Hospital Diet Research Articles

Nutritional Discrepancies Among Inpatients and Outpatients Diagnosed with Hypertension.

Objectives: Arterial hypertension (AH) is one of the most common disorders affecting the human population. The diet of patients with AH can influence the course of the disease and prognosis. The aim of this study was to investigate the differences in nutrition in hospitalised and non-hospitalised hypertensive patients, compared to control groups of non-hypertensive patients from the same medical centres. Methods: Patients from nine centres-six hospitals and three ambulatory care centres-were surveyed. The Questionnaire for the Assessment of Dietary Habits, Lifestyle, and Nutrition Knowledge (KomPAN) was administered by interviewers. Results: Complete results were obtained from 172 hospitalised and 63 non-hospitalised patients. A significantly higher mean body mass index was found for the hypertensive patients (p < 0.001), and a higher unhealthy diet index score was also shown for the hypertensive patients (p = 0.003). Over and above this, a lower mean health-promoting diet index score was found in the hospitalised group (who were on a hospital diet) for the hypertensive patients (p = 0.018). Summary: The study highlights a strong positive correlation between body mass index (BMI) and arterial hypertension (AH), with patients exhibiting higher BMI levels compared to a control group. A BMI of over 25 significantly increases the likelihood of developing AH, and obesity is associated with a higher risk in both men and women. Conclusions: The study indicates that a hospital diet may not be suitable for people with AH. Further research should be conducted to obtain reliable results. Clinical implications: The study showed which factors should be considered when composing a diet for people with hypertension, the relevance of which was demonstrated in the discussion. The study shows that the problem that clinicians have been struggling with for years is still present and inadequately remedied.

Digital Education on Hospital Nutrition Diets: What Do Patients Want to Know?

Therapeutic nutrition plays an imperative role during a patient's hospital course. There is a tremendous body of literature that emphasizes the systematic delivery of information regarding hospital nutrition diets. A major component of delivering healthcare information is the principle of providing quality healthcare information, but this has not yet been investigated on hospital nutrition diets. This study aimed to evaluate the comprehension and readability of patient education materials regarding therapeutic hospital diets. The methodology employed the use of publicly available questions regarding hospital nutrition diets and categorized them per Rothwell's Classification of Questions. Additionally, the questions were extracted online and have an associated digital article linked to the question. These articles underwent analysis for readability scores. This study's findings reveal that most hospital diets do not meet the recommended grade-reading levels. This underscores the need for healthcare providers to enhance patient education regarding hospital diets. The prevalence of "Fact" questions showcases the importance of clearly explaining diets and dietary restrictions to patients.

Therapeutic diet plate waste and satisfaction among adult patients

Introduction: There are limited studies on plate waste and satisfaction levels among adult patients receiving therapeutic diets in hospitals, particularly in the local context. Therefore, this study aimed to determine the percentage of plate waste and the level of satisfaction among adult patients receiving therapeutic diets, as well as the contributing factors. Methods: This cross-sectional study was conducted at a university hospital during lunch and dinner hours on eleven types of therapeutic diets. Food weighing and photography-assisted visual estimation by the Comstock scale were used to measure plate waste. Interviews were conducted with patients using the Acute Care Hospital Foodservice Patient Satisfaction Questionnaire (ACHFPSQ) to collect information about their satisfaction towards food quality and service. Results: Mean overall plate waste rate for 96 patients receiving therapeutic diets was 43.6% (40.0% for lunch, 47.3% for dinner), with the highest rate of wastage in a combined diet low in fat and salt. Overall score for patient satisfaction was 3.7 out of 5. Patients had higher satisfaction levels with staff and food service (4.0) compared to food quality (3.4). Food quality negatively contributed to the rate of plate waste in terms of taste (r=-0.107, p=0.035), presentation (r=-0.078, p=0.043), and texture (r=-0.052, p=0.020). Conclusion: Therapeutic diet plate waste among adult patients in this study was high and primarily attributable to food quality. Efforts to minimise therapeutic diet plate waste should be made by improving food quality for the best possible outcomes for patients.

