Skip to main content Accessibility help
×
Home

The effect of conventional v. à la carte menu on energy and macronutrient intake among hospitalized cardiology patients

  • Camilla S. Larsen (a1) and Søren Toubro (a1)

Abstract

Undernutrition among hospitalized patients is highly prevalent. In contrast, the obesity pandemic is increasing in prevalence among all, including cardiology patients. The dietary challenge during hospitalization is to provide a healthy diet that stimulates the appetite and is suitable for both patients at risk of undernutrition and of cardiovascular events. The aim of the present study was to compare energy and macronutrient intake between a conventional hospital menu (Fixed) with a concept providing free serving hours and ad libitum intake à la carte (Free) among cardiology patients. The comparison was done between concepts for all lean (BMI < 25 kg/m2) and overweight and obese (BMI ≥ 25 kg/m2) patients and subgroups. Food intake was registered during a 3-week period on Fixed for forty-eight randomly selected patients and later by two similar time periods on Free1 for twenty-eight and Free2 for thirty-seven other patients. Free compared with Fixed increased the energy intake – but not above requirement – among the obese only (P < 0·001; Free v. Fixed). This was explained by an increase in the relative fat intake of 50 % (P < 0·001) and 37 % (P < 0·001) for Free1 and Free2 respectively. During Free1, the relative fat intake correlated positively with BMI (r 0·6; P < 0·01), and the relative carbohydrate intake negatively with BMI (r − 0·7; P < 0·01); the same pattern was seen during Free2, although insignificant. We conclude that the introduction of an ad libitum à la carte kitchen (Free) to cardiology patients slightly increases the average nutritional intake, but contains a potential health hazard for overweight cardiovascular patients, due to the selection of high-fat dishes and decreased carbohydrate intake. This emphasises the need for improvement in fat sources and in dietary advice when an ad libitum concept is applied during hospitalization.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      The effect of conventional v. à la carte menu on energy and macronutrient intake among hospitalized cardiology patients
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      The effect of conventional v. à la carte menu on energy and macronutrient intake among hospitalized cardiology patients
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      The effect of conventional v. à la carte menu on energy and macronutrient intake among hospitalized cardiology patients
      Available formats
      ×

Copyright

Corresponding author

*Corresponding author: Associate Professor Søren Toubro, fax +45 3632 3789, email st@life.ku.dk

