of energy eating, their ability to sustain the effort will no doubt cause them to fatigue. This article will provide a brief overview of factors that contribute to fatigue at mealtimes and how the fatigue might be reduced.

Many people feel sleepy after a meal but there is a big difference between being sleepy and being fatigued. For people who fatigue easily during a meal there is normally an underlying medical condition that causes the fatigue. The average person eats without exerting enough effort for them to be aware that they are expending any energy. As we learn to feed ourselves as infants, we develop the muscle strength and coordination to make eating easy and, for the most part, automatic. 

The most obvious reason that someone fatigues quickly at mealtimes is that they are frail. Both the elderly and individuals with degenerative conditions exhibit rapid fatigue. It is recommended that for these individuals, mealtimes be abbreviated and meals supplemented with nutritious snacks. Therefore, that person will be provided three small meals that can be consumed in fifteen minutes or less, and the meals will then be supplemented with three of four snacks, depending upon the number of calories that are needed to sustain the particular individual. Furthermore, within this scenario, the eating/feeding practices can be modified to conserve energy. Half-way through the meal the caregiver can provide more assistance either by helping load the utensil or by offering to feed the individual. Also, food preparation can contribute to reducing the level of effort that is required to feed oneself. If meat is cut into very small pieces then it can be picked up easily with either a spoon or fork and will require less chewing before it is ready to be swallowed, thus, less energy is expended by the person eating.

For many people, the physical exertion required to go through the steps needed for self-feeding are extremely demanding and will cause rapid fatigue. If muscle control and coordination is difficult, executing the complex task of picking up food and bringing it to the mouth can be exhausting. For those who fatigue rapidly due to the demands of muscle control, various approaches can be offered. As mentioned previously, one approach is to shorten mealtimes. Instead of three meals a day, five smaller meals can be provided. The provision of small meals provided more frequently, reduces the demands on muscles for extended times. (However, the logistics of doing this is difficult for some people, particularly children in school or those who reside in an institutional setting where scheduling food for times other than set mealtimes is difficult.)

Another approach to reducing fatigue due to muscle coordination demands is to reduce the number of movements that are required for each bite of food. For example, supporting the individual’s elbows and forearms stabilizes the arms and makes moving food from a bowl to the mouth easier.

Also, in some cases, if the individual only eats what food they can until they start to fatigue, it helps the mealtime to be enjoyable and stress free. At that time a supplemental drink can be offered to provide the additional calories needed. It requires much less effort (i.e., energy) to drink than to eat. Mealtimes should be enjoyable and relaxing and if someone is “pushed” to continue eating once they are tired, the mealtime pleasure is quickly removed.

Fatigue occurs more rapidly if someone is unwell. For example they have a cold. Also, if effort has been expended on an activity prior to the meal, the individual will become tired sooner.

All of these factors should be considered to make appropriate mealtime accommodations for those who fatigue easily due to self-feeding or eating. For those who fatigue very rapidly due to the effort of self-feeding, assistive technology should be considered to reduce the effort expended during meals. Equipment like the Mealtime Partner Dining System can enable people to continue feeding themselves even if they easily fatigue when feeding themselves in the traditional manner.