Effect of providing fortified meals and between-meal snacks on energy and protein intake of hospital patients

Gall, Marilyn; Grimble, GK; Reeve, Nigel; Thomas, Seb J

doi:10.1016/s0261-5614(98)80317-8

Cited by 106 publications

(69 citation statements)

References 12 publications

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“…Nasogastric feeding, which potentially has more risk of complications, is likely to be targeted at those requiring higher levels of supplementation. Attempts to overcome the poor compliance with oral supplements, include specially fortified hospital meals, the provision of frequent small snacks, and small volume oral feeds prescribed with drug rounds (Gall et al, 1998;Stephen et al, 1998;Potter et al, 2001). The provision of health-care assistants, specially trained to help all aspects of patients' feeding, is being evaluated in the care of acutely ill older patients (Hickson et al, 1999).…”

Section: Discussionmentioning

confidence: 99%

A systematic review of protein and energy supplementation for hip fracture aftercare in older people

Avenell

Handoll

2003

Eur J Clin Nutr

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Objectives: To evaluate whether protein and energy supplementation influences recovery after hip fracture. Design: Systematic review of randomised and quasi-randomised trials in people aged 65 y and over. Data sources: We searched seven electronic databases from 1966 to April 2002, four journals and reference lists of relevant articles. We contacted trial investigators and experts for details of other trials. Main outcome measures: Mortality, complications and unfavourable outcome (mortality or survivors with complications) were the primary outcomes. We also sought data on length of hospital stay, functional status after hip fracture, quality of life and compliance with supplementation. Results: In total, 12 randomised trials involving 898 participants were included. Nine trials evaluated protein and energy supplementation (five oral and four nasogastric feeding), and a further three trials tested oral protein supplementation. Potential biases resulting from inadequate allocation concealment and lack of assessor blinding and intention-to-treat analysis, as well as the limited outcome data, mean that the results must be interpreted with caution. Pooled data from eight of the nine trials evaluating protein and energy supplements showed no evidence for an effect on mortality (relative risk 0.92, 95% CI 0.56-1.50). Limited data from only three trials showed that oral protein and energy supplements may reduce unfavourable outcome (relative risk 0.52, 95% CI 0.32-0.84). Conclusion: Based on limited evidence, oral protein and energy supplementation after hip fracture may reduce unfavourable outcome. Further evidence from good-quality randomised trials is required to inform clinical practice.

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Section: Discussionmentioning

confidence: 99%

A systematic review of protein and energy supplementation for hip fracture aftercare in older people

Avenell

Handoll

2003

Eur J Clin Nutr

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“…Similar to Bellisle et al (2003), we did not show a difference in total energy intake when snacks were consumed. However, Gall et al (1998) found that among elderly hospitalized patients, the provision of energy and proteinrich snacks increased their overall energy intake. Therefore, there is the possibility that consumption of fortified, nutrient-rich snacks could potentially increase energy and nutrient intake.…”

Section: Food Wastagementioning

confidence: 98%

Nutrient intake and plate waste from an Australian residential care facility

Grieger

Nowson

2006

Eur J Clin Nutr

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Objective: To determine the plate waste, energy and selected-nutrient intake, from elderly residents living in a high-level care (HLC) and low-level care (LLC) facility. Design: Three, single, whole day assessments of plate waste, energy, and selected nutrients, using a visual rating plate waste scale. Setting: Long-term residential care establishment. Subjects: One hundred and sixty-nine (93 HLC and 76 LLC) individual daily intakes. Main findings: The mean energy wasted throughout the whole day was 17%. The energy wasted from main meals (16%) was significantly less than the energy wasted at mid-meals (22%, P ¼ 0.049). The lowest mean energy wastage occurred at breakfast (8%) compared to lunch (22%) and dinner (25%, Po0.001). The mean (s.d.) daily energy served and consumed was 8.1 (2.0) and 6.6 (2.2) MJ, respectively. There was no difference in energy served or consumed between HLC and LLC residents. On the observation day, 60% of residents consumed less than their estimated energy requirement. The mean calcium intake was 796 (346) mg, and the median (inter-quartile range) vitamin D intake was 1.78 (2.05) mg. Conclusion: On 1 day, more than half the residents surveyed were at risk of consuming an inadequate energy intake, which over-time, may result in body weight loss. Although wastage was not excessive and energy served was adequate, the amount of food eaten was insufficient to meet energy and calcium requirements for a significant number of residents and it is not possible to consume sufficient vitamin D through food sources.

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“…Individualised dietetic assessment and treatment can improve protein and energy intake [17][18][19], and may lead to reductions in mortality [20], complications [19] and re-admissions to hospital [19]. Fortification of hospital food has also proved successful in increasing protein and energy intakes [21][22][23].…”

Section: Introductionmentioning

confidence: 99%

The impact of trained volunteer mealtime assistants on dietary intake and satisfaction with mealtime care in adult hospital inpatients: A systematic review

Howson

Sayer

Roberts

2017

The Journal of nutrition, health and aging

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BackgroundMalnutrition is common in hospital inpatients and is associated with increased morbidity and mortality. Insufficient assistance at mealtimes can contribute to this and therefore trained volunteer mealtime assistants may be of benefit. ObjectivesTo identify and review the current evidence for the impact of trained volunteer mealtime assistants on dietary intake and satisfaction with mealtime care in adult hospital inpatients. MethodsA systematic search of Medline, Embase and CINAHL was conducted to identify relevant articles. Articles of any methodology were considered. Quality assessment and data extraction were carried out by two reviewers independently. ParticipantsParticipants were inpatients in a hospital setting, including rehabilitation units. Participants in long term care facilities were excluded. InterventionArticles that examined the effect of trained volunteer mealtime assistants on nutritional outcomes or satisfaction with mealtime care were included. Results 5576 articles were identified, of which 14 were included in the review. Nine were small research studies and five were quality improvement initiatives. The quality of eight studies was moderate, with one study being of lower quality. Eight articles reported dietary intake and seven demonstrated an improvement, with protein intakes at volunteer mealtimes increasing by 4.3g-10.1g and energy intakes by 44-105kcal. Ten articles reported positive staff, patient and volunteer feedback. No adverse events were reported. ConclusionThere is evidence from small studies and improvement projects that trained volunteer mealtime assistants are safe and improve satisfaction with mealtime care in hospital inpatients, although evidence for an effect on dietary intake was less consistent. Larger studies with robust methodology are required to confirm this.

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Effect of providing fortified meals and between-meal snacks on energy and protein intake of hospital patients

Cited by 106 publications

References 12 publications

A systematic review of protein and energy supplementation for hip fracture aftercare in older people

A systematic review of protein and energy supplementation for hip fracture aftercare in older people

Nutrient intake and plate waste from an Australian residential care facility

The impact of trained volunteer mealtime assistants on dietary intake and satisfaction with mealtime care in adult hospital inpatients: A systematic review

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