Evaluation of nutritional status, food intake and food waste costs in ‎hospitalized patients, considering relevant causes and finding possible ‎solutions: Protocol of a mixed-method study (Preprint)

2020 ◽  
Author(s):  
Maryam Amini ◽  
Bahareh Nikooyeh ◽  
Delaram Ghodsi ◽  
Parisa Torabi ◽  
Tirang Reza Neyestani
Keyword(s):  
Food Intake ◽  
Nutritional Status ◽  
Food Waste ◽  
Mixed Method ◽  
Nutritional Assessment ◽  
Financial Burden ◽  
Mini Nutritional Assessment ◽  
Assessment Tools ◽  
Mixed Method Study ◽  
Inflammatory Status

BACKGROUND Hospitalization may seriously affect patients’ nutritional status and may ‎occasionally be accompanied by malnutrition development or aggravation. Food intake is ‎often altered during hospitalization, which is tightly connected to malnutrition. On the other ‎hand, a huge amount of plate food wasted by patients, in addition to its health consequences, ‎has enormous economic and environmental expenses for governments and societies. OBJECTIVE This ‎investigation aims firstly to assess the nutritional status of the patients hospitalized in general ‎wards and secondly to evaluate the quantity and financial burden of patients’ food waste ‎along with its possible nutritional outcomes.‎ METHODS A mixed-method study is performed in three general hospitals in Tehran. Adult ‎inpatients with eligibility criteria are recruited to the study from medical and surgical ‎wards. Anthropometric and demographic data are collected and energy and protein intakes ‎are extracted from a 24-hour food recall. Plate food wastes of eligible patients are weighed ‎in breakfast, lunch, and snacks during one day. Then, the economic cost of food waste is ‎calculated for each meal, patient, and ward. Nutritional status is determined through the ‎following methods: 1. Subjective criteria (Mini Nutritional Assessment and Subjective ‎Global Assessment tools) for malnutrition; 2. Measuring serum albumin, pre-albumin and ‎total protein for protein status; 3. Measuring serum retinol and 25-hydroxycalciferol assay ‎to assess certain micronutrient status (vitamins A and D); and 4. Examination of serum β-‎carotene, total antioxidant capacity, malondialdehyde, and highly sensitive C-reactive ‎protein to determine oxidative stress and inflammatory status. Also, a qualitative study is ‎conducted to evaluate the possible reasons for wasting food in these hospitals.‎ RESULTS ----- CONCLUSIONS This study will provide appropriate data regarding the health and economic burden ‎of food waste in studied hospitals. These data are especially useful to healthcare authorities ‎and policymakers for planning efficient solutions to decrease food waste and to improve ‎patients' nutritional status. ‎

scholarly journals Assessment of nutritional status of hospitalized patients including their food intake and evaluation of food waste, its causes and consequences in some selected Tehran hospitals: a cross-sectional study protocol

2020 ◽  
Author(s):  
Razieh Anari ◽  
Maryam Amini ◽  
Bahareh Nikooyeh ◽  
Delaralm Ghodsi ◽  
Parisa Torabi ◽  
...  
Keyword(s):  
Food Intake ◽  
Nutritional Status ◽  
Food Waste ◽  
Financial Burden ◽  
Mini Nutritional Assessment ◽  
Cross Sectional Study ◽  
Assessment Tools ◽  
Sectional Study ◽  
Cross Sectional ◽  
Inflammatory Status

