Journal of Clinical Nutrition and Metabolism

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Monitoring of Nutrition Intake in Hospitalized Patients: Can We Rely on the Feasible Monitoring Systems?

Rationale: Monitoring nutrition intake provides the basis for decision making on nutrition therapy in patients at nutritional risk and provides data on efficacy in nutrition intervention studies. Sufficient monitoring seems however difficult to achieve, and little is known about the specificity of current practises. This study aimed to investigate whether the nurses’ quartile nutrition registration method and the 24-hour recall dietary interview, may be used as a valid indication of a patient's energy- and protein intake in daily practice as well as clinical research, with regard to accuracy and feasibility.

Methods: For four week days, patients at nutritional risk admitted to Department of Medical Gastroenterology had all oral nutrition intakes measured by the nurses’ quartile nutrition registration method, the 24-hour recall dietary interview, single item weighed method, and the Dietary Intake Monitoring System [DIMS]. Statistical evaluation was performed between the three first methods, and a narrative assessment was made for the feasibility of the DIMS. Results: The 32 patients consumed on average 6755.5 ± 4921.2 kJ/day. Average protein intake was 54.5 ± 36.7 G/day. Average requirement was 6953 kJ/day and 80.8g protein/day. Overall, the nurses’ registration was well associated with the weighed method for energy as well as protein, with a slight but insignificant overestimation. The 24-hour dietary recall underestimated average total intake (E and P) significantly compared to the weighed method, mainly caused by underestimation of snacks and in particular lunch and drinks. However the difference may in a clinical point of view, be reasonable correlated to the weighed food record. The DIMS was found very positive for further development. Conclusion: The nurses’ quartile method for registration of food intake is practicable and sensitive enough for clinical practice as well as for research purposes. The 24-hour dietary recall interview is found less sensitive, however sensitive enough for decision-making in clinical practice. Not all patients were able to comply with the 24-hour recall interview.

The DIMS seems promising in individual planning of nutritional therapy.

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