Assessment of hospital meals dedicated to diabetic patients. Divergencies between received meals, model menu and guidelines. HDMI- Hospital Diet Medical Investigation Study

IntroductionIn Poland, it is estimated that more than 2 million individuals have diabetes. Intervening in modifiable risk factors can effectively prevent and delay the onset of type 2 diabetes. Previous reports claimed that the Polish healthcare system did not guarantee proper nutrition and nutritional education. This publication aimed to examine the dietary provisions for diabetic patients in Poland's hospitals and evaluate their compliance with the "Good Meal in the Hospital" guidelines.Material and methodsHospital workers were asked to fulfil the survey regarding hospital (degree of reference, number of beds in total and internal medicine unit, availability of diet dedicated to diabetic patient, performing nutritional education and presence of dietitian) and attach menus from meals received by patients from following 10 days. Then the menus were analyzed, compared to self-made model menu and “Dobry Posiłek w Szpitalu” (Good Meal in Hospital) guidelines.ResultsSeventy menus from seven hospitals were examined. Five hospitals met eight and two hospitals met seven out of thirteen criteria. The discrepancies particularly concerned excessive levels of saturated fatty acids and mono- and disaccharides, and insufficient amounts of legumes and fish in the hospital diets. Only four out of seven hospitals had a resident dietitian present.ConclusionsProviding meals containing typical nutritional errors representing the pattern of the Polish population during hospitalization may lead to potential post-discharge dietary errors. They might result in deterioration in glycemic regulation, lipid profiles, and heightened susceptibility to complications, including an elevated cardiovascular risk.

Thick Liquids and Clinical Outcomes in Hospitalized Patients With Alzheimer Disease and Related Dementias and Dysphagia

Oropharyngeal dysphagia is common in hospitalized patients with Alzheimer disease and related dementias (ADRD). Although the use of thick liquids in patients with dysphagia has been shown to reduce aspiration on direct visualization, there is no clear evidence that this practice translates into improved clinical outcomes. To determine whether a diet of thick liquids compared with thin liquids is associated with improved outcomes in hospitalized patients with ADRD and dysphagia. This cohort study included adults aged 65 years and older with ADRD who were admitted to the medicine service across 11 diverse hospitals in New York between January 1, 2017, and September 20, 2022, with clinical suspicion of dysphagia during hospitalization and survival for at least 24 hours after hospital arrival. Patients were grouped according to whether at least 75% of their hospital diet consisted of a thick liquid diet or a thin liquid diet. Propensity score matching was used to balance covariates across the 2 groups for the following covariates: demographics (eg, age, sex), baseline clinical characteristics (eg, Charlson Comorbidity Index), and acute presentation (eg, respiratory diagnosis, illness severity, delirium). Hospital outcomes included mortality (primary outcome), respiratory complications (eg, pneumonia), intubation, and hospital length of stay (LOS). Of 8916 patients with ADRD and dysphagia included in the propensity score matched analysis, the mean (SD) age was 85.7 (8.0) years and 4829 were female (54.2%). A total of 4458 patients receiving a thick liquid diet were matched with 4458 patients receiving a thin liquid diet. There was no significant difference in hospital mortality between the thick liquids and thin liquids groups (hazard ratio, 0.92; 95% CI, 0.75-1.14]; P = .46). Compared with patients receiving thin liquids, patients receiving thick liquids were less likely to be intubated (odds ratio [OR], 0.66; 95% CI, 0.54-0.80), but they were more likely to have respiratory complications (OR, 1.73; 95% CI, 1.56-1.91). This cohort study emphasizes the need for prospective studies that evaluate whether thick liquids are associated with improved clinical outcomes in hospitalized patients with ADRD and dysphagia.

Cost of patient and staff diet in Teaching Hospital Karapitiya, Galle

Background: Government hospitals in Sri Lanka offer all services free of charge including the patient diet. Currently patient care services are affected by increasing health care cost in state hospitals. Cost cutting measures are essential in health care management in public sector without sacrificing the standards of care provision. Analysing hospital diet costs is crucial to figuring out how to save indirect operating costs while maintaining service quality and standards.Objective: To determine the cost of diet for patients and staff in the Teaching Hospital, Karapitiya.Methods: A descriptive cross-sectional study was carried out retrospectively to determine the cost of patient and staff diet. The step-down costing method was used in this study, and secondary data was collected from kitchen records, the diet branch and the finance branch during the month of August 2023.Results: The total expenditure for the diet during the period was 9,864,157 LKR and per unit cost was 182.76 LKR to provide diet for patients and staff. The cost of breakfast, lunch and dinner was, 117 LKR, 225.39 LKR and 179.5 LKR respectively.Conclusion: The unit cost for diet was higher compared to previous Sri Lankan hospital study findings but lower than the present market price. Separate registers to record capital items and consumables are recommended to determine the diet cost in future and for the interventions to improve quality and reduce the cost.