Abstract Background: Hospitalization may seriously affect patients’ nutritional status and may occasionally be accompanied by malnutrition development or aggravation. Food intake is often altered during hospitalization, which is tightly connected to malnutrition. On the other hand, a huge amount of plate food wasted by patients, in addition to its health consequences, has enormous economic and environmental expenses for governments and societies. This investigation aims firstly to assess nutritional status of the patients hospitalized in general wards and secondly to evaluate the quantity and financial burden of patients’ food waste along with its possible nutritional outcomes.Methods: A cross-sectional study is performed on 171 adult inpatients with eligibility criteria from medical and surgical wards of three general hospitals in Tehran. Nutritional status of patients is evaluated through the following methods: 1. Assessment of malnutrition using subjective criteria (Mini Nutritional Assessment and Subjective Global Assessment tools); 2. Assessment of protein status using determination of serum albumin, pre-albumin and total protein; and 3. Assessment of certain micronutrient status notably vitamins A and D using serum retinol and 25-hydroxycalciferol assay. Also, oxidative stress and inflammatory status are evaluated using examination of serum β-carotene, total antioxidant capacity, malondialdehyde and highly sensitive C-reactive protein. Anthropometric and demographic data are collected and energy and protein intakes are extracted from a 24-hour food recall. Plate food wastes for selected patients are weighed in breakfast, lunch and snacks for one day. Then, economic cost of food waste is calculated for each meal, patient and ward. Finally, the possible reasons for wasting food in these hospitals will be evaluated through conducting a qualitative study.Discussion: Findings of this study will provide appropriate data regarding health and economic burden of food waste in studied hospitals. These data are especially useful to healthcare authorities and policy makers for planning efficient solutions to decrease food waste and to improve patients' nutritional status.

scholarly journals Inflammation, Appetite and Food Intake in Older Hospitalized Patients

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 1986 ◽  
Author(s):  
Sieske ◽  
Janssen ◽  
Babel ◽  
Westhoff ◽  
Wirth ◽  
...  
Keyword(s):  
Food Intake ◽  
Nutritional Status ◽  
Nutritional Assessment ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
Hospitalized Patients ◽  
Assessment System ◽  
Diagram Method ◽  
Poor Appetite ◽  
Severe Inflammation

The effect of inflammation on appetite and food intake has been rarely studied in humans. In this study, we examined the association of C-reactive protein (CRP), as an inflammatory marker, with appetite and food intake among older hospitalized patients. A total of 200 older individuals, who were consecutively admitted to a geriatric acute care ward, participated in this prospective observational study. Appetite was evaluated using the Edmonton Symptom Assessment System (ESAS) and the Simplified Nutritional Appetite Questionnaire (SNAQ), respectively. Food intake was measured according to plate diagram method and participants were categorized as having food intake <75% and ≥75% of meals served. Nutritional status was evaluated using the Mini Nutritional Assessment Short Form (MNA-SF). In addition, serum CRP was analyzed and the levels >3.0 (mg/dL) were considered as moderate to severe inflammation. Of total population with mean age 81.4 ± 6.6 years (62.5% females), 51 (25.5%) had no inflammation and 88 (44.0%) and 61 (30.5%) had mild and moderate to severe inflammation, respectively. According to MNA-SF, 9.0% and 60.0% had normal nutritional status or a risk of malnutrition, respectively, whereas 31.0% were malnourished. Based on the SNAQ-appetite-question, 32.5% of the patients demonstrated poor and very poor appetite whereas 23.5% reported severe loss of appetite according to ESAS. Ninety-five (48.0%) of the participants had food intake <75% of the meals offered. Significant associations between SNAQ-appetite (p = 0.003) and ESAS-appetite (p = 0.013) scores and CRP levels were observed. In addition, significant differences were observed in CRP levels between intake ≥75% and <75% of meals served (p < 0.001). Furthermore, there were significant associations between appetite and nutritional status whereas malnourished older patients demonstrated a decreased appetite compared to those with normal nutritional status (p = 0.011). In a regression analysis, inflammation was the major independent risk factor for patients’ appetite (p = 0.003) and food intake (p = 0.011) whereas other variables such as infection (p = 0.960), chronic inflammatory diseases (p = 0.371), age (p = 0.679) and gender (p = 0.447) do not show any impact on appetite. Our findings confirm that poor appetite and low food intake are associated with inflammation in older hospitalized patients, suggesting that inflammation may contribute an important aspect to the development of malnutrition in these patients.

scholarly journals Study of community-living Alzheimer’s patients’ adherence to the Mediterranean diet and risks of malnutrition at different disease stages

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e5150 ◽  
Author(s):  
Mariona Rocaspana-García ◽  
Joan Blanco-Blanco ◽  
Alfonso Arias-Pastor ◽  
Montserrat Gea-Sánchez ◽  
Gerard Piñol-Ripoll
Keyword(s):  
Food Intake ◽  
Nutritional Status ◽  
Mediterranean Diet ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Food Groups ◽  
Global Deterioration Scale ◽  
Cross Sectional ◽  
Mediterranean Countries ◽  
The Mediterranean

