Estimation of Calorie and Protein Intake/Consumption
in Aged Patients
Calorie & Protein Study Background
Weight loss results from a negative energy balance, a situation where
energy intake does not match energy requirements. Estimates of patient
calorie consumption in hospitals are not performed routinely because of
technical difficulties. 3 studies were carried out to investigate the
meal-portion method as a tool for estimating calorie and protein intakes
in clinical situations.
Calorie & Protein Study Methods
The meal-portion method was designed to estimate calorie and protein consumption
from the portion of the food items actually eaten by the patient, which
is evaluated at the time plates and dishes are cleared away. Study 1 tested
accuracy of the MP method in 50 meals by comparison to food weighing.
Study 2 evaluated the validity of estimates obtained by a physician, a
member of nursing staff, and a dietician in 30 elderly patients. Study
3 evaluated the robustness and feasibility of the method by comparing
estimates obtained by nursing staff (after 1 year of practice with no
additional training) and that of a dietician.
Calorie & Protein Study Results
Comparison of estimates and true values (obtained by weighing) showed
a mean difference of -2 kcal/-0.8 g of protein from evaluations of one-half
portions of food (50 meals) and -7 kcal/-1.0 g of protein from one-quarter
portions of food; the difference was only significant for protein and
one-quarter portions. When evaluations were performed by observers of
different professional categories (nursing staff, physicians, and dieticians)
on actual meals consumed by 30 elderly people afflicted with disease,
no statistical differences were shown. This interobserver agreement remained,
regardless of the cognitive or physical status of the patient. A third
study, performed after 1 year of no additional training, showed that the
meal-portion method is robust, but prone to clerical errors.
Calorie & Protein Study Conclusion
Valid estimates of calorie and protein consumption can be obtained with
the meal-portion method, quoting in one-half portions. Quality controls
are required both at the food production site (to avoid propagation of
errors arising from food composition) and in data collection (to eliminate
clerical mistakes). These results suggest that the MP method could be
a tool for estimating calorie and protein intakes in many clinical situations.
Source: 2002 The Gerontological Society
of America.
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