A patient-centered nutritional intervention with a new fortified high-protein high-energy paste: an observational study to assess nutritional intakes in hospitalized older adults

Protein-energy undernutrition in hospitalized older adults remains a major issue that warrants purposeful intervention.

To assess how a nutritional management process, using a fortified high-protein, high-energy paste, could help meet patient nutritional requirements.

An observational study was carried out between September 2021 and April 2022 in a community hospital's multidisciplinary care unit (MCU) and geriatric rehabilitation unit (GRU). Hospital stays of patients aged 75 years or older were included. Intakes were recorded for each component of each lunchtime and evening meal throughout the hospital stay. Daily energy and protein intakes were compared to patient recommended requirements, i.e. 30 kcal/kg/day and 1.2 g/kg/day.

Analysis included 403 hospital stays (296 in the MCU, 107 in the GRU). Energy recommended requirements were met in 23.3% of MCU stays and 31.8% of GRU stays. Daily energy intakes were lower than the recommended level in both units (P < 0.001): 25.2 ± 7.7 kcal/kg/day in the MCU and 27.0 ± 6.9 in the GRU. Protein recommended requirements were reached in 45.3% of MCU stays and 58.9% of GRU stays. Daily protein intakes were not significantly lower than the recommended level in both units: 1.17 ± 0.39 g/kg/day in the MCU (P = 0.10) and 1.26 ± 0.35 in GRU (P = 0.96).

The nutritional management process helped patients covering their protein requirements especially in the geriatric rehabilitation unit, but more efforts are still needed to reach energy requirements. Healthcare teams should be alert to the dependency in activities of daily living of patients.