Study finds malnutrition is ‘rampant’ in US hospitals

Is your loved one getting the right amount of nutrients in the hospital?

Hospitals are not known for having the most gourmet food options, but a new study shows that patients are not finishing their meals and that can cause more health problems.

Just over half (51 percent) of patients leave most of their meals uneaten while staying in the hospital, a study released Wednesday from health nonprofit nutritionDay Worldwide found. Not eating well-rounded meals while staying in the hospital can increase patients’ risk of health complications and delay recovery, the study, published in peer-reviewed Journal of Parenteral and Enteral Nutrition, concluded.

“Malnutrition can be invisible to the eye and is rampant in US hospitals because it’s not always top of mind,” said Gail Gewirtz, president and founder of nutritionDay in the US. “Our data shows that one warning sign — poor food intake — is very common in hospitals and this is something health-care providers can easily look out for and address.’’ (The American Hospital Association declined to comment.)

Researchers surveyed nearly 10,000 patients from 245 US hospitals and found that one in three hospitalized adults is at risk of malnutrition. Adults who ate none of their food had a nearly six times higher risk of death than those who ate some food, the study said.

Of course, patients may not finish their food because they are sick and simply don’t feel like eating three meals per day. “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 Abby Sauer, a registered dietitian at Abbott Laboratories and lead author of the study.

“Hospital malnutrition is a public health problem globally, affecting approximately 30 percent to 50 percent of patients,” the study added. “Often patients enter the hospital malnourished or at risk of malnutrition and experience nutrition decline during their stay, placing them at higher risk for adverse outcomes following hospital discharge.”

Hospitals serve more than 6.3 million employees and 481 million patients each year, according to the Centers for Disease Control and Prevention. The health organization released a “health hospital tool kit” in 2014 to help hospitals “ensure that the healthier choice is the easier choice” for patients, employees and visitors.

The CDC suggested more fruits, whole nuts and vegetables for vending machines and fewer packaged chips and candies and sugary drinks and diet sodas. For cafeteria food, the CDC suggests promoting healthy serving sizes and minimizing advertising of unhealthy options like fries, pies, pizzas or cheeseburgers.

Many hospitals are working to make changes. In 2017, the American Medical Association, a professional society representing more than 200,000 physicians, called on hospitals to reduce unhealthy foods including sugar-sweetened beverages and processed meats.

In 2018, food nonprofit Northwell Health hired a Michelin-starred chef to rehabilitate food services at 23 New York hospitals.

In addition to improving food options, the nutritionDay Worldwide study suggested increased attention to nutrition.

The study was conducted in collaboration between nutritionDay and Abbott. Abbott, the pharmaceutical company behind the study, produces nutritional beverages and, as such, has a vested interest in selling them to patients. Abbott provided funding for the study, but the authors said the data was independently collected by nutritionDay. (There’s more information on the methodology here.)

Methods for treating malnutrition vary by hospital and some doctors have criticized sugary meal supplements and replacements as being unhealthy for patients. Some 50 percent to 60 percent of patients do not eat all of a meal that is offered, a 2016 study from the Medical University of Vienna found. Its survey of 91,245 patients was published in the The American Journal of Clinical Nutrition.

That study showed methods like evaluating patients’ eating habits, offering frequent snacks and coaching relatives on how to encourage patients to eat can be helpful in reducing malnutrition among patients.