Nutritional Intake by Meal Time Zone in Geriatric Patients Is Related to Nutritional Assessment Index

Abstract

Background:The blood metabolome profiles depend on the meal intake time zone regardless of having the same meal. The serum albumin (Alb) level, which is important in managing geriatric patients with chronic diseases, is included in the metabolome analysis. In this study, we aimed to examine the relationship between Alb and the nutritional value of hospital meals consumed at breakfast, lunch, and dinner among geriatric patients. Chrononutrition was considered while drawing inferences. Methods:We retrospectively surveyed 52 geriatric patients with chronic diseases (aged 79.7 ± 8.7 years) admitted at a small-scale hospital providing combined healthcare measures and oral nutritional support. The dietary intake per kilogram of body weight of nutritional components for breakfast, lunch, and dinner was individually expressed as the ratio to the whole daily food intake. The dietary pattern was determined by principal component analysis. We also conducted linear regression analysis, with Alb as the dependent variable, and age, sex, and grade assigned in this study as well as the first, second, and third principal components of the dietary patterns as the independent variables.Results: Three principal components with an eigenvalue of > 1 were extracted. The second principal component was a significantly negative determinant factor for Alb (B = -0.108, P = 0.016). In patients with high Alb levels, the energy, protein, and fat ratios at lunch were positively correlated, while the energy and carbohydrate ratios at dinner were negatively correlated. Mealtimes were fixed. Conclusions:The results of this study showed that the dietary pattern predominantly observed in patients with high Alb levels may be positively associated with Alb synthesis.

Positive Correlation Between Changes in Serum Albumin Levels and Breakfast Non-Protein Calorie/Nitrogen Ratio in Geriatric Patients

“…Breakfast NPC/N tended to be higher in the upper group than in the lower group. NPC/N indicates the ratio of non-protein energy intake (energy from carbohydrates and lipids) per gram of nitrogen contained in protein [ 6 ]. Therefore, higher amounts of energy were derived from carbohydrates and lipids in the upper Alb-RC group.…”

“…NPC/N is an index that determines whether administered amino acids are effectively synthesized into proteins [ 6 ]. It is also an index applicable to hospital food ingested orally.…”

“…We have previously reported that the differences in intake by breakfast, lunch, and dinner, as well as by nutrient calculated from the nutrition of hospital food consumed by geriatric patients, may affect the Alb synthesis ability in the liver [ 6 ]. In addition, we have clarified that NPC/N in nutrition intake affects the selection of discharge destination [ 7 ].…”

Nutritional Interpretation of Hospital Diets for Elderly Patients With Chronic Diseases and Analysis of Factors Influencing Actual Intakes

“…The NPC/N ratio indicates the amount of carbohydrates and protein that should be consumed per protein intake to maximize protein utilization [ 3 ]. In previous studies, we have shown that differences in nutrient intake from breakfast/lunch/dinner, which is calculated from nutritional intake obtained through hospital meals consumed by elderly patients might affect albumin (Alb) synthesis in the liver [ 4 ]. We also found that the NPC/N ratio in elderly patients’ nutritional intake may influence their discharge locations [ 5 ].…”