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  • Acute stroke patients not meeting their nutrition requirements: Investigating nutrition within the enriched environment

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    Anstey232781.pdf (613.6Kb)
    Author(s)
    Robertson, Samantha T
    Grimley, Rohan S
    Anstey, Chris
    Rosbergen, Ingrid CM
    Griffith University Author(s)
    Anstey, Christopher
    Grimley, Rohan
    Year published
    2020
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    Abstract
    Background & aims: Malnutrition is common after stroke. We investigated the impact of environmental enrichment strategies on dietary intake and rates of malnutrition in an acute stroke unit. Methods: We performed a before-after study. In standard care, meals were delivered to participants’ rooms whilst in the enriched environment, communal meals with assistance were offered and nutritional intake reminders were placed at the patient bedside. Nutrition supplementation was provided to both groups if indicated. Breakfast and lunch meals were directly observed while remaining intake was calculated using food charts. Nutrition ...
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    Background & aims: Malnutrition is common after stroke. We investigated the impact of environmental enrichment strategies on dietary intake and rates of malnutrition in an acute stroke unit. Methods: We performed a before-after study. In standard care, meals were delivered to participants’ rooms whilst in the enriched environment, communal meals with assistance were offered and nutritional intake reminders were placed at the patient bedside. Nutrition supplementation was provided to both groups if indicated. Breakfast and lunch meals were directly observed while remaining intake was calculated using food charts. Nutrition requirements were calculated for energy (ratio method), protein (1 g/kg) and proportion of requirements met. Malnutrition was assessed using the Subjective Global Assessment and body weight. ANCOVA adjusting for stroke severity was used to determine between group differences. Stepwise multivariable logistic regression was performed to assess predictors of nutritional outcomes, adjusting for intervention group, demographic, clinical and baseline nutritional factors. Results: Neither standard care (n = 30, age 76.0yrs ± SD12.8) nor enriched environment (n = 30, age 76.7yrs ± SD12.1, p = 0.84) met daily requirements for energy (70.7% ± SD16.8 vs. 70.7% ± SD17.3, p = 0.94) or protein intake (73.2% ± SD18.6 vs. 69.8% ± SD17.3, p = 0.70). Mean body weight dropped: standard care 0.92 kg ± SD2.47 vs. enriched 0.64 kg ± SD3.12 (p = 0.53) and malnutrition increased: standard care 3.3%–26.6% vs. enriched 6.6%–13.3% (p = 0.07). Predictors of malnutrition on discharge in logistic regression models were: length of stay (p < 0.01) and protein (p < 0.01) or energy intake (p = 0.02). Conclusions: Acute stroke patients were not meeting nutritional requirements and losing body weight. The enriched environment showed no effect on nutritional intake. Malnutrition was associated with lower energy and protein intakes and increased length of stay.
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    Journal Title
    Clinical Nutrition
    DOI
    https://doi.org/10.1016/j.clnu.2019.06.009
    Copyright Statement
    © 2019 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.
    Note
    This publication has been entered into Griffith Research Online as an Advanced Online Version
    Subject
    Nutrition and Dietetics
    Acute stroke unit
    Enriched environment
    Malnutrition
    Nutrition
    Nutritional intake
    Publication URI
    http://hdl.handle.net/10072/386731
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    • Journal articles

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