Abstract
ObjectiveHospitalization is generally accompanied by changes in food intake. Patients typically receive hospital meals upon personal preference within the framework of the food administration services of the hospital. In the present study, we assessed food provision and actual food and snack consumption in older patients admitted for elective hip or knee arthroplasty.DesignA prospective observational study.SettingOrthopedic nursing ward of the Maastricht University Medical Centre+.ParticipantsIn the present study, n=101 patients (age: 67±10 y; hospital stay: 6.1±1.8 d) were monitored during hospitalization following elective hip or knee arthroplasty.MeasurementsEnergy and protein provided by self-selected hospital meals and snacks, and actual energy and protein (amount, distribution, and source) consumed by patients was weighed and recorded throughout 1–6 days.ResultsSelf-selected meals provided 6.5±1.5 MJ·d-1, with 16, 48, and 34 En% provided as protein, carbohydrate, and fat, respectively. Self-selected hospital meals provided 0.75±0.16 and 0.79±0.21 g·kg-1·d-1 protein in males and females, respectively. Actual protein consumption averaged merely 0.59±0.18 and 0.50±0.21 g·kg-1·d-1, respectively. Protein consumption at breakfast, lunch, and dinner averaged 16±8, 18±9, and 20±6 g per meal, respectively.ConclusionsThough self-selected hospital meals provide patients with ∼0.8 g·kg-1·d-1 protein during short-term hospitalization, actual protein consumption falls well below 0.6 g·kg-1·d-1 with a large proportion (∼32%) of the provided food being discarded. Alternative strategies are required to ensure maintenance of habitual protein intake in older patients admitted for elective orthopedic surgery.
Highlights
Hospitalization in older adults is accompanied by substantial changes in food intake
Energy consumption was lower in females when compared with males on day 2 and 3 of hospitalization and tended to be lower in females on day 1 (P=0.084)
We assessed actual energy and protein consumption patterns during short-term hospitalization in older patients admitted for elective hip and knee arthroplasty
Summary
Hospitalization in older adults is accompanied by substantial changes in food intake. The hospitalization duration in older patients is 5 days or longer [1, 2] During such a short period of hospitalization, food intake is generally reduced due to periods of fasting, adverse effects of medication, strict timing of food provision, reduced appetite, and/or pain and discomfort [3,4,5]. Such a reduced food intake throughout the hospitalization period often results in a negative energy and/or protein balance. Malnutrition during hospitalization has been shown to increase the length of hospital stay, the risk for infections, the incidence of hospital readmissions, and mortality rates [9,10,11,12]
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