BackgroundAlzheimer’s disease (AD) is a neurodegenerative disease that is characterized by deficits in episodic memory. It is the most common form of dementia and affects 50–70% of patients with cognitive impairments over the age of 65. Elderly people are particularly susceptible to malnutrition and that risk is even higher in patients with AD. This study assessed the nutritional status of patients with AD at different stages of AD and explored how that status correlated with cognitive, functional and behavioural variables and caregiver overburden. The characteristics of the diet and the degree of adherence to the Mediterranean diet were also analysed.MethodsThis was a cross-sectional study that was representative of the general population and it was carried out in the Unit of Cognitive Disorders, Lleida, Spain. The participants were 111 subjects with AD who were aged 65 and over and still living at home. The subjects’ nutritional status was assessed using the Mini Nutritional Assessment (MNA) and Controlling Nutritional Status system. The monthly food intake was estimated using the short Food Frequency Questionnaire and adherence to the Mediterranean diet was evaluated using the Mediterranean Diet Score. The Mini Mental State Examination (MMSE), Global Deterioration Scale, Neuropsychiatric Inventory (NPI) and Zarit Burden Interview (ZBI) were also used.ResultsWe found that 68% of the subjects presented with a risk of malnutrition and 19% were malnourished according to the MNA scale. Patients ate a higher quantity of meat and dairy products than recommended and fewer products from the remaining healthier food groups. Of the 111 subjects, 73% showed low adherence to the Mediterranean diet and 27% showed moderate adherence. There was a partial correlation between nutritional status and the MMSE when the data were adjusted for age and sex (r = 0, 318;p = 0.001) and inverse correlations were found for functional status (r =  − 0.283;p = 0.004) and the NPI (r =  − 0.409;p = 0.000) and ZBI scales (r =  − 0.433;p = 0.000) when they were adjusted using the same variables. The ZBI scale (OR 1.08, 95% CI [1.01–1.15]) showed an increase in the risk of malnutrition in the multivariate analysis.DiscussionAlterations in nutritional status were more common during the advanced stages of AD and were also associated with behavioural changes and caregiver overburden. Low adherence to traditional healthy diets in Mediterranean countries and food intake profiles should be considered when managing patients with AD. Other countries can use the results to examine diets in people with AD that are high in meat and dairy and low in healthy food groups like fruit and vegetables.

scholarly journals DOES THE MINI NUTRITIONAL ASSESSMENT-SHORT FORM PREDICT CLINICAL OUTCOMES IN YOUNGER REHABILITATION PATIENTS?

2014 ◽  
pp. 1-7
Author(s):  
L. Wegener ◽  
S. James ◽  
A. Slattery ◽  
M. Satanek ◽  
M. Miller
Keyword(s):  
At Risk ◽  
Nutritional Status ◽  
Clinical Outcomes ◽  
Nutritional Assessment ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
Assessment Tools ◽  
Post Discharge ◽  
Retrospective Case ◽  
Nutrition Screening

Objectives: To identify the nutritional status of younger patients on admission to rehabilitation using the Mini Nutritional Assessment – Short Form (MNA-SF) and determine whether the MNA-SF has predictive validity for clinical outcomes in this setting. Design: Retrospective case note audit. Setting: Rehabilitation Unit, Repatriation General Hospital, Adelaïde, Australia. Participants: Fifty four patients under 65 years (mean age 52.9±10 years, 54% female). Measurements: Case notes for adults admitted consecutively to rehabilitation were reviewed. Risk of malnutrition was categorised using the MNA-SF. Outcomes measured were length of stay (LOS), complications and poor participation during admission, change in function, discharge to higher level of care, and acute readmissions and mortality 18 months post discharge. Results: Fourteen (26%) subjects were malnourished and 28 (52%) were at risk of malnutrition as classified by the MNA-SF. There were no significant differences in clinical outcomes between patients classified as malnourished or at risk of malnutrition and those of normal nutritional status. Conclusion: Over three quarters of subjects were classified as malnourished or at risk of malnutrition. These patients were more likely to have adverse clinical outcomes than their well-nourished counterparts but the difference was not significant. Further research is required to investigate the validity of the MNA-SF and other nutrition screening and assessment tools for adults under 65 years old undergoing rehabilitation.

