title: Individually prescribed diet is fundamental to optimize nutritional treatment in geriatric patients.
abstract: Malnutrition is a well-recognized problem in geriatric patients. Individually prescribed diet is fundamental to optimize nutritional treatment in geriatric patients. The objective of this study was to investigate routines regarding dietary prescriptions and monitoring of food intake in geriatric patients and to see how well the prescribed diet conforms to the patients' nutritional status and ability to eat. A further aim was to identify the most common reasons and factors interacting with patients not finishing a complete meal.
  
  
  
  This study combines two methods using both qualitative and quantitative analysis. Patients (n = 43; 82.5 ± 7.5 yrs; 60% females) at four geriatric wards performed a two-day dietary record, assisted by a dietician. Nurses and assistant nurses at each ward participated in a semi-structured interview regarding prescription of diets and portion size for the patients.
  
  
  
  The prescribed diet differed significantly (P < 0.01) from a diet based upon the patient's nutritional status and ability to eat. Only 30% of the patients were prescribed an energy-enriched diet in contrast to 60% that was in need of it. The most common reason for not finishing the meal was lack of appetite. Diet prescription for the patient was based upon information about eating difficulties identified in the Mini Nutritional Assessment-Short Form (MNA-SF) at admission and the type of diet that was prescribed on a previous ward. Monitoring of the patients' food intake was described as a continuous process discussed daily between the staff.
  
  
  
  Patients' nutritional status and to what extent they were able to eat a complete meal was not routinely considered when prescribing food and monitoring food intake in this study. By making use of this information the diet could be tailored to the patients' needs, thereby improving their nutritional treatment.
authors.affiliation: Department of Clinical Nutrition and Dietetics, Karolinska University Hospital, Stockholm, Sweden. Electronic address: sanna_hedman@hotmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Hedman
authors.affiliation: Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Nydahl
authors.affiliation: Department of Clinical Nutrition and Dietetics, Karolinska University Hospital, Stockholm, Sweden; Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Faxén-Irving
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D015930:Diet Records; D000072001:Diet, Healthy; D004046:Dietetics / Q000379:methods*; D058620:Elder Nutritional Physiological Phenomena; D001068:Feeding and Eating Disorders / Q000175:diagnosis* / Q000178:diet therapy / Q000628:therapy; D005260:Female; D015577:Geriatric Assessment; D006785:Hospitals, University; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D015596:Nutrition Assessment; D009752:Nutritional Status; D018529:Nutritional Support; D010349:Patient Compliance; D064787:Portion Size; D057285:Precision Medicine; D015995:Prevalence; D012306:Risk; D013548:Sweden / Q000453:epidemiology; D000078329:Workforce
keywords: Appropriate diet; Food prescription; Geriatric patients; Mini nutritional assessment; Portion size