Novel Meal Service Improves Nutritional Intake

Completed

Brief Summary: This study aims to investigate whether a novel meal service FoodforCare (FfC), comprising 6-protein-rich meals a day following proactive advice from a nutritional assistant, improves dietary intake and patient satisfaction, compared to the traditional 3-meals a day service (TMS).

Detailed Description: The investigators performed a quasi experimental study at medical (Gastroenterology) and surgical (Gynecology, Urology, Orthopedics) wards. Patients were offered TMS (July 2015 - May 2016; n=326) or FfC meal service (after stepwise introduction per ward from January 2016 - December 2016; n=311). Primary outcome was the mean percentage of protein and energy intake relative to requirements, between patients receiving TMS and those receiving FfC, on the first and fourth day of full oral intake. Patient satisfaction comprised rating of the experienced quality of the food and the meal service and by means of a validated questionnaire.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Traditional meal service	Meal service	TMS consists of three meals served by nutritional assistants throughout the day. Preference for dinner can be indicated in the morning by the individual patient from a menu list with predefined choices for meat, potatoes/rice/pasta and vegetables with various portion sizes.
FoodforCare	Meal service	FfC consists of a 6-meals per day service. At bedside, patients are offered one or more small protein-rich dishes from a choice of 3. Nutritional assistants play a key role in recommending and delivering these protein-rich meals and assist patient in choosing the most optimal dish, based on the patient's nutrition order in the electronic patient record.

Primary Outcome Measures

Name	Time	Method
Protein intake day 1 (gram)	1 day	The percentage of protein intake (gram) relative to requirements (1.2 gram/kilogram bodyweight) on the first day of full oral intake.
Protein intake day 4 (gram)	4 days	The percentage of protein intake (gram) relative to requirements (1.2 gram/kilogram bodyweight) on the fourth day of full oral intake.
Energy intake day 1 (kcal)	1 day	The percentage of energy intake (kcal) relative to requirements (Harris \& Benedict formula \* 1.3) on the first day of full oral intake.
Energy intake day 4 (kcal)	4 days	The percentage of energy intake (kcal) relative to requirements (Harris \& Benedict formula \* 1.3) on the fourth day of full oral intake.

Secondary Outcome Measures

Name	Time	Method
Patients' satisfaction (food appreciation and access to food)	3 day	Patients completed a questionnaire on food appreciation and experiences regarding food access on the third day of full oral intake in the hospital.
Patients' satisfaction (food quality and meal service)	3 day	Patients completed a questionnaire in which they rated the quality of the food and the meal service (scale 0-10) on the third day of full oral intake in the hospital.
Change in nutritional status (body weight)	4 days	Body weight (in kg) was measured prior to meals in the morning of the first and fourth day of oral intake.
Change in nutritional status (handgrip strength)	4 days	Handgrip strength (in kg) was measured prior to meals in the morning of the first and fourth day of oral intake.
Nutritional status (height)	1 day	Height (in cm) was measured prior to meals in the morning of the first day of oral intake.
Nutritional status (malnutrition universal screening tool)	1 day	Malnutrition universal screening tool (MUST)) was measured prior to meals in the morning of the first day of oral intake. Weight (kg) and height (cm) will be combined to report BMI in kg/m\^2.