title: A foodservice approach to enhance energy intake of elderly subacute patients: a pilot study to assess impact on patient outcomes and cost.
abstract: effective strategies are required to support the nutritional status of patients.
  
  
  
  to evaluate a foodservice nutrition intervention on a range of participant outcomes and estimate its cost.
  
  
  
  parallel controlled pilot study.
  
  
  
  subacute hospital ward.
  
  
  
  all consecutively admitted adult patients were eligible for recruitment under waiver of consent.
  
  
  
  the intervention was a modified hospital menu developed by substituting standard items with higher energy options. The control was the standard menu. All participants received usual multidisciplinary care. Outcomes were change in weight and hand grip strength (HGS) between admission and day 14 and; energy and protein intake and patient satisfaction with the foodservice at day 14. The additional cost of the intervention was also estimated.
  
  
  
  the median (interquartile range) age of participants (n = 122) was 83 (75-87) years and length of stay was 19 (11-32) days. One-third (38.5%) were malnourished at admission. There was no difference in mean (SD) HGS change (1.7 (5.1) versus 1.4 (5.8) kg, P = 0.798) or weight change (-0.55 (3.43) versus 0.26 (3.33) %, P = 0.338) between the intervention and control groups, respectively. The intervention group had significantly higher mean (SD) intake of energy (132 (38) versus 105 (34) kJ/kg/day, P = 0.003) and protein (1.4 (0.6) versus 1.1 (0.4) g protein/kg/day, P = 0.035). Both groups were satisfied with the foodservice. The additional cost was £4.15/participant/day.
  
  
  
  in this pilot, the intervention improved intake and may be a useful strategy to address malnutrition. Further consideration of clinical and cost implications is required in a fully powered study.
authors.affiliation: Department of Nutrition and Dietetics, Monash University, Level 1, 264 Ferntree Gully Road , Notting Hill, Victoria 3168, Australia.
authors.forename: Jorja
authors.initials: J
authors.lastname: Collins
authors.affiliation: Department of Nutrition and Dietetics, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, Victoria 3168, Australia.|Department of Dietetics, Eastern Health, 5 Arnold Street, Box Hill, Victoria, Australia.
authors.forename: Judi
authors.initials: J
authors.lastname: Porter
authors.affiliation: Department of Nutrition and Dietetics, Monash University, Level 1, 264 Ferntree Gully Road , Notting Hill, Victoria 3168, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Truby
authors.affiliation: Department of Nutrition and Dietetics, Monash University, Level 1, 264 Ferntree Gully Road , Notting Hill, Victoria 3168, Australia.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Huggins
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003362:Cost-Benefit Analysis; D004044:Dietary Proteins / Q000008:administration & dosage*; D004435:Eating; D002149:Energy Intake; D004734:Energy Metabolism; D005260:Female; D005521:Food Service, Hospital / Q000191:economics*; D015577:Geriatric Assessment / Q000379:methods; D018737:Hand Strength; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000178:diet therapy* / Q000191:economics* / Q000503:physiopathology; D008612:Menu Planning; D015596:Nutrition Assessment; D009752:Nutritional Status; D017060:Patient Satisfaction; D010865:Pilot Projects; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D014739:Victoria; D015430:Weight Gain
chemical_list: D004044:Dietary Proteins
keywords: cost; foodservice; malnutrition; nutrition intervention; older people; subacute care