A novel in-hospital meal service improves protein and energy intake

Dijxhoorn, D.N.; Berg, M.G.A. van den; Kievit, Wietske; Korzilius, Julia; Drenth, Joost P.H.; Wanten, Geert

doi:10.1016/j.clnu.2017.10.025

Cited by 33 publications

(41 citation statements)

References 23 publications

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“…As the maintenance of habitual protein intake levels is key to attenuate muscle mass loss, a more protein-dense diet should be consumed as total energy intake is typically reduced during hospitalization. Various strategies can be applied to increase the relative protein intake in the diet, including the consumption of more protein-rich foods, supplementation with oral nutritional supplements (ONS), fortification of meals with protein isolates, and/or the provision of well-timed protein-rich snacks ( 36 , 38 , 60 , 61 ). To increase absolute protein intake in the diet, a first target for intervention should be breakfast.…”

Section: Discussionmentioning

confidence: 99%

“…During subsequent days of hospitalization, food fortification, provision of more protein-dense foods, and/or an adding an extra protein meal will likely be more appropriate. In line, provision of protein-enriched foods (such as bread, yoghurt, cake, fruit juice, and soup) or the use of more protein-dense foods throughout the day have been shown effective in improving protein intake during hospitalization ( 36 , 38 , 60 ). In addition, the timing of protein-rich products serves as alternative strategy to increase protein intake levels during hospitalization.…”

Section: Discussionmentioning

confidence: 99%

“…Whereas several studies have assessed energy and/or protein provision in patients during hospitalization (3, 9, 27-33), only few studies have measured the actual amount of energy and protein consumed by patients (4, 34-38). In addition, snack consumption between meals is generally not reported.…”

Section: Introductionmentioning

confidence: 99%

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Protein Intake Falls below 0.6 g·kg-1·d-1 in Healthy, Older Patients Admitted for Elective Hip or Knee Arthroplasty

Weijzen

Kouw

Verschuren³

et al. 2019

The Journal of nutrition, health and aging

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Objective Hospitalization is generally accompanied by changes in food intake. Patients typically receive hospital meals upon personal preference within the framework of the food administration services of the hospital. In the present study, we assessed food provision and actual food and snack consumption in older patients admitted for elective hip or knee arthroplasty. Design A prospective observational study. Setting Orthopedic nursing ward of the Maastricht University Medical Centre+. Participants In the present study, n=101 patients (age: 67±10 y; hospital stay: 6.1±1.8 d) were monitored during hospitalization following elective hip or knee arthroplasty. Measurements Energy and protein provided by self-selected hospital meals and snacks, and actual energy and protein (amount, distribution, and source) consumed by patients was weighed and recorded throughout 1–6 days. Results Self-selected meals provided 6.5±1.5 MJ·d -1 , with 16, 48, and 34 En% provided as protein, carbohydrate, and fat, respectively. Self-selected hospital meals provided 0.75±0.16 and 0.79±0.21 g·kg -1 ·d -1 protein in males and females, respectively. Actual protein consumption averaged merely 0.59±0.18 and 0.50±0.21 g·kg -1 ·d -1 , respectively. Protein consumption at breakfast, lunch, and dinner averaged 16±8, 18±9, and 20±6 g per meal, respectively. Conclusions Though self-selected hospital meals provide patients with ∼0.8 g·kg -1 ·d -1 protein during short-term hospitalization, actual protein consumption falls well below 0.6 g·kg -1 ·d -1 with a large proportion (∼32%) of the provided food being discarded. Alternative strategies are required to ensure maintenance of habitual protein intake in older patients admitted for elective orthopedic surgery. Electronic Supplementary Material Supplementary material is available for this article at 10.1007/s12603-019-1157-2 and is accessible for authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Protein Intake Falls below 0.6 g·kg-1·d-1 in Healthy, Older Patients Admitted for Elective Hip or Knee Arthroplasty

