Abstract
Diets of high nutritional quality can aid in the prevention and management of malnutrition in hospitalized patients. This study evaluated the nutritional quality of hospital patient menus. At three large acute care hospitals in Ontario, Canada, 84 standard menus were evaluated, which included regular and carbohydrate-controlled diets and 3000 mg and 2000 mg sodium diets. Mean levels of calories, macronutrients and vitamins and minerals provided were calculated. Comparisons were made with the Dietary Reference Intakes (DRI) and Canada’s Food Guide (CFG) recommendations. Calorie levels ranged from 1281 to 3007 kcal, with 45% of menus below 1600 kcal. Protein ranged from 49 to 159 g (0.9–1.1 g/kg/day). Energy and protein levels were highest in carbohydrate-controlled menus. All regular and carbohydrate-controlled menus provided macronutrients within the Acceptable Macronutrient Distribution Ranges. The proportion of regular diet menus meeting the DRIs: 0% for fiber; 7% for calcium; 57% for vitamin C; and 100% for iron. Compared to CFG recommended servings, 35% met vegetables and fruit and milk and alternatives, 11% met grain products and 8% met meat and alternatives. These data support the need for frequent monitoring and evaluation of menus, food procurement and menu planning policies and for sufficient resources to ensure menu quality.
Highlights
Malnutrition, a concern in acute care hospitals, is associated with adverse clinical outcomes, including delayed wound healing and increased length of stay, rates of readmission and increased healthcare costs [1]
One aspect of addressing malnutrition is careful menu planning in hospitals, which would ensure that menus provide adequate energy, macronutrients, vitamins and minerals and meet the nutritional needs of patients during a hospital stay [3]
This cross-sectional study evaluated the energy, macronutrient and vitamin and mineral composition, as well as the number of Canada’s Food Guide (CFG) servings provided by patient menus at three academic acute care hospitals in Ontario, Canada, between November 2010 and August 2011
Summary
Malnutrition, a concern in acute care hospitals, is associated with adverse clinical outcomes, including delayed wound healing and increased length of stay, rates of readmission and increased healthcare costs [1]. One aspect of addressing malnutrition is careful menu planning in hospitals, which would ensure that menus provide adequate energy, macronutrients, vitamins and minerals and meet the nutritional needs of patients during a hospital stay [3]. There are only a few studies that have evaluated the nutritional quality of hospital patient menus, and there are no known studies in Canada [3,14]. It is unknown if hospitals meet these basic guidelines for healthy eating and if menus are of adequate nutritional quality to meet the increased nutritional needs of acutely ill patients. Despite the careful design and scrutiny that hospital menus receive, we hypothesized that nutrient levels would vary greatly due to a lack of standards guiding menu planning
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