title: Does a new steam meal catering system meet patient requirements in hospital?
abstract: BACKGROUND
  It has been consistently observed that a significant proportion of hospital inpatients are malnourished and many actually develop malnutrition in hospital. The NHS provides over 300 million meals each year at a cost of pound 500 million, yet there is relatively little research evaluating how well different catering systems provide for the needs of hospital inpatients.
  
  
  OBJECTIVE
  The aim of the study was to: (i) evaluate whether a new steam meal catering system (Steamplicity) enables patients in theory to meet their energy requirements in hospital and (ii) compare energy and protein intake using Steamplicity with a traditional bulk cook-chill system.
  
  
  METHODS
  Patients not at nutritional risk had their food intake at one lunchtime assessed. Energy intake was compared with the patients' energy requirements and energy and protein intake were compared with previous data from a bulk system.
  
  
  RESULTS
  Fifty-seven patients had a median daily energy requirement of 7648 kJ (1821 kcal) [inter-quartile range (IQR): 6854-9164 kJ]. Assuming 30% [2293 kJ (546 kcal)] should be supplied by the lunch meal the average intake of 1369 kJ (326 kcal) fell short by 40%. Patients served meals from Steamplicity ate less energy [1369 kJ versus 1562 kJ (326 kcal versus 372 kcal) P = 0.04] but similar protein (18 g versus 19 g P = 0.34) to the bulk system. The largest difference was the energy provided by the dessert since the bulk system served more hot high-calorie desserts.
  
  
  CONCLUSIONS
  Patient intakes did not meet their estimated requirements. The patients in this study were eating well and not at nutritional risk, thus patients with a poor appetite will be even less likely to meet their nutritional requirements. Steamplicity meals result in a lower energy intake than meals from a bulk cook-chill system, but similar protein intakes.
authors.affiliation: Dietetic Research Group, Hammersmith Hospitals NHS Trust, London, UK. mhickson@hhnt.nhs.uk
authors.forename: M
authors.initials: M
authors.lastname: Hickson
authors.forename: L
authors.initials: L
authors.lastname: Fearnley
authors.forename: J
authors.initials: J
authors.lastname: Thomas
authors.forename: S
authors.initials: S
authors.lastname: Evans
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004044:Dietary Proteins / Q000008:administration & dosage*; D002149:Energy Intake; D005260:Female; D005521:Food Service, Hospital / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018673:Nutrition Policy; D009751:Nutritional Requirements; D017060:Patient Satisfaction
chemical_list: D004044:Dietary Proteins