scholarly journals Determinants of under nutrition among the elderly in South Gondar Zone, Ethiopia

2021 ◽  
Author(s):  
Hiwot Yisak ◽  
Ismael Maru ◽  
Misganaw Abie ◽  
Getachew Aragie ◽  
Amien Ewunetei ◽  
...  
Keyword(s):  
Food Intake ◽  
Nutritional Status ◽  
Elderly Population ◽  
Assessment Tool ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Public Health Burden ◽  
Under Nutrition ◽  
South Gondar

Abstract Background: The number of the elderly population is expected to become the largest demographic group. Malnutrition in older adults is related with complications and premature death. The progression to malnutrition is often insidious and often undetected. No study has been ever conducted or documented to explore the nutritional status of elderly in south Gondar Zone . Hence, this study was aimed to assess the determinants of under nutrition among the elderly people aged ≥65 years. A cross-sectional study was conducted from October 1 to December 15, 2020. A community based study was conducted in south Gondar Zone, Ethiopia. A total of 290 elderly aged greater or equal to 65 years of age selected by systematic random sampling technique were included in the study. Pretested and structured questionnaire adapted from different literature was used to collect data. Anthropometric measurements; weight and height were measured following standard procedures. Mini-Nutritional Assessment (MNA) tool was used to assess nutritional status of elderly. Descriptive and summary statistics were employed. Multiple logistic regression was fitted to identify determinants of under nutrition. Odds ratios and their 95% confidence intervals were computed to determine the level of significance. Results: Based on their BMI status 27.57%, 95%CI (22.4-32.8) of elderly were underweight and 2.1%, 95% CI (0.7-3.8) were overweight. Likewise, 29.7%, 95%CI (24.5-35.2) of elderly were malnourished and 61.7%, 95% CI (55.5-67.2) were at risk of malnutrition based on Mini-Nutritional Assessment tool. Rural residence (AOR= 10.32, 95%CI (3.62-29.39)), unable to read and write (AOR = 3.54, 95%CI (1.64-7.64)), decline in food intake (AOR= 13.47, 95%CI (6.14-29.52)) and household monthly income <35.6USD (AOR = 4.32, 95%CI (1.97- 9.46)) were significantly and independently associated with under nutrition in elderly population.Conclusion: The prevalence of under nutrition among the elderly in the study area was high, and making it an important public health burden. Place of residence, educational status, food intake and household income were the determinants of under nutrition.

Comparing Cognition, Mealtime Performance, and Nutritional Status in People With Dementia With or Without Ideational Apraxia

2014 ◽  
Vol 17 (2) ◽  
pp. 199-206 ◽  
Author(s):  
Hua-Shan Wu ◽  
Li-Chan Lin
Keyword(s):  
Food Intake ◽  
Nutritional Status ◽  
Prevalence Rate ◽  
Nutritional Assessment ◽  
Mini Nutritional Assessment ◽  
Memory Training ◽  
Term Care ◽  
Eating Time ◽  
People With Dementia ◽  
Severe Stage

Objective: To describe the prevalence rate of ideational apraxia (IA) affecting self-feeding in people with dementia, confirm the stage of dementia at which IA most commonly occurs, and compare mealtime performance and nutritional status between people with dementia (PWD) with and without IA. Method: A cross-sectional design with between-subject comparison was used. Among the 395 potential participants recruited from dementia special care units at nine long-term care facilities in central and northern Taiwan, 98 met the operational definition of IA and were included in the PWD with IA group. From the remaining pool, 98 participants, matched for age and sex with the PWD with IA group, were randomly allocated to the PWD without IA group. Eating Behavior Scale (EBS) scores, food intake, total eating time, meal assistance, body mass index, Mini-Nutritional Assessment (MNA), and Mini-Mental State Examination scores were collected. Results: The prevalence rate of IA affecting self-feeding in our study population of PWD was 24.8%. PWD with IA had significantly lower EBS scores, had more food intake ( p < .001), spent more time being fed by caregivers, needed more verbal and feeding assistance, and had lower MNA scores than PWD without IA. Decline in the self-feeding ability of PWD affected by IA most commonly occurred in the severe stage of dementia. Conclusion: When dementia progresses to the late stage, staff should pay special attention to residents’ mealtime performance and nutritional status. For PWD with IA, reassigning staff at mealtimes based on eating ability and providing memory training are recommended.

