Nutritional intake analysis of hospital diets in elderly inpatients in Peking Union Medical College Hospi-tal / 中华临床营养杂志

Objective To investigate the nutritional management level of Department of Clinical Nutrition in elderly inpatients through analyzing the actual hospital dietary intakes in elderly inpatients in Peking Union Medical College Hospital from 2013-2015.Methods Using continuous sampling, the nutrients contents and the eating rates of hospital meals ordered by the elderly inpatients on the 1st, 15th, 29th of every month from May 2013 to October 2015 were selected.The intake levels of energy, protein, calcium, vitamin A, vitamin B1 , and vitamin C were calculated and compared with the Chinese dietary reference intakes (DRIs).The nutritional in-take differences between diabetes diet and the basic hospital diet were also compared.Results A total of 90 days of hospital dietary data from 8 402 elderly inpatients were included in the study.The average eating rate was (50.1 ±4.2)%, which was lower than the general eating rate of the hospital [ (59.0 ±4.0)%, P<0.001]. Only protein intake from hospital diet reached the requirement target [male (103.1 ±47.3)%, femal (98.3 ± 33.8)%].Individual compliance rates were 63.2%and 59.8%, respectively, while the other kinds of nutrients were lower.The compliance rates of energy [ (73.3 ±26.3)%vs.(62.1 ±38.2)%, P<0.001] and ma-jor nutrient intake [ protein: ( 119.1 ±41.2 )% vs.( 93.3 ±65.1 )%, P <0.001; calcium: ( 55.5 ± 26.7)% vs.(34.3 ±34.2)%, P <0.001; vitamin A: (75.2 ±48.3)% vs.(57.4 ±97.1)%, P<0.001;vitamin B1:(76.4 ±38.2)%vs.(52.1 ±46.6)%, P<0.001;vitamin C:(92.2 ±51.4)%vs. (49.3 ±55.0)%, P<0.001) in diabetes diet group were significantly higher than those in the basic hospi-tal diet group.Conclusions The nutritional intakes from hospital diets may not meet the nutritional require-ments based on DRIs in elderly inpatients.Medical diet designed by physicians and dietitians should be ex-panded to improve the nutritional management level for these patients.

Discurso médico e práticas alimentares no Hospital Real de Moçambique no início do século XIX / Medical discourse and eating habits in the Hospital Real de Moçambique in the early nineteenth century

Com base em estudos e documentos de arquivo, explora-se o modo como as práticas médicas europeias que relacionavam dieta e saúde, no início do século XIX, foram transpostas para África, especificamente Moçambique. Examina-se a evolução das teorias europeias sobre o papel preventivo e terapêutico da alimentação, destacando-se as concepções da medicina humoral e a sua reconfiguração pela ciência iluminista. Descreve-se o hospital moçambicano, considerando as categorias de doentes assistidos e as doenças prevalecentes na região. Focam-se as alterações introduzidas na alimentação hospitalar, aproximando-a da europeia. Analisam-se essas modificações em articulação com os desenvolvimentos do discurso médico europeu, reconstruído pela fisiologia e pela química, em torno do corpo e dos alimentos.

Based on studies and archive documents, this work investigates the way European medical practice that interrelated diet and health in the early nineteenth century was transported to Africa, specifically Mozambique. The development of European theories about the preventive and therapeutic role of diet is examined, highlighting the conceptions of humoral theory and its reconfiguration by the science of the Enlightenment. The Mozambican hospital is described, taking into account the categories of patients cared for and prevailing diseases in the region. Focus is given to the changes introduced to hospital food to bring it closer to European habits. These changes are analyzed in the light of developments in European medical discourse about the body and foodstuffs, reconstructed by physiology and chemistry.

Acompanhamento dietoterápico durante a internação em pacientes hospitalizados

O objetivo deste estudo foi analisar o acompanhamento dietoterápico e a aceitação da dieta hospitalar. Estudo prospectivo com 926 pacientes adultos e idosos hospitalizados, sendo analisados os seguintes dados: doença, sexo, idade, tempo de internação, estado nutricional, aceitação, modificação e ingestão da dieta, durante o período de internação. Foi aplicado o teste qui-quadrado para verificar se houve diferença na distribuição percentual das variáveis, na população agrupada conforme o diagnóstico (p<0,05). A distribuição percentual do estado nutricional e da aceitação alimentar nos grupos conforme o diagnóstico foi diferente (p<0,05). 74% apresentaram boa aceitação da dieta hospitalar e em 82% dos pacientes, não foi necessário realizar adequações na prescrição dietética; já quanto à ingestão energética, foi verificado que 71,3% apresentavam consumo inferior às suas necessidades, mostrando que apesar da maioria dos pacientes apresentarem boa aceitação da dieta, houve uma ingestão energética abaixo de suas necessidades energéticas. Os dados permitiram concluir a importância do processo de atenção nutricional durante a hospitalização, com vistas na alimentação em si, e não só na identificação do estado nutricional, o que pode contribuir para um indicador de qualidade para o Serviço de Nutrição e Dietética Hospitalar.

