P783 - HOSPITAL DIETS FOR HOSPITALIZED PATIENTS ARE INSUFFICIENTLY MEETING THEIR ENERGY AND PROTEIN NEEDS: A THREE-DAY RETROSPECTIVE CROSS-SECTIONAL ANALYSIS

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P783

HOSPITAL DIETS FOR HOSPITALIZED PATIENTS ARE INSUFFICIENTLY MEETING THEIR ENERGY AND PROTEIN NEEDS: A THREE-DAY RETROSPECTIVE CROSS-SECTIONAL ANALYSIS

O. Montillet1,2, F. Michel3, R. Thibault1,2,*

1Endocrinology-Diabetology-Nutrition, CHU Rennes, 2Nutrition Metabolisms and Cancer, NuMeCan, INRAE, INSERM, Univ Rennes, 3Hospital food service, CHU Rennes, Rennes, France

 

Rationale: Hospital nutrition should help prevent malnutrition. Objectives: To assess the adequacies between the energy/protein intake and needs of hospitalized patients (primary), and in those with cancer < 6 mo and obesity (secondary).

Methods: Retrospective cross-sectional study of adult patients in the pulmonology (P), orthopedics (O), and geriatrics/post-acute care (G) departments of a university hospital over 4 3-day periods spaced 1 to 2 months apart. Lunch trays served (representative of the day (1)) were weighed before and after meals. The weights, energy and protein values of the foods served, wasted, consumed were calculated individually meal by meal, then averaged for a period and per patient. Resting energy expenditure (REE)=110% of Harris-Benedict formula (2). Protein needs=1.2 g/kg actual weight (using adjusted weight if obese)/day. Coverage of energy (ER) and protein (PR) needs/patient (%)=(mean kcal or g protein consumed/REE) x 100.

Results: 245 patients were analyzed: P, n=78, O, n=93, G, n=74; 70.9±13.8 yr, 46% women, 18% obesity, 10% cancer. ER: 82.5±21.8% (G, 107.6±74.8; O, 71.5±55.3; P, 68.4±47.5%); PR: 69.8±18.5% (G, 91.0±48.9; P, 61.8±46.3; O, 56.6±44.9%). Intakes < protein needs: P, 65.3±12.8 vs. 72.2±24.4; O, 47.4±19.0 vs. 72.5±28.0; G, 48.7±13.4 vs 67.9±24.0 g, p<0.0001). ER and PR <100%: 169/245 (69%) patients (23% (P)+32% (O)+14% (G)). CE or CP <70%: 44 and 52%; CE or CP <100%: 63 & 99%. ER and PR different if obesity vs no (86.1±23.8 vs 52.7±21.9%; 89.0±28.6 vs. 74.7±19.8%, p=0.002), cancer vs no (68.4±35.5 vs 85.8±38.4; 78.1±39.1 vs 105.6±41.0%, p=0.05).

Conclusion: Only 30% of hospitalized patients meet their energy and protein needs, and almost all did not meet 100% of protein needs. This is particularly pronounced among patients with cancer.

References:         1. Hiesmayr et al. Clin Nutr 2009;28: 484‑91 ; 2. Thibault et al. Clin Nutr 2011;30:289‑96.

Disclosure of Interest: None declared