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During Hospitalization, Older Patients at Risk for Malnutrition Consume <0.65 Grams of Protein per Kilogram Body Weight per Day.
Nutr Clin Pract. 2020 Aug; 35(4):655-663.NC

Abstract

BACKGROUND

Malnutrition is prevalent in hospitalized patients. To support muscle maintenance in older and chronically ill patients, a protein intake of 1.2-1.5 g/kg/d has been recommended during hospitalization. We assessed daily protein intake levels and distribution in older patients at risk for malnutrition during hospitalization.

METHODS

In this prospective, observational study, we measured actual food and food supplement consumption in patients (n = 102; age, 68 ± 14 years; hospital stay, 14 [8-28] days) at risk of malnutrition during hospitalization. Food provided by hospital meals, ONS, and snacks and the actual amount of food (not) consumed were weighed and recorded for all patients.

RESULTS

Hospital meals provided 1.03 [0.77-1.26] protein, whereas actual protein consumption was only 0.65 [0.37-0.93] g/kg/d. Protein intake at breakfast, lunch, and dinner was 10 [6-15], 9 [5-14], and 13 [9-18] g, respectively. The use of ONS (n = 62) resulted in greater energy (1.26 [0.40-1.79] MJ/d, 300 [100-430] kcal/d) and protein intake levels (11 [4-16] g/d), without changing the macronutrient composition of the diet.

CONCLUSION

Despite protein provision of ∼1.0 g/kg/d, protein intake remains well below these values (∼0.65 g/kg/d), as 30%-40% of the provided food and supplements is not consumed. Provision of ONS may increase energy and protein intake but does not change the macronutrient composition of the diet. Current nutrition strategies to achieve the recommended daily protein intake in older patients during their hospitalization are not as effective as generally assumed.

Authors+Show Affiliations

Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, the Netherlands.Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, the Netherlands.Department of Dietetics, Maastricht University Medical Centre+, Maastricht, the Netherlands.Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, the Netherlands.Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre+, Maastricht, the Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32578906

Citation

Weijzen, Michelle E G., et al. "During Hospitalization, Older Patients at Risk for Malnutrition Consume <0.65 Grams of Protein Per Kilogram Body Weight Per Day." Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, vol. 35, no. 4, 2020, pp. 655-663.
Weijzen MEG, Kouw IWK, Geerlings P, et al. During Hospitalization, Older Patients at Risk for Malnutrition Consume <0.65 Grams of Protein per Kilogram Body Weight per Day. Nutr Clin Pract. 2020;35(4):655-663.
Weijzen, M. E. G., Kouw, I. W. K., Geerlings, P., Verdijk, L. B., & van Loon, L. J. C. (2020). During Hospitalization, Older Patients at Risk for Malnutrition Consume <0.65 Grams of Protein per Kilogram Body Weight per Day. Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition, 35(4), 655-663. https://doi.org/10.1002/ncp.10542
Weijzen MEG, et al. During Hospitalization, Older Patients at Risk for Malnutrition Consume <0.65 Grams of Protein Per Kilogram Body Weight Per Day. Nutr Clin Pract. 2020;35(4):655-663. PubMed PMID: 32578906.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - During Hospitalization, Older Patients at Risk for Malnutrition Consume <0.65 Grams of Protein per Kilogram Body Weight per Day. AU - Weijzen,Michelle E G, AU - Kouw,Imre W K, AU - Geerlings,Phil, AU - Verdijk,Lex B, AU - van Loon,Luc J C, Y1 - 2020/06/24/ PY - 2020/6/25/pubmed PY - 2020/6/25/medline PY - 2020/6/25/entrez KW - energy KW - hospitalization KW - malnutrition KW - older adults KW - oral nutrition supplements KW - protein SP - 655 EP - 663 JF - Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition JO - Nutr Clin Pract VL - 35 IS - 4 N2 - BACKGROUND: Malnutrition is prevalent in hospitalized patients. To support muscle maintenance in older and chronically ill patients, a protein intake of 1.2-1.5 g/kg/d has been recommended during hospitalization. We assessed daily protein intake levels and distribution in older patients at risk for malnutrition during hospitalization. METHODS: In this prospective, observational study, we measured actual food and food supplement consumption in patients (n = 102; age, 68 ± 14 years; hospital stay, 14 [8-28] days) at risk of malnutrition during hospitalization. Food provided by hospital meals, ONS, and snacks and the actual amount of food (not) consumed were weighed and recorded for all patients. RESULTS: Hospital meals provided 1.03 [0.77-1.26] protein, whereas actual protein consumption was only 0.65 [0.37-0.93] g/kg/d. Protein intake at breakfast, lunch, and dinner was 10 [6-15], 9 [5-14], and 13 [9-18] g, respectively. The use of ONS (n = 62) resulted in greater energy (1.26 [0.40-1.79] MJ/d, 300 [100-430] kcal/d) and protein intake levels (11 [4-16] g/d), without changing the macronutrient composition of the diet. CONCLUSION: Despite protein provision of ∼1.0 g/kg/d, protein intake remains well below these values (∼0.65 g/kg/d), as 30%-40% of the provided food and supplements is not consumed. Provision of ONS may increase energy and protein intake but does not change the macronutrient composition of the diet. Current nutrition strategies to achieve the recommended daily protein intake in older patients during their hospitalization are not as effective as generally assumed. SN - 1941-2452 UR - https://www.unboundmedicine.com/medline/citation/32578906/During_Hospitalization,_Older_Patients_at_Risk_for_Malnutrition_Consume_<0.65_Grams_of_Protein_per_Kilogram_Body_Weight_per_Day L2 - https://doi.org/10.1002/ncp.10542 DB - PRIME DP - Unbound Medicine ER -
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