How Do Older Patients with End-Stage Osteoarthritis of the Hip Eat Prior to Hip Replacement? A Preliminary Snapshot That Highlights a Poor Diet

Abstract

Diet quantity and quality in older adults is critical for the proper functioning of the musculoskeletal system. In view of hip surgery, old patients should consume 1.2–1.5 g of proteins and 27–30 kcal per kilo of body weight daily, and adhere to healthy eating habits. In this analytical study, we studied diet quantity and quality in relation to the clinical chemistry and functional status of 57 older adults undergoing elective hip replacement. Nine in ten patients did not meet suggested protein and energy intakes and only one in ten patients exhibited high adherence to the Mediterranean diet. Legume consumption adjusted for sex, age, body mass index, and health status successfully forecasted haemoglobin levels (p < 0.05), and patients regularly consuming olive oil reported minor hip disability compared to those using it less frequently (p < 0.05). Patients who reported daily ingestion of <1 serving of meat versus those consuming >1.5 servings had greater cumulative comorbidity (p < 0.05), with meat consumption independently predicting walking ability, mobility, and balance in the fully adjusted model (p < 0.01). In conclusion, our patients seem to eat poorly. There is room for improvement in pre-operative pathways to make older adults eat better, but there is a need to plan an interventional study to fully understand the cause–effect of a dietary pattern or specific food in enhancing recovery after surgery.

A Proposal for a Multidisciplinary Integrated Oral Health Network for Patients Undergoing Major Orthopaedic Surgery (IOHN-OS)

“…It is estimated that there are around 100 million people over the age of 65 living on this planet with a disabling musculoskeletal condition who would benefit from surgery [ 8 ]. Among older adults scheduled for joint replacement surgery, only 1 in 10 eat healthily [ 37 ], 3 in 10 show systemic signs of micronutrient deficiencies [ 38 ], and 4 in 10 are malnourished before surgery [ 39 ]. Given the malnutritional phenotype of the older patient undergoing major orthopaedic surgery, it is not surprising that oral problems in this cluster have a higher prevalence than their healthy counterparts.…”