An audit of meal provision in an elderly care hospital

To estimate the nutritional provision to elderly patients, to compare with United Kingdom (UK) Government dietary reference values (DRV), to modify food provision to correct any major deficiencies, and to evaluate these modifications for their acceptability and consumption.

Energy, principal macro nutrients, vitamins, minerals and non-starch polysaccharide (NSP) and dietary fibre provision were measured prospectively throughout the menu cycle in a 72-bedded hospital for patients over 65 years before and after dietary supplementation with both energy-rich foods and high-fibre cakes.

At baseline, mean energy provision was 1472(320) kcal, 6153(1340) kJ, representing less than the estimated average requirement (EAR) for elderly males and females. Fat provided 49% of total energy, daily protein provision exceeded the EAR for males and females (16% energy) and provision of the micro nutrients thiamine, riboflavin, vitamins B12, C, A, calcium and iron met or exceeded these recommendations. Vitamin B6 provision was only adequate for females. Provision of niacin, folate, vitamin D, NSP and dietary fibre was also below recommendations. Supplementation allowed energy provision to reach the target EAR and fibre provision the reference nutrient intake.

Nutritional provision in hospital is meeting some, but not all, available Government standards for nutritional guidelines in elderly people. Increased fibre provision was poorly tolerated, but dietary supplementation with energy-rich foods was well tolerated.