Comparing nutritional requirements, provision and intakes among patients prescribed therapeutic diets in hospital: An observational study

Abstract

Objective: Nutrition is an important part of recovery for hospitalized patients. The aim of this study was to assess the nutritional adequacy of meals provided to and consumed by patients prescribed a therapeutic diet. Methods: Patients (N ¼ 110) prescribed a therapeutic diet (texture-modified, low-fiber, oral fluid, or food allergy or intolerance diets) for medical or nutritional reasons were recruited from six wards of a tertiary hospital. Complete (24-h) dietary provisions and intakes were directly observed and analyzed for energy (kJ) and protein (g) content. A chart audit gathered demographic, clinical, and nutrition-related information to calculate each patient’s disease-specific estimated energy and protein requirements. Provisions and intake were considered adequate if they met 75% of the patient’s estimated requirements. Results: Mean energy and protein provided to patients (5844 2319 kJ, 53 30 g) were signifi- cantly lower than their mean estimated requirements (8786 1641 kJ, 86 18 g). Consequently, mean nutrition intake (4088 2423 kJ, 37 28 g) were significantly lower than estimated requirements. Only 37% (41) of patients were provided with and 18% (20) consumed adequate nutrition to meet their estimated requirements. No therapeutic diet provided adequate food to meet the energy and protein requirements of all recipients. Patients on oral fluid diets had the highest estimated requirements (9497 1455 kJ, 93 16 g) and the lowest nutrient provision (3497 1388 kJ, 25 19 g) and intake (2156 1394 kJ, 14 14 g). Conclusion: Hospitalized patients prescribed therapeutic diets (particularly fluid-only diets) are at risk for malnutrition. Further research is required to determine the most effective strategies to improve nutritional provision and intake among patients prescribed therapeutic diets. 2017 Else