Nutritional status, energy and protein intake in general medical patients in three Nordic hospitals

The energy and protein intake before and during hospitalization was studied in 56 elderly patients (age 70 +/- 9 yr) admitted to general medical service in three Nordic hospitals. Nutritional status at admission was evaluated using weight index, arm muscle circumference, triceps skinfold, serum albumin, total iron-binding capacity, haemoglobin and serum iron levels. A history of food intake before hospitalization was taken at admission. Food intake during hospital stay was estimated from precise weighing and recording and intake of energy and protein calculated. On admission, 16 patients (28.5 per cent) had three or more of the studied nutritional parameters below reference value. Mean energy intake for men at home and in hospital was 10.0 +/- 2.3 MJ/d and 7.1 +/- 1.3 MJ/d, respectively, and for women 7.8 +/- 1.7 MJ/d and 6.6 +/- 1.4 MJ/d, respectively. Mean protein intake for men at home and in hospital was 72 +/- 19 g/d and 74 +/- 15 g/d, respectively, and for women 60 +/- 15 g/d and 68 +/- 13 g/d, respectively. In patients with a hospital stay exceeding two weeks a correlation between changes in body weight and energy intake was found. Likelihood of developing undernutrition during hospitalization, defined as a daily energy intake below 90 kJ/kg BW per day, was seen in 20 patients (36 per cent). The data obtained indicate that at least 120 kJ/kg should be regarded as necessary to maintain body weight in elderly general medical patients. It reveals the importance of regular nutritional assessment of these patients.