We like to think that our hospitals provide just about anything a patient might need, including meals with the nutrients they need to thrive and survive. But in reality, malnutrition is a widespread problem in hospitals, despite the focus on providing nutritious, balanced meals. Moreover, a new study suggests that the inability to eat those meals is a marker of malnutrition in hospital patients. In addition, diminished food intake is associated with a higher risk of in-hospital death.

What Did The Study Find?

According to the report in The Journal of Parenteral and Enteral Nutrition, about 1 in 3 hospital patients (32%) eat a quarter or even less of the meals they’re provided. In the study, Abby Sauer of the Columbus, Ohio-based Abbott Nutrition Center (which funded the study) and colleagues looked at 9,959 adult patients at a total of 245 hospitals who took part in the nutritionDay survey between 2009 and 2015. The nutritionDay survey is a one-day, cross-sectional survey of food-related factors conducted annually in hospitals and nursing homes around the world. 

Compared to patients who ate all of their meals, those who ate 25% or less were three times more likely to die during hospitalization. Patients who had the opportunity to eat, but did not consume any food, were six times more likely to die than those who ate their entire meals. In all, 51% of patients ate half or less of their meals, and only 11% of patients who ate none were given a nutrition supplement. The researchers looked at 30-day, in-hospital mortality after controlling for age, mobility, and other factors.

“Patients don’t always have the best appetite or desire to eat while in the hospital, so it’s important to create an environment and serve up options that promote optimal food intake,” said Sauer in a statement. “This study provides the most robust estimate of malnutrition risk in US hospitalized patients to date, finding that approximately 1 in 3 are at risk.”

What Can Healthcare Providers Do?

According to the study’s authors, a few things:

• Consider a consultation with a registered dietitian nutritionist for patients with a low appetite, special needs, or risk factors.

• Help patients with impairments or limited mobility by opening the packaging, preparing utensils, and removing anything that may interfere with a patient’s desire to eat.

• Ensure your facility has a backup plan to provide food to patients who miss a meal.

• Provide a supplement drink to patients struggling to eat solid food, have poor food intake, or may be malnourished.

• If you are a patient yourself, talk to healthcare providers about proper nutrition and ask to see a dietitian to discuss nutrition needs both in the hospital and after discharge.