Does eating environment have an impact on the protein and energy intake in the hospitalised elderly?

Abstract

This pilot study aimed to examine the difference in energy and protein intake of the midday meal in two different eating environments-the communal dining room and patient bedside-and to obtain feedback on patient preference at each location. Elderly patients in two rehabilitation wards were observed consuming the midday meal on two consecutive days: day 1 in the dining room and day 2 at the bedside. The patients' intake was recorded by a visual 5-point assessment scale and analysed for protein and energy content using the hospital food services nutrient analysis of the menu. Patients were also surveyed on preference of eating environment through a written survey. This study found that patients consumed 20% more energy and protein when dining in a communal environment (P = 0.006 and 0.01, respectively). Patients with a body mass index of less than 22 (P = 0.01 and 0.01, respectively) and those with significant cognitive impairment (P = 0.001 and 0.007, respectively) ate 30% more protein and energy in the dining room, and those identified at risk of malnutrition (Malnutrition Screening Tool (MST) ≥ 2) ate 42% more energy and 27% more protein in the dining room, although this was not statistically significant (P = 0.05 and 0.16). A total of 86% of surveyed patients favoured eating their midday meal in the dining room. This study supports the contention that a dining room environment can increase food intake, increase patients' opportunities to enjoy the social aspect of meal times, and potentially lead to weight gain and reduced malnutrition risk in the rehabilitation setting.