Prise en charge diététique du sujet obèse à l’hôpital : quels régimes ?

Guidelines on Standard and Therapeutic Diets for Adults in Hospitals by the French Association of Nutritionist Dieticians (AFDN) and the French Speaking Society of Clinical Nutrition and Metabolism (SFNCM)

“…Food intake should be considered an essential component of the treatment of hospitalized patients, even though many patients do not consume half of the meals served in the hospital, primarily due to anorexia linked to treatment and secondly to organizational or food provision reasons [ 12 ]. Based on calculations drawn from intake recommendations (excluding during resuscitation care), the Lausanne University Hospital team determined that both energy and protein requirements are not fulfilled when providing a standard diet of 1800 kcal and 60 g of protein per day for patients reaching the moderate obesity stage [ 53 ]. In cases of massive obesity and conditional to the total consumption of the meal tray, the energy deficit is approximately 500 kcal while the protein deficit is at least 55 g [ 53 ].…”

“…Based on calculations drawn from intake recommendations (excluding during resuscitation care), the Lausanne University Hospital team determined that both energy and protein requirements are not fulfilled when providing a standard diet of 1800 kcal and 60 g of protein per day for patients reaching the moderate obesity stage [ 53 ]. In cases of massive obesity and conditional to the total consumption of the meal tray, the energy deficit is approximately 500 kcal while the protein deficit is at least 55 g [ 53 ]. A study conducted by the same team showed that, on the one hand, the standard food provision was deemed not only insufficient but, in addition, under-consumption secondary to the disease worsened the protein-energy deficit; therefore, there was a risk of undernutrition and loss of lean body mass [ 54 ].…”

“…On the contrary, however, the nutritional management of obese patients requires expertise and multidisciplinary management in order to assess the dietary intakes and individually adapt the latter to the calculated needs of the patients [ 53 ].…”

“…On the contrary, however, the nutritional management of obese patients requires expertise and multidisciplinary management in order to assess the dietary intakes and individually adapt the latter to the calculated needs of the patients [53]. In chronic kidney disease (CKD), the beneficial effects of controlling protein intake are manyfold: lowering of albuminuria and proteinuria, decrease in plasma and urinary urea, decrease in phosphatemia, reduction in insulin resistance and control of acidosis.…”