Development of a mobile application to represent food intake in inpatients: dietary data systematization

BackgroundNutritional risk situations related to decreased food intake in the hospital environment hinder nutritional care and increase malnutrition in hospitalized patients and are often associated with increased morbidity and mortality. The objective of this study is to develop and test the reliability and data similarity of a mobile application as a virtual instrument to assess the acceptability and quality of hospital diets for inpatients.MethodsThis intra- and interobserver development and reliability study investigated an in-hospital food intake monitoring application based on a validated instrument for patients with infectious diseases who were treated at the Evandro Chagas National Institute of Infectious Diseases (INI/FIOCRUZ). The instrument was sequentially administered to patients 48 h after admission to INI hospital units using the printed instrument (paper) and the digital application (ARIETI) simultaneously. The tested reliability factor was the consistency of the method in the digital platform, checking whether the application provided equivalent data to the paper instrument, and finally, a statistical analysis plan was performed in the R platform version 4.2.0. This project was authorized by the FIOCRUZ/INI Research Ethics Committee.ResultsThe ARIETI was developed and tested for reliability in 70 participants, showing a similar ability to calculate caloric intake in Kcal, protein intake (g), the proportion of caloric intake and protein intake relative to the prescribed goal. These instrument comparison analyses showed statistical significance (p < 0.001). The application was superior to the paper-based instrument, accelerating the time to perform the nutritional risk diagnosis based on food intake by approximately 250 s (average time).ConclusionsThe ARIETI application has demonstrated equivalent reliability compared to the original instrument. Moreover, it optimized the time between the diagnosis of nutritional risk related to dietary intake and the nutritionist’s decision making, showing an improved ability to maintain information quality compared to the paper-based instrument.

Ascorbic acid deficiency amongst spondylodiscitis patients.

Spondylodiscitis can be a disabling and life-threatening infection. Ascorbic Acid is crucial for neutrophil function and collagen formation. Its association and clinical relevance in spondylodiscitis has not been previously examined. To determine the prevalence, characteristics, and clinical outcomes of spondylodiscitis patients with Ascorbic Acid deficiency. Sixty-eight consecutive patients admitted with spondylodiscitis, between December 2021 and August 2023 were included. Clinical characteristics, Ascorbic Acid levels and clinical outcomes were evaluated. Thirty-seven patients had Ascorbic Acid levels taken during admission. The median initial Ascorbic Acid level was 15 μmol/L with an IQR 6.5-27 μmol/L. Depletion defined as <28 μmol/L was present in 78% of patients. Deficiency defined as ≤11 μmol/L was present in and 46% of patients. Patients with depletion were more likely to require Intensive Care Admission (absolute risk increase = 24.1%; 2.6%-45.7%). Fifteen patients had repeat serum levels taken during admission with median increase of 17 μmol/L and an IQR 0-26 μmol/L. Patients that received supplementation had a significantly greater increase in Ascorbic Acid levels compared with those that did not receive supplementation (P = 0.002). Ascorbic acid deficiency is highly prevalent amongst spondylodiscitis patients. Depletion was associated with worse outcomes. Replacement significantly increased serum levels in comparison to standard hospital diet. The clinical significance of replacement remains to be evaluated.

Análise comparativa da percepção de pessoas idosas e adultos hospitalizados sobre a qualidade da dieta hospitalar

Abstract Objective To analyze and compare the perception of hospital diet quality between older adults and hospitalized adults. Method Quali-quantitative research conducted at a public hospital in the state of São Paulo, Brazil, involving older adults (n=185) and adults (n=185) who have been hospitalized for at least three days, receiving a general/soft oral diet, and classified according to the prescribed diet type: unrestricted diet (GSR), for glycemic control (GDM), or low-sodium (GHSS). The data were collected through individual interviews, utilizing a validated questionnaire. Diet quality was assessed using a Likert scale, considering the categories of taste, temperature, quantity, appearance, meal timing, hygiene, and availability for food substitution. The qualitative data were subjected to thematic content analysis, while the quantitative data underwent descriptive and statistical analysis using Kruskal-Wallis tests (for quantitative variables) and chi-square tests (for qualitative variables). Results Regardless of the prescribed diet (p≥0.05), both older adults and hospitalized adults considered the quality of hospital food satisfactory (Good/Excellent) across the assessed satisfaction categories, except for taste, which showed a significant association with the prescribed diet for older adults (p=0.05). Three thematic categories emerged from the reports, indicating that both older adults and adults understand the importance of hospital diet for health recovery, yet a negative expectation regarding the offered meal is still prevalent. Hospital diets with restrictions influence taste perception in older adults. Understanding this particularity can assist in the creation of strategies for adaptation and better acceptance of hospital diets for this age group.

Comparative analysis of older adults and hospitalized adults' perception of hospital diet quality

Resumo Objetivo analisar e comparar a percepção da qualidade da dieta hospitalar entre pessoas idosas e adultos hospitalizados. Método pesquisa quali-quantitativa, desenvolvida em um hospital público do interior paulista, com pessoas idosas (n=185) e adultos (n=185), hospitalizados há pelo menos três dias, recebendo dieta via oral geral/branda e distribuídos segundo o tipo de dieta prescrito: sem restrição de alimentos (GSR), para controle glicêmico (GDM) ou hipossódica (GHSS). Os dados foram coletados por entrevistas individuais, empregando-se questionário validado. A qualidade da dieta foi avaliada por meio da escala Likert, considerando-se as categorias sabor, temperatura, quantidade, aparência, horário das refeições, higiene e disponibilidade para substituição de alimentos. Os dados qualitativos foram submetidos à análise de conteúdo temática e, os quantitativos à análise descritiva e estatística pelos testes Kruskal-Wallis (variáveis quantitativas) e qui-quadrado (variáveis qualitativas). Resultados independentemente da dieta prescrita (p≥0,05), pessoas idosas e adultos hospitalizados consideraram a qualidade da dieta hospitalar satisfatória (Bom/Ótimo) entre as categorias de satisfação avaliadas, exceto o sabor, que para as pessoas idosas, apresentou associação significativa com a dieta prescrita (p=0,05). Três categorias temáticas emergiram dos relatos, mostrando que pessoas idosas e adultos compreendem a importância da dieta hospitalar para recuperação da saúde, mas ainda se vê a expectativa negativa quanto à refeição ofertada. Conclusão a dieta hospitalar com restrição influencia a percepção de sabor em pessoas idosas. Conhecer essa particularidade pode auxiliar na criação de estratégias de adequação e melhor aceitação da dieta hospitalar para esse grupo etário.

Re-Thinking Hyperkalaemia Management in Chronic Kidney Disease-Beyond Food Tables and Nutrition Myths: An Evidence-Based Practice Review.

Potassium dysregulation can be life-threatening. Dietary potassium modification is a management strategy for hyperkalaemia. However, a 2017 review for clinical guidelines found no trials evaluating dietary restriction for managing hyperkalaemia in chronic kidney disease (CKD). Evidence regarding dietary hyperkalaemia management was reviewed and practice recommendations disseminated. A literature search using terms for potassium, hyperkalaemia, and CKD was undertaken from 2018 to October 2022. Researchers extracted data, discussed findings, and formulated practice recommendations. A consumer resource, a clinician education webinar, and workplace education sessions were developed. Eighteen studies were included. Observational studies found no association between dietary and serum potassium in CKD populations. In two studies, 40-60 mmol increases in dietary/supplemental potassium increased serum potassium by 0.2-0.4 mmol/L. No studies examined lowering dietary potassium as a therapeutic treatment for hyperkalaemia. Healthy dietary patterns were associated with improved outcomes and may predict lower serum potassium, as dietary co-factors may support potassium shifts intracellularly, and increase excretion through the bowel. The resource recommended limiting potassium additives, large servings of meat and milk, and including high-fibre foods: wholegrains, fruits, and vegetables. In seven months, the resource received > 3300 views and the webinar > 290 views. This review highlights the need for prompt review of consumer resources, hospital diets, and health professionals' knowledge.

Examining the Nutrition of Cardiological Patients in Hospitals: Evaluating the Discrepancy between Received Diets and Reference Diet Based on ESC 2021 Guidelines-Hospital Diet Medical Investigation) (HDMI) Study.

Cardiovascular diseases (CVDs) are the leading causes of death worldwide. CVDs have become the dominant cause of death and have been a significant health challenge since the second half of the 20th century in the Polish population. The aim of our HDMI (hospital diet medical investigation) study was to examine the quality of the hospital diets given to cardiac patients and assess how much they adhere to the European Society of Cardiology (ESC) 2021 guidelines. By comparing the diets received by patients with the recommended dietary patterns outlined in the ESC 2021 guidelines, we sought to identify discrepancies. The study was conducted in two steps: creating a 7-day model menu and comparing it with the received diets and then making comparisons with ESC 2021 guidelines. Additionally, we designed a survey to obtain the characteristics of the hospitals. The results show that the nutrition in hospitals remains substandard. None of the diets had an appropriate salt supply or predominance of plant-based food patterns. Only 1/7 diets avoided sweetened beverages, and 2/7 diets had an appropriate amount of fiber. This underscores a gap in the healthcare system to improve patients' health by implementing dietary interventions that foster the development of healthy eating habits.

A 4:1 ketogenic diet to acute stroke patients is safe and feasible: A randomized controlled trial

Objective: Ketone bodies can meet more than 60% of brain’s energy needs. Controlled studies consistently show neuroprotective effects in ketotic rodents with induced ischemia. We studied the safety and feasibility of using a ketogenic diet for acute stroke patients and investigated potential neuroprotective effects. Research Methods &amp; Procedures: Acute stroke patients were randomized to a 4:1 ketogenic diet or to a standard hospital diet for one week at three different hospitals in Copenhagen. Primary endpoints were: physical function, fasting b-glucose and p-C-peptide. Secondary endpoints included: nutritional intake, gastrointestinal complications, lipids, safety blood markers and degree of ketosis.

Patients’ Satisfaction Regarding Dietary Service at Tertiary Hospitals

Aim: Hospital diet is an integral part of the management of in-ward patients. Patient satisfaction is a key criterion by which the quality of dietary services can be evaluated. This study was conducted to assess the patients’ satisfaction regarding dietary service at tertiary hospitals.&#x0D; Methodology: The present cross-sectional study had been carried out among 247 dietary service receivers to assess the patients’ satisfaction regarding dietary service at tertiary hospitals. The study was conducted in Shaheed Suhrawardi Medical Collage Hospital and Dhaka Dental College Hospital, Bangladesh from January to December, 2022. Convenience sampling technique was adopted and a pre-tested structured questionnaire based on Acute Care Hospital Foodservice Patient Satisfaction Questionnaire (ACHFPSQ) was used for measuring patients’ satisfaction with dietary services.&#x0D; Results: The mean age of the service receivers was 39.24±13.09 years where more than half of the respondents (59%) were male and 65% of the respondents are from rural area. All of the respondents took hospital diet 3 times daily. Among the respondents 97.6% stated that they never had any option to choose their meal and 47.4% of them sometimes felt hungry between two meals. 87% of the respondents considered that the dietary staff always had good behavior. Among the respondent 41.30% had good satisfaction, 30.40% had moderate satisfaction and 22.70% had very good satisfaction regarding hospital dietary service.&#x0D; Conclusion: The study concluded that almost half of respondents had good satisfaction with the overall dietary service whereas about one third of the respondents rated dietary services as average. Hospitals should strengthen the ongoing dietary service by providing a menu with variety of food daily and improve the taste of supplied food.

Nutritional Interpretation of Hospital Diets for Elderly Patients With Chronic Diseases and Analysis of Factors Influencing Actual Intakes.

The provision of hospital meals is considered a therapeutic intervention, and a therapeutic diet consisting of a post-discharge meal sample is provided. For elderly patients who require long-term care, it is important to determine the significance of nutrition by taking into account hospital meals, including therapeutic meals for conditions such as diabetes. Therefore, it is important to identify the factors that influence this judgment. This study aimed to investigate the difference between the expected nutritional intake via nutritional interpretation and actual nutritional intake. The study included 51 geriatric patients (77.7 ± 9.5 years; 36 males and 15 females) who could eat meals independently. The participants completed a dietary survey to determine the perceived nutritional intake obtained from hospital meal contents. Additionally, we investigated the amount of hospital meal leftovers from the medical records and the amount of nutrients from the menus to calculate the actual nutritional intake. We calculated the amount of calories, protein concentration, and non-protein/nitrogen ratio from the perceived and actual nutritional intake values. We then calculated the cosine similarity and conducted a qualitative analysis of factorial units to examine similarities between perceived and actual intake. Among factors that constituted the large cosine similarity group (gender, age, etc.), gender was found as a particularly significant factor, with a high number of female patients (P = 0.014). Gender was found to influence the appropriate interpretation of the significance of hospital meals. The perception of such meals as samples for post-discharge dietary practice was more significant among female patients. This demonstrated that in elderly patients, it is important to consider gender differences when providing diet and convalescence guidance.

The Efficacy of a Persian Medicine-Based Dietary Protocol on Hospitalized COVID-19 Patients: A Randomized Controlled Trial

This study aimed to evaluate the effectiveness of a Persian Medicine-based dietary protocol (PM diet) in patients infected with COVID-19. A randomized clinical trial was performed from July 2020 to January 2021 in Tehran, Iran. Eighty patients admitted due to pulmonary dysfunction caused by COVID-19 were randomly allocated into two groups: the PM diet or the common hospital (CH) diet. Eight beds in 2 rooms were considered for each group. Patients were randomly hospitalized in these rooms and received these diets up to discharge or death.. Oxygen saturation level and duration of hospitalization, the rate of mortality, duration of fever, and duration of cough were considered as the primary and secondary outcomes, respectively. Oxygen saturation and fever duration were not different between groups (P value= 0.08, 0.312, respectively). But the duration of hospitalization and the duration of cough in the PM diet group were significantly shorter than in the CH diet (P value= 0.002, 0.009, and HR=2.02, 1.86 respectively). The mortality rate was significantly lower in the PM diet group than in the CH diet group (Odds ratio: 0.12, P value=0.026). PM diet caused a lower mortality rate, shorter hospital stay, and better improvement in cough, but did not have a significant effect on O2 saturation and fever.

Nondrug Intervention for Opportunistic Infections in Individuals With Hematological Malignancy: Systematic Review.

Hematological malignancies disturb the blood, lymph nodes, and bone marrow. Taking medications for treating opportunistic infections (OIs) in these individuals may enhance the risk of medication interaction as well as adverse drug reactions. This review aims to evaluate the effectiveness of nondrug interventions in reducing OIs among patients with hematological cancers. The PubMed, CENTRAL (Cochrane Central Register of Controlled Trials), and Embase databases were searched on December 26, 2022, for all randomized controlled trials (RCTs). The primary endpoint was OIs. The quality of included studies was assessed by the Cochrane Risk-of-Bias tool. A total of 6 studies were included in this review with 4 interventions: (1) types of mouthwash received, (2) presence of coating on central venous catheters (CVCs), (3) use of well-fitted masks, and (4) types of diet consumed. The results were presented in 8 different comparisons: (1) chlorhexidine-nystatin versus saline mouth rinse, (2) chlorhexidine versus saline mouth rinse, (3) nystatin versus saline mouth rinse, (4) chlorhexidine silver sulfadiazine-coated CVCs versus uncoated catheters, (5) well-fitted masks versus no mask, (6) amine fluoride-stannous fluoride versus sodium fluoride mouthwash, (7) low-bacterial diet versus standard hospital diet, and (8) herbal versus placebo mouthwash. No clear differences were reported in any of the outcomes examined in the first 3 comparisons. There were also no clear differences in the rate of catheter-related bloodstream infection or insertion site infection between the use of chlorhexidine silver sulfadiazine-coated CVCs versus uncoated catheters in the patients. Further, no significant differences were seen between patients who used a well-fitted mask and those without a mask in the incidence of OI. The all-cause mortality and mortality due to OI were similar between the 2 groups. There was no clear difference in all-cause mortality, although common adverse effects were reported in patients who used sodium fluoride mouthwash compared with those using amine fluoride-stannous fluoride mouthwash. There was no evidence of any difference in the incidence of possible invasive aspergillosis or candidemia between patients who consumed a low-bacterial diet and a standard diet. For the last comparison, no significant difference was seen between patients who received herbal and placebo mouthwash. Very limited evidence was available to measure the effectiveness of nondrug interventions in hematological cancers. The effectiveness of the interventions included in this review needs to be evaluated further in high-quality RCTs in a dedicated setting among patients with hematological malignancies. PROSPERO International Prospective Register of Systematic Reviews CRD42020169186; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=169186.

Purine Content and Renal Acid Load Evaluation in Healthy Japanese Diets.

During the treatment of hyperuricemia, attention should be paid to purine intake as part of the diet. Additionally, many patients with obese hyperuricemic expect early weight loss through glucose restriction. However, the amounts of purine in the diet are unknown. This study aimed to compare the purine content and potential renal acid load (PRAL) of a hospital diet and a low carbohydrate (LC). We calculated the nutritional values in the menus of the normal hospital (NH), energy-control (EC) diets served at several Shizuoka general hospitals, and the menus of LC diets. The amount of purine and PRAL was determined based on the nutritional values. The average daily purine content and energy were NH 349.0 mg, 1,808 kcal, EC 340.4 mg, 1,681 kcal, and LC 697.6 mg, 1,454 kcal, respectively. LC consumed more purine than the recommended daily intake of 400 mg. The PRAL score for NH was 4.5 mEq/d, EC 3.8 mEq/d, and LC 19.0 mEq/d, with LC representing diets with a higher acid load. In terms of both purine intake and uric acid excretion, the hospital diet is preferred over the low-carbohydrate diet for patients. Dietitians should exercise caution when recommending a low-carbohydrate diet for patients with hyperuricemia.

Does Aging Have an Impact on Vitamin C Status and Requirements? A Scoping Review of Comparative Studies of Aging and Institutionalisation

The global healthcare burden of an aging population continues to increase, with nearly a quarter of the total global burden of disease attributable to people aged ≥60 years. Older people are at greater risk of micronutrient deficiencies, including immune-supportive vitamin C, which is both a contributor to and a consequence of acute and chronic illnesses. However, whether healthy aging, per se, is associated with depleted vitamin C status and increased requirements for the vitamin is less certain. A systematic scoping review was carried out to assess comparative studies that reported the vitamin C status and prevalence of deficiency in older versus younger people and in older people relative to residential status. Furthermore, vitamin C requirements were assessed through comparative studies reporting vitamin C status and pharmacokinetics in older people relative to younger people. Overall, there was limited evidence to suggest that healthy aging, per se, is related to lower vitamin C status or higher requirements for the vitamin. However, institutionalised elderly had lower vitamin C status and enhanced vitamin C requirements, primarily as a result of low intakes and/or chronic illnesses, which were not being met by hospital or residential diets. Because institutionalised elderly are vulnerable to malnutrition and micronutrient deficiencies, it is imperative that appropriate nutritional interventions are instigated to provide optimal micronutrient intake to support healthy aging.

Food without nutritional purpose in the medical therapeutics in the modern age at Hospital de Santiago in Vitoria (Alava, Spain)

Introduction: although important, food in medieval and modern hospitals was far from the excellence and abundance suggested by some historians, probably due to an incorrect assessment of hospital documentation, considering all food expenditure to be for food when much of it was destined for the apothecary's shop. Aim/method: to identify the foodstuffs used for non-nutritional therapeutic purposes during the modern age at Hospital de Santiago in Vitoria (Alava, Spain), to describe the system of consignment, and to review the bibliography of the period in order to facilitate documentary assessment strategies for researchers. Results: between 1592 and 1813, 42 groups of foodstuffs acquired for non-nutritional therapeutic purposes were identified. The system of annotation in the expenditure books is neither systematic nor homogeneous, but highly variable and dependent on who made the entry. Twenty-seven terms were identified for the recognition that a given foodstuff was intended for the apothecary's shop and not the kitchen. Fourteen sanitary texts of the period were chosen as clarifying bibliography, finding the 17th century nursing manuals most useful for the proposed purposes. Conclusions: the variety and quantity of foodstuffs destined for the apothecary's shop shows the risk of confusion in unfamiliar researchers when analysing hospital diets from account books. A proposal of terms and strategies for discriminating the nutritional or non-nutritional use of the food acquired, together with bibliographical recommendations, is essential for an adequate assessment of historical hospital diets.