Weijzen

Kouw

Verschuren³

et al. 2019

The Journal of nutrition, health and aging

View full text Add to dashboard Cite

show abstract

“…We believed that the NPC/N ratios of the food consumed by our subjects were influenced by the type of hospital food ordered and the actual quantity consumed. Hospital meals are prepared according to patients' clinical conditions and contain protein and energy quantities specified by hospital dietary rules [10,11]. Thus, different meal types have different NPC/N ratios.…”

Section: Discussionmentioning

confidence: 99%

Influence of Geriatric Patients’ Food Preferences on the Selection of Discharge Destination

Fukuda

Kohara²,

Hatakeyama

et al. 2020

J Clin Med Res

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Background: The nonprotein calorie/nitrogen (NPC/N) ratio of food remains poorly investigated. Thus, this study examined the nutritional factors that influence the choice of discharge destination for geriatric patients. Methods: We retrospectively investigated the patient characteristics, clinical laboratory test results, and hospital food consumption of 65 geriatric patients (80.0 ± 8.2 years; 31 males, 34 females), who were receiving oral nutritional support at a small mixed-care hospital and further explored their discharge destinations. The NPC/N ratios were calculated according to the menus for the meals provided during the first 4 weeks after admission. For logistic regression analysis, the objective variables were discharge destinations (i.e., nursing care facilities including home or medical institutions) whereas the predictor variables were age, sex, nursing care level, hospitalization duration, serum albumin level (Alb), estimated glomerular filtration rate (eGFR), and NPC/N ratio.

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“…Nutrition assistants not only serve the meals: a new and major task for them is to provide proactive advice, taking the risk of malnutrition into account and nudging the patient toward his or her individual nutritional needs. The impact of the concept is impressive: compared to the traditional three-meals-a-day service, the intake of proteins and energy increased significantly (Dijxhoorn et al 2017). In particular, patients appreciated the appearance and smell of the meals.…”

Section: Redesign Of Meal Services For Hospitalized Patientsmentioning

confidence: 99%

Implementation of Patient Engagement in the Netherlands: A Stimulating Environment within a Large Academic Medical Centre

Faber¹,

Vijn²,

Jillissen³

et al. 2018

hcq

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Patients are the official third party of the Dutch healthcare system, apart from healthcare providers and insurers. Radboud university medical center (Radboudumc) is a regional centre for specialized secondary care in the Netherlands. Here innovation is recognized as a decisive factor when it comes to the implementation of patient engagement. Therefore, all employees are invited to innovate, experiment, fail and implement promising innovations into practice. In this paper, we demonstrate how this stimulating environment led to a rich collection of patient engagement activities in organizational (re-)design and in educational programs for students and employees. Résumé Les patients sont une tierce partie officielle du système de santé néerlandais, en plus des prestataires de soins de santé et des assureurs. L'hôpital universitaire Radboud (Radboudumc) est un centre régional de soins secondaires spécialisés des Pays-Bas. L'innovation y est reconnue comme un facteur probant du déploiement de l'engagement du patient. Tous les employés sont donc invités à innover, à expérimenter, à échouer et à mettre en pratique des innovations prometteuses. Dans cet article, nous montrons comment ce milieu stimulant a conduit à une abondante collection d'activités relatives à l'engagement du patient dans la conception ou la refonte organisationnelle, ainsi que dans des programmes de formation destinés aux étudiants et aux employés.

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A novel in-hospital meal service improves protein and energy intake

Cited by 33 publications

References 23 publications

Protein Intake Falls below 0.6 g·kg-1·d-1 in Healthy, Older Patients Admitted for Elective Hip or Knee Arthroplasty

Protein Intake Falls below 0.6 g·kg-1·d-1 in Healthy, Older Patients Admitted for Elective Hip or Knee Arthroplasty

Influence of Geriatric Patients’ Food Preferences on the Selection of Discharge Destination

Implementation of Patient Engagement in the Netherlands: A Stimulating Environment within a Large Academic Medical Centre

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