Individualised nutritional treatment increases the positive effects of a novel á la carte hospital food service concept: Results of a quasi-experimental study

Abstract

One-third of hospitalised patients are at nutritional risk, and limited choice regarding meals and meal times, and inadequate nutritional support may contribute to inadequate nutritional intake during hospitalisation. The aim was to test the effect of a novel á la carte hospital food service concept as a stand-alone intervention and combined with individualised nutritional treatment. Medical inpatients at nutritional risk were recruited for this three-arm quasi-experimental study. The control group received meals from the traditional bulk trolley food service system. Intervention group 1 (IG1) received meals from a novel á la carte food service concept with an electronic ordering system, whereas intervention group 2 (IG2) in addition to this received individualised nutritional treatment by a clinical dietitian. Nutritional intake and length of stay was measured, and patient satisfaction was assessed with purpose-designed questionnaires. 206 patients were included: 67 in the control group, 68 in IG1, and 71 in IG2. The proportion of participants reaching ≥75% of both their energy and protein requirement was higher in IG1 compared to the control group (34% vs. 12%, p=0.002) and higher in IG2 compared to IG1 (53% vs. 34%, p=0.035). Length of stay was shorter in IG2 compared to the control group (6.0 vs. 8.7 days, p=0.005). It was important to participants to be able to choose when and what to eat, and this preference was met to a larger extent in the intervention groups. The novel á la carte concept increases energy and protein intake in hospitalised patients, and the positive effects are increased, when the concept is used in combination with individualised nutritional treatment.