Nutritional assessment of hospitalized medical patients

A sample of 93 adult hospitalized medical (non surgical) patients were recruited from five different hospitals in Beirut. The regular and therapeutic diets of the hospitals were assessed for nutritional adequacy. Nutritional assessment of the patient was done by recording actual food intake from the hospital diet and by obtaining anthropometric and hematological measurements. Among the anthropometric parameters used were body weight, height, triceps skinfold thickness , mid-arm circumference and mid-arm muscle circumference. The clinical parameters evaluated were total lymphocyte count, hemoglobin and hematocrit. Triceps skinfold was the only parameter to identify a relatively high prevalence of mild to moderate depletion was 25.8, 35.4, and 29 of patients as indicated by triceps skinfold thickness, mid-arm circumference and mid-arm muscle circumference respectively. In case of hematological indices, 21.5 were having deficient total lymphocyte count, 20.4 of the patients had deficient hemoglobin and 23.6 had deficient hematocrit as compared to standard values. A computer dietary analysis program was used to calculate the nutritive composition of the hospital regular, soft, and diabetic diets served to, and eaten by the patients. The adequacy of these diets were evaluated by measuring amount of different food served at each meal for a period of three days. Results obtained showed that most hospital diets were low in the following: folacin, vitamin B6, vitamin D, zinc, and copper, vitamin C was low only at one hospital. The amount of food consumed were evaluated according to the average of three days food intake. Food consumed by the patients was low in calcium, iron, zinc, copper, vitamin A, vitamin B12, vitamin B6, folic acid, ascorbic acid, vitamin D and riboflavin in majority of the patients at the different hospitals. Only 11.8 of the patients had low caloric intake. These findings demonstrate that hospital diets are inadequate in some of the essential nutrients and that patient's food intake is deficient in a number of vitamins and minerals. Serious measures for improving quality and appeal of hospital diets are recommended.