A foodservice approach to enhance energy intake of elderly subacute patients: A pilot study to assess impact on patient outcomes and cost

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Background: effective strategies are required to support the nutritional status of patients.Objectives: to evaluate a food service nutrition intervention on a range of participant outcomes and estimate its cost.Design: parallel controlled pilot study.Setting: subacute hospital ward.Subjects: all consecutively admitted adult patients were eligible for recruitment under waiver of consent.Methods: the intervention was a modified hospital menu developed by substituting standard items with higher energy options. The control was the standard menu. All participants received usual multidisciplinary care. Outcomes were change in weight and hand grip strength (HGS) between admission and day 14 and; energy and protein intake and patient satisfaction with the food service at day 14. The additional cost of the intervention was also estimated.Results: the median (interquartile range) age of participants (n = 122) was 83 (75–87) years and length of stay was 19 (11–32) days. One-third (38.5%) were malnourished at admission. There was no difference in mean (SD) HGS change(1.7 (5.1) versus 1.4 (5.8) kg, P = 0.798) or weight change (−0.55 (3.43) versus 0.26 (3.33) %, P = 0.338) between the intervention and control groups, respectively. The intervention group had significantly higher mean (SD) intake of energy (132(38) versus 105 (34) kJ/kg/day, P = 0.003) and protein (1.4 (0.6) versus 1.1 (0.4) g protein/kg/day, P = 0.035). Both groups were satisfied with the food service. The additional cost was £4.15/participant/day.Conclusions: in this pilot, the intervention improved intake and may be a useful strategy to address malnutrition. Further consideration of clinical and cost implications is required in a fully powered study.
Original languageEnglish
Article numberafw238
Pages (from-to)486-493
Number of pages7
JournalAge and Ageing
Issue number3
Publication statusPublished - May 2017


  • Cost
  • Foodservice
  • Malnutrition
  • Nutrition intervention
  • Older people
  • Subacute care

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