Can hospitalized patients adequately estimate their own food intake? A cross-sectional pilot study

Abstract

Objective To assess and identify factors linked to the accuracy of patients’ food intake estimations through a self-monitoring instrument filled in by the patient. Methods This cross-sectional study approached adult hospital patients subjected to regular or therapeutic diets. The actual food intake percentage was obtained by the ratio between the actual food intake and the amount of food served x 100. Patients had to complete a food chart including 9 circles representing plates of food in percentages (increasing scale of 12.5%) to represent their food intake at lunch and/or dinner. The Bland-Altman method assessed the agreement between the actual and the estimated values. The associations between variables (age, sex, hospitalization day, diet prescription, amount of food served and actual food intake percentage) and the accuracy of the food intake estimation (adequate ±10%, overestimated and underestimated) were evaluated through univariate multinomial logistic regression. Results Ninety-six patients were evaluated (51.0% male; 44.0±15.8 years of age). The Bland-Altman analysis showed good agreement between the actual and the estimated food intake. The actual food intake percentage was the only variable associated with the accuracy of the food intake estimation. Conclusion Most patients (~70%) adequately estimated their food intake using the 9-point food chart tested. Furthermore, the only factor linked to the accuracy of the food intake estimation was the actual food-intake percentage. These findings provide preliminary support for the usefulness of this instrument. However, it must be tested in a representative sample of hospitalized patients.

Dietary assessment methods for measurement of oral intake in acute care and critically ill hospitalised patients: a scoping review

“…In total, twenty-three (15%) studies reported on validation of the reported method in comparison to another dietary assessment method in the acute setting (criterion validity) (Table 1) (24,28,30,36,41,44,53,54,72,82,87,94,98,117,122,123,125,135,140,147,153,160,174) . Estimated plate waste was the most common dietary assessment method which underwent validation, with fifteen (60%) of the twenty-three studies reporting on the validity of this method in comparison with a reference tool.…”

“…In total 15 (65%) studies reported using an objective (weighed) method as the reference method. However, intake was only weighed pre-and post-consumption in six (26%) studies with the other nine (39%) studies calculating intake on the basis of comparison of a standard portion to the weight of the food remaining after consumption (24,30,36,41,53,54,72,82,87,117,122,147,153,160,174) . The remaining eight (35%) studies assessed validity in comparison with reference methods reliant on estimation of consumption including estimated food records (n = 1, 4%), estimated plate waste (n = 5, 22%) or 24 h recalls (n = 2, 4%) (28,44,94,98,123,125,135,140) .…”

“…The remaining eight (35%) studies assessed validity in comparison with reference methods reliant on estimation of consumption including estimated food records (n = 1, 4%), estimated plate waste (n = 5, 22%) or 24 h recalls (n = 2, 4%) (28,44,94,98,123,125,135,140) . Researchers (n = 13, 56%) and Amaral, 2022 (24) Food record Patient Weighed plate waste Nutrition students Percentage of meal consumed Berrut, 2002 (28) Meal portion method (estimated plate waste)…”

“…Energy and protein dietitians (n = 6, 26%) were predominantly responsible for applying the reference method with validity assessed in the majority of studies (n = 14, 61%) via comparison of energy and protein estimates (28,30,36,44,53,54,72,82,87,94,98,117,122,125,135,147,153,160,174) . Most studies compared nutrient estimates via comparison of either one or two meals (n = 10, 43%) (17,24,28,30,36,72,82,87,123,147) . The remaining studies looked at average intake from either a single day of intake data (n = 6, 26%) or multiple days of intake data (n = 7, 30%) (41,44,53,54,94,98,117,122,125,135,140,153,160) .…”

“…Existing guidelines emphasise the importance of using validated tools when measuring dietary intake with attention also paid to the quality of validation completed (176) . Yet, of the fifteen studies which reported validating the tool of interest in comparison with an objective reference method (weighed food records or plate waste), only six of these studies actually calculated intake on the basis of weights of food measured pre-and post-consumption (24,41,53,54,72,160) . The remaining nine studies calculated intake on the basis of the difference between standard portions and the weight of food remaining postconsumption, such an approach has the potential to introduce bias compromising the criterion validity of the reference method (30,36,82,87,117,122,147,153,174,176) .…”