The Nutritionist's Educational Intervention on the Protein Intake in Hospitalized Elderly People

Study Overview
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Brief Summary
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The food intake is often compromised in the elderly, and during hospitalization, dietary restrictions may be imposed, making them more susceptible to the risk of malnutrition and sarcopenia. It is essential to make an early identification of the elderly with low intake and involve them in their self-care. The aims will be assess the influence of the nutritionist's educational action to increase protein intake in elderly patients, to analyze the knowledge on its importance in the prevention of sarcopenia and to identify the prevalence of nutritional risk. This is a field, prospective, correlational, comparative and randomized study. The elderly patients will be randomized into a Control Group and Intervention Group.

Detailed Description
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The Control Group will follow the flow of nutritional assessment and monitoring while the Intervention Group will receive daily visits to monitor food intake, leaflet and educational video on the importance of protein and its source foods. In both groups, a questionnaire on knowledge of protein sources and its importance will be applied, and we will calculated the 24-hour recall of a regular day and for three days of hospitalization. Patients will be assessment by Mini Nutritional Assessment-Short Form and SARC-F and will be the measurements of calf circumference and hand grip strength.

Official Title
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Does the Nutritionist's Educational Intervention Influence Protein Intake in Hospitalized Elderly People?

Conditions
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Old Age; Cachexia, Dietary Habits, Sarcopenia, Protein Malnutrition, Patient Participation

Intervention / Treatment
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* Other: educational intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: elderly patients aged 60 years or older, with a prescription of oral feeding, exclusively, minimum period of three days. Exclusion Criteria: palliative care, treatment for chronic renal failure, patients with neurological deficit and dysphagia, readmissions during the study, receiving enteral and/or parenteral nutritional therapy, patients in isolation.

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: A prospective, correlational, comparative and randomized study, with hospitalized elderly over 60 years, at a private hospital. Patients will be randomized through a numerical sequence list, into Intervention Group (IG) or Control Group (CG). Before the nutritionist performs the first assessment, the envelope to determine which group the patient would be allocated will be selective. The CG will follow the flow of nutritional assessment and monitoring while the IG will receive daily visits to monitor food intake, leaflet and educational video on the importance of protein and its source foods. In both groups, a questionnaire on knowledge of protein sources and its importance will be applied, and we will calculated the 24-hour recall of a regular day and for three days of hospitalization. Patients will be assessment by Mini Nutritional Assessment-Short Form and SARC-F and will be the measurements of calf circumference and hand grip strength.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control Group<br>This group will follow the hospital's standard nutritional assessment and monitoring flow: 24-hour recall: patients will be interviewed to report about one day of their usual diet. Application of a questionnaire: to assess the knowledge about the importance of protein intake in the prevention of sarcopenia and functionality, and whether the participant regularly performs physical activity. Energy and protein needs: estimated according to the clinical status and patient associated pathologies. The protocol of the Clinical Nutrition Service will be followed. Calculation of the Body Mass Index (BMI) Nutritional risk was determined using the Mini Nutritional Assessment-Short Form Screening for sarcopenia: SARC-F ,Calf Circumference and Hand Grip Strength | |
| Active Comparator: Intervention Group<br>In this group, the steps below are added: On the first day, the delivery of the leaflet on the importance of nutrition in the hospital environment will be added in addition to verbal guidance. On the second day, an educational institutional video with duration of two minutes, will be shown with the title Food Intake and Oral Supplement in Nutritional Rehabilitation via tablet or mobile phone. When the 24-hour recall will be collected, an assessment of food intake will be performed, mainly of foods that are sources of protein and, when they were less than 75%, strategies must be designed to increase the acceptance or indication of oral nutritional supplements (ONS). | Other: educational intervention<br>* In this group, the steps below are added:on the first day, the delivery of the leaflet on the importance of nutrition in the hospital environment will be added in addition to verbal guidance. On the second day, an educational institutional video with duration of two minutes, will be shown with the title Food Intake and Oral Supplement in Nutritional Rehabilitation via tablet or mobile phone. When the 24-hour recall will be collected, an assessment of food intake will be performed, mainly of foods that are sources of protein and, when they were less than 75%, strategies must be designed to increase the acceptance or indication of oral nutritional supplements.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total energy and protein needs and intakes from dietary and oral nutritional supplements during hospitalization, according to the study group | Energy and protein intakes per kg of actual body weight and per day | three days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Assessment and screening of sarcopenia risk by SARC-F questionnaire | Patients who present a result greater than or equal to 4 of this questionnaire are classified as risk of sarcopenia | one day (first day of assessment) | 
| Assessment of low muscle strength | The values that discriminate the altered exam are different for each age and sex. The result will be expressed as normal or low muscle strength | one day (first day of assessment) | 
| Assessment of low muscle mass by measuring the calf circumference | the cutoff points of 33cm for females and 34cm for males were used | one day (first day of assessment) | 
| Assessment and screening of nutritional risