A novel in-hospital meal service improves protein and energy intake

Clin Nutr. 2018 Dec;37(6 Pt A):2238-2245. doi: 10.1016/j.clnu.2017.10.025. Epub 2017 Nov 9.

Abstract

Background & aims: Improvement of hospital meal services is a strategy to optimize protein and energy intake and prevent or treat malnutrition during hospitalization. FoodforCare (FfC) is a new concept comprising 6-protein-rich meals per day, provided directly at the bedside following proactive advice from a nutritional assistant. Our aim is to investigate whether this new concept, FfC, improves dietary intake and patient satisfaction, compared to the traditional 3-meals a day service (TMS).

Methods: We performed a quasi experimental study at medical (Gastroenterology) and surgical (Gynecology, Urology, Orthopedics) wards. Patients were offered TMS (July 2015-May 2016; n = 326) or FfC meal service (after stepwise introduction per ward from January 2016-December 2016; n = 311). Primary outcome was the mean percentage of protein and energy intake relative to requirements, between patients receiving TMS and those receiving FfC, on the first and fourth day of full oral intake. Patient satisfaction comprised rating of the experienced quality of the meals and the meal service by means of a validated questionnaire.

Results: Patient characteristics were similar between groups, with the exception that the FfC group contained more oncology patients (p = 0.028). FfC improved mean daily protein intake (in g/day) relative to requirements (1.2 g/kg/day) at day 1 (mean % ±SD: 79 ± 33 vs. 59 ± 28; p < 0.05) and day 4 (73 ± 38 vs. 59 ± 29; p < 0.05). Mean daily energy intake (in kcal/day) relative to requirements improved at day 1 (88 ± 34 vs. 70 ± 30; p < 0.05) and day 4 (84 ± 40 vs. 73 ± 31; p = 0.05). On a scale of 1-10, patient satisfaction remained unchanged, in terms of food quality (7.7 ± 1.5 vs. 7.4 ± 1.4; p = 0.09) and meal service (7.8 ± 1.3 vs. 7.7 ± 1.1; p = 0.29). The FfC group was more satisfied with the appearance and smell of the meals (both p < 0.05).

Conclusions: Implementation of this novel meal service substantially improved protein and energy intake while maintaining, and to some extent, improving patient satisfaction.

Registration no: NCT03195283.

Keywords: Hospitalized patients; Malnutrition; Meal service; Nutrition; Protein intake; Satisfaction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Dietary Proteins
  • Energy Intake / physiology*
  • Female
  • Food Service, Hospital*
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Nutritional Status / physiology
  • Patient Satisfaction / statistics & numerical data*

Substances

  • Dietary Proteins

Associated data

  • ClinicalTrials.gov/NCT03195283