Association of GDF15 With Inflammation and Physical Function During Aging and Recovery After Acute Hospitalization: A Longitudinal Study of Older Patients and Age-Matched Controls

2021 ◽  
Author(s):  
Juliette Tavenier ◽  
Line Jee Hartmann Rasmussen ◽  
Aino Leegaard Andersen ◽  
Morten Baltzer Houlind ◽  
Anne Langkilde ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Physical Function ◽  
Plasma Levels ◽  
Older Patients ◽  
Nutritional Assessment ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
Acute Illness ◽  
Urokinase Plasminogen Activator Receptor

Abstract Growth differentiation factor 15 (GDF15) is a stress-induced cytokine. Its plasma levels increase during aging and acute illness. In older Patients and age-matched Controls, we evaluated whether GDF15 levels (i) were associated with recovery after acute illness, and (ii) reflected different trajectories of aging and longitudinal changes in health measures. Fifty-two older Patients (≥65 years) were included upon admission to the emergency department (ED). At 30 days after discharge (time of matching), Patients were matched 1:1 on age and sex with Controls who had not been hospitalized within 2 years of inclusion. Both groups were followed up after 1 year. We assessed plasma levels of GDF15 and inflammatory biomarkers, frailty, nutritional status (mini nutritional assessment short-form), physical and cognitive function, and metabolic biomarkers. In Patients, elevated GDF15 levels at ED admission were associated with poorer resolution of inflammation (soluble urokinase plasminogen activator receptor [suPAR]), slowing of gait speed, and declining nutritional status between admission and 30-day follow-up. At time of matching, Patients were frailer and overall less healthy than age-matched Controls. GDF15 levels were significantly associated with participant group, on average Patients had almost 60% higher GDF15 than age-matched Controls, and this difference was partly mediated by reduced physical function. Increases in GDF15 levels between time of matching and 1-year follow-up were associated with increases in levels of interleukin-6 in Patients, and tumor necrosis factor-α and suPAR in age-matched Controls. In older adults, elevated GDF15 levels were associated with signs of accelerated aging and with poorer recovery after acute illness.

Effect of the Mini Nutritional Assessment-Short Form (MNA-SF) in Elderly Burn Patients

2021 ◽  
Author(s):  
Jia-Yu Wei ◽  
Shu-Ting Shi ◽  
Dan Sun ◽  
Guo-Zhong Lyu
Keyword(s):  
Wound Healing ◽  
Nutritional Status ◽  
Nutritional Assessment ◽  
Short Form ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Reference Points ◽  
Nutrition Intervention ◽  
Burn Patients ◽  
Cross Sectional

Abstract Objective Nutritional assessment can early identify patients who are malnourished and at risk of malnutrition. To examine the effect of nutritional status on wound healing in elderly burn patients, we used the MNA-SF to measure the nutritional status of elderly patients. This study aimed to examine the role of MNA-SF in elderly burn patients through the correlation analysis of wound-healing indicators and MNA-SF score. Design Prospective observational and cross-sectional study. Methods This study used the MNA-SF to investigate the elderly burn patients at the department of burn. According to the score, the patients fell into three groups: good nutritional status (more than 12 points), malnutrition risk (8~11 points), and malnutrition (0~7 points). At the same time, we measured and compared the wound-healing indicators among the three groups of patients, and detected the correlation. Results The statistical analysis found gender had a slight influence on the score of nutritional status. While age was negatively correlated with the MNA-SF score and nutrition-related indicators. There was a low positive linear correlation between the wound healing percent area change or wound healing rate of patients and the score of the MNA-SF. Conclusion This study finds malnutrition is common among hospitalized elderly burn patients. The application of the MNA-SF in elderly burn patients is efficient and accurate to identify malnutrition early and prevent further obstruction of the normal wound healing, which can provide reference points for early nutrition intervention programs.

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