References

Hide All
McWhirter, JP & Pennington, CR (1994) Incidence and recognition of malnutrition in hospital. BMJ 308, 945948.
Waitzberg, DL, Caiaffa, WT & Correia, MITD (2001) Hospital malnutrition: The Brazilian National Survey (IBRANUTRI): a study of 4000 patients. Nutrition 17, 573580.
Kondrup, J, Johansen, N, Plum, LM, Bak, L, Larsen, IH, Martinsen, A, Andersen, JR, Bærnthsen, H, Bunch, E & Lauesen, N (2002) Incidence of nutritional risk and causes of inadequate nutritional care in hospitals. Clin Nutr 21, 461468.
Rasmussen, HH, Kondrup, J, Staun, M, Ladefoged, K, Kristensen, H & Wengler, A (2004) Prevalence of patients at nutritional risk in Danish hospitals. Clin Nutr 23, 10091015.
Sullivan, DH (1999) Protein-energy undernutrition among elderly hospitalized patients. A prospective study. JAMA 281, 20132019.
Edington, J, Boorman, J, Durrant, ER, et al. (2000) Prevalence of malnutrition on admission to four hospitals in England. Clin Nutr 19, 191195.
Bacquer de, D, Backer de, G, Cokkinos, D, Keil, U, Montaye, M, Östör, E, Pyörälä, K & Sans, Sfor EUROASPIRE II Study Group (2004) Overweight and obesity in patients with established coronary heart disease: are we meeting the challenge? Eur Heart J 25, 121128.
Lorgeril, M, Renaud, S, Mamelle, N, Salen, P, Martin, J-L, Monjaud, I, Guidollet, J, Touboul, P & Delaye, J (1994) Mediterranean α-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet 343, 14541459.
Ornish, D, Scherwitz, LW, Billings, JH, et al. (1998) Intensive lifestyle changes for reversal of coronary heart disease. JAMA 280, 20012008.
American Heart Association (2002) AHA Guidelines for primary prevention of cardiovascular disease and stroke: 2002 update. Circulation 106, 388391.
Pedersen, AN & Ovesen, L (2000) Dietary recommendations for institutions in Denmark. 3rd ed, pp. 5963. Søborg, Denmark: Fødevaredirektoratet.
Mathey, MF, Vanneste, VGG, de Graff, C, de Groot, LC & van Staveren, WA (2001) Health effect of improved meal ambience in a Dutch nursing home: a 1-year intervention study. Prev Med 32, 416423.
Mathey, MF, Siebelink, E, de Graff, C & van Staveren, WA (2001) Flavour enhancement of food improves dietary intake and nutritional status of elderly nursing home residents. J Gerontol Med Sci 56, 200205.
Nielsen, MA, Biltz, C, Freil, M, Gut, R & Almdal, TP (2004) Menu composition of evening meals increases energy and protein intake in patients with low nutritional intake and reduces waste. Ugeskr Læger 166, 267270.
Pedersen, UP (2005) Nutritional care: the effectiveness of actively involving older patients. J Clin Nurs 14, 247255.
Barton, AD, Beigg, CL, Macdonald, IA & Allison, SP (2000) A recipe for improving food intakes in elderly hospitalized patients. Clin Nutr 19, 451454.
Almdal, T, Viggers, L, Beck, AM & Jensen, K (2003) Food production and wastage in relation to nutritional intake in a general district hospital – wastage is not reduced by training the staff. Clin Nutr 22, 4751.
Kondrup, J, Allison, SP, Elia, M, Vellas, B & Plauth, M (2003) ESPEN Guidelines for Nutrition Screening 2002. Clin Nutr 22, 415421.
World Health Organization (1997) Obesity: Prevention and Managing the Global Epidemic. Report of a WHO Consultation on Obesity. Geneva, 3–5 June 1997. Geneva: WHO.
World Health Organization (1985) Energy and Protein Requirements. Joint FAO/WHO/UNU Expert Consultation. WHO Technical Report Series no. 724, pp. 7179. Geneva: WHO.
Johansen, N, Kondrup, J, Plum, LM, Bak, L, Nørregaard, P, Bunch, E, Bærnthsen, H, Andersen, JR, Larsen, IH & Martinsen, A (2004) Effect of nutritional support on clinical outcome in patients at nutritional risk. Clin Nutr 23, 539550.
Dupertuis, YM, Kossovsky, MP, Kyle, UG, Raguso, CA, Genton, L & Pichard, C (2003) Food intake in 1707 hospitalised patients: a prospective comprehensive hospital survey. Clin Nutr 22, 115123.
Allison, SP (2003) Hospital food as treatment. Clin Nutr 22, 113114.
Beck, AM, Balknäs, UN, Fürst, P, et al. (2001) Food and nutritional care in hospitals: how to prevent undernutrition – report and guidelines form the Council of Europe. Clin Nutr 20, 455460.
Gall, MJ, Grimble, GK, Reeve, NJ & Thomas, SJ (1998) Effect of providing fortified meals and between-meal snacks on energy and protein intake of hospital patients. Clin Nutr 17, 259264.
Mosca, L, Jones, WK, King, KB, Ouyang, P, Redberg, RF & Hill, MN, for the American Heart Association Women's Heart Disease and Stoke Campaign Task Force (2000) Awareness, perception, and knowledge of heart disease risk and prevention among women in the United States. Arch Fam Med 9, 506515.
Naudziunas, A, Jankauskiene, L, Kalinauskiene, E & Pilvinis, V (2005) Implementation of the patient education about cardiovascular risk factors into a daily routine of the cardiology unit of the hospital. Prev Med 41, 570574.
Aquilani, R, Boni, R & Verdiroso, S (2002) An organizational model to translate nutritional recommendations into routine clinical practice in secondary prevention of coronary artery disease. Prev Med 34, 138143.
World Health Organization (2003) Diet, Nutrition and the Prevention of Chronic Diseases. Report a Joint WHO/FAO Expert Consultation. Geneva, 28 January to 1 February 2002. Geneva: WHO.

Keywords

The effect of conventional v. à la carte menu on energy and macronutrient intake among hospitalized cardiology patients

  • Camilla S. Larsen (a1) and Søren Toubro (a1)

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed