Are elderly hospitalized patients getting enough protein?
OBJECTIVE
To determine the protein requirements of elderly hospitalized patients.


METHODS
Cross-sectional evaluation of nitrogen balance.


METHODS
Short-stay geriatric ward or rehabilitation care unit.


METHODS
Thirty-six elderly hospitalized patients (aged 65-99) admitted to short-stay and rehabilitation care units.


METHODS
Resting energy expenditure and nitrogen balance were determined under usual and spontaneous energy and protein intake after subjects were clinically stable (3-5 days after admission). All items consumed over a 3-day period were weighed to determine energy and protein intake.


RESULTS
Energy (23.5+/-6.3 kcal/kg per day) and protein (0.99+/-0.24 g/kg per day) intake were similar in men and women, and nitrogen balance was neutral (0.37+/-2.6 g/day; P=.41 vs a neutral nitrogen balance, i.e., 0 g/d). Half of the patients had a positive nitrogen balance. Plasma C-reactive protein, renal function, nutritional status, and initial diagnosis had no influence on nitrogen balance. In contrast, energy and protein intakes correlated positively with nitrogen balance. Linear regression analysis suggested that an elderly hospitalized patient with an energy intake of 1.31 times resting energy expenditure or greater appears to require a minimum protein intake of 1.06+/-0.28 g/kg per day.


CONCLUSIONS
Mean protein intake to reach a neutral nitrogen balance in elderly hospitalized patients is 1.06+/-0.28 g/kg per day, which is higher than current recommendations for healthy elderly people. Safe protein intake (that would be adequate to ensure that 95% of patients remain in positive nitrogen balance) is difficult to establish.
Department of Metabolic Diseases and Internal Medicine, University Hospital of Angers, Angers, France.
Cathy
C
Gaillard
Emmanuel
E
Alix
Yves
Y
Boirie
Gilles
G
Berrut
Patrick
P
Ritz
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D003430:Cross-Sectional Studies; D004044:Dietary Proteins; D002149:Energy Intake; D004734:Energy Metabolism; D005260:Female; D006760:Hospitalization; D006801:Humans; D016014:Linear Models; D008297:Male; D009584:Nitrogen / Q000378:metabolism; D009751:Nutritional Requirements; D011502:Protein-Energy Malnutrition / Q000517:prevention & control*
D015415:Biomarkers; D004044:Dietary Proteins; D009584:Nitrogen