The objective of this study was to analyze nutritional therapy monitoring and acceptance of hospital diet. A prospective study with 926 adult and elderly hospitalized patients, analyzing the following data: disease, gender, age, hospitalization duration, nutritional status, acceptance and dietary modification and ingestion during hospitalization. The chi-square test was used to determine if the distribution of the percentages of the variables differed in the population grouped according to diagnosis (p<0.05). The percentage distribution of the nutritional status and diet acceptance in the groups according to diagnosis differed (P<0.05): 74% presented good acceptance of the hospital diet and 82% of the patients did not require dietary adjustments or modifications in the diet prescribed at admission. Meanwhile, energy intake was below the daily requirement in 71.3% of the patients, showing that even though most of the patients accepted the diet well, they ate less than they should. The data allowed us to realize the importance of the process of nutritional care during hospitalization, focusing not only on the nutritional status but also on food consumption; the latter may contribute as a quality indicator of the Hospital Nutrition and Dietary Service.

Effects of Nutrition Service Improvement Activities for Reducing Plate Waste of the Diabetic Mellitus Diet in a General Hospital / 대한지역사회영양학회지

Hospital malnutrition could be caused by not completing the food served in the hospital. This has been a big problem since it delays the recovery of the patient and extends the length of hospital stay. The purpose of the study was to reduce the plate waste for the DM diet by performing several nutrition service improvement activities. The study was performed in a general hospital with 900 beds. A questionnaire survey was taken by 39 DM patients to obtain their aspect of the hospital foodservice systems and the quality of the meals at the beginning of the study. The amounts of foods served in the hospital kitchen and returned were measured by weights. After the improvement activities, the measurement of the plate waste was performed again for comparison. The average percentage of plate waste for the DM diet was 23.2%. The survey showed no difference by sex, age or duration of admission in plate waste. However, this food wastage percentage showed differences between the patients having a chance to get information about the diet therapy (12.21%) and not having one(26.06%) (p < 0.05). Using a five-point Likert-type scale, the quality of food by its taste was 2.49 (1: very poor, 5: excellent), the temperature score was 3.56 (1: very poor, 5: excellent), and the amount of food served score was 2.95 (1: very poor, 5: excellent), and the preference score was 3.13 (1: very dislike, 5: very like). Nutritional care improving activities were performed by adjusting seasonings, developing new menus, and standardizing cooking methods in order to increase the satisfaction of meal quality. The dietitian's inpatients care protocol was adjusted to expand the nutritional counseling chance for the DM patients. After the improvement activities, the average plate waste was reduced to 14.6%, and the satisfaction of food taste and preference increased to 3.21 (p < 0.001), and 3.36 (p < 0.05) correspondingly. The result shows that, for therapeutic diet patients, food intake could be increased by improving the food service satisfaction by controlling the meal quality and clinical nutritional service activities.

Nutrition Care of Diet - refusal Patients having Difficulties in Adapting to Hospital Diet

The purpose of this study was to produce proper nutrition and foodservice through positive intervention for diet-refusal patients who has difficulties in adaptation to hospital diet, and to contribute to hospital management with the focus of fast recovery. The survey was conducted using questionnaires between July 18 and August 17, 2000. The subjects were consisted of 24 diet-refusal patients who were hospitalized in St. Mary's Hospital except the patients hospitalized for the purpose of operation or pre-therapy tests. Also chart reviews were conducted. The statistical analysis of data was done by SAS/win 6.11 package to determine descriptive analysis and paired t-test and Pearson's correlation. The summary of study results is as follows : 1. Most of the subjects was receiving chemotherapy. The leading place for offering private food was from patient's home. Subjects worried about delayed recovery from illness due to nutritional problems caused by extreme fasting. The problems were in order of anorexia, nausea and vomiting during therapy process. 52.4% of subjects ate hospital diet after positive intervention. 2. Major reasons of hospital diet-refusal patients' dissatisfation were in order of expeness, dissatisfation, serum total protein levels were significantly lower(p<.05). 3. Serum Alb(p<.05), Hb(p<.05), Hct(p<.05) and TLC(p<.001) levels showed significantly negative correlations with fasting duration. With these results, it is concluded that a major cause of malnutrition among patients is to last fasting.