title: To eat or not to eat? Indicators for reduced food intake in 91,245 patients hospitalized on nutritionDays 2006-2014 in 56 countries worldwide: a descriptive analysis.
abstract: Inadequate nutrition during hospitalization is strongly associated with poor patient outcome, but ensuring adequate food intake is not a priority in clinical routine worldwide. This lack of priority results in inadequate and unbalanced food intake in patients and huge amounts of wasted food.
  
  
  
  We evaluate the main factors that are associated with reduced meal intake in hospitalized patients and the differences between geographical regions.
  
  
  
  We conducted a descriptive analysis of data from 9 consecutive, annual, and cross-sectional nutritionDay samples (2006-2014) in a total of 91,245 adult patients in 6668 wards in 2584 hospitals in 56 countries. A general estimation equation methodology was used to develop a model for meal intake, and P-value thresholding was used for model selection.
  
  
  
  The proportion of patients who ate a full meal varied widely (24.7-61.5%) across world regions. The factors that were most strongly associated with reduced food intake on nutritionDay were reduced intake during the previous week (OR: 0.20; 95% CI: 0.17, 0.22), confinement to bed (OR: 0.49; 95% CI: 0.44, 0.55), female sex (OR: 0.53; 95% CI: 0.5, 0.56), younger age (OR: 0.74; 95% CI: 0.64, 0.85) and older age (OR: 0.80; 95% CI: 0.74; 0.88), and low body mass index (OR: 0.84; 95% CI: 0.79, 0.90). The pattern of associated factors was homogenous across world regions.
  
  
  
  A set of factors that are associated with full meal intake was identified and is applicable to patients hospitalized in any region of the world. Thus, the likelihood for reduced food intake is easily estimated through access to patient characteristics, independent of world regions, and enables the easy personalization of food provision. This trial was registered at clinicaltrials.gov as NCT02820246.
authors.affiliation: Department of Internal Medicine III, Division of Endocrinology and Metabolism, karin.schindler@meduniwien.ac.at.
authors.forename: Karin
authors.initials: K
authors.lastname: Schindler
authors.affiliation: Core Unit for Medical Statistics and Informatics.
authors.forename: Michael
authors.initials: M
authors.lastname: Themessl-Huber
authors.affiliation: Division of Cardiac-, Thoracic-, Vascular Anesthesia and Intensive Care, and.
authors.forename: Michael
authors.initials: M
authors.lastname: Hiesmayr
authors.affiliation: Division of Cardiac-, Thoracic-, Vascular Anesthesia and Intensive Care, and.
authors.forename: Sigrid
authors.initials: S
authors.lastname: Kosak
authors.affiliation: Departments of Cardiology and.|Research and Education, General Hospital Celje, Celje, Slovenia.
authors.forename: Mitja
authors.initials: M
authors.lastname: Lainscak
authors.affiliation: Department of Clinical Medicine, University La Sapienza, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Laviano
authors.affiliation: Faculty of Medicine and Health, School of Health and Medical Sciences, Department of Surgery, Örebro University; Örebro, Sweden.
authors.forename: Olle
authors.initials: O
authors.lastname: Ljungqvist
authors.affiliation: Division of Cardiac-, Thoracic-, Vascular Anesthesia and Intensive Care, and.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Mouhieddine
authors.affiliation: Gastroenterology and Nutrition, Archet University Hospital, Nice, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Schneider
authors.affiliation: Department of Nutrition and Dietetics, Vrije Universiteit, Medical Center, Amsterdam, Netherlands.
authors.forename: Marian
authors.initials: M
authors.lastname: de van der Schueren
authors.affiliation: Core Unit "Nutrition and Clinical Phenotyping," Integrated Research and Treatment Center AdiposityDiseases, University of Leipzig, Leipzig, Germany.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Schütz
authors.affiliation: Section for Medical Expert and Knowledge-Based Systems, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Schuh
authors.affiliation: Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Petah Tikva, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; and.
authors.forename: Pierre
authors.initials: P
authors.lastname: Singer
authors.affiliation: Core Unit for Medical Statistics and Informatics.
authors.forename: Peter
authors.initials: P
authors.lastname: Bauer
authors.affiliation: Geneva University Hospital, Geneva, Switzerland.
authors.forename: Claude
authors.initials: C
authors.lastname: Pichard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D004435:Eating; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D005521:Food Service, Hospital; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D008297:Male; D062407:Meals; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: disease-related malnutrition; food intake; hospital; mobility; patient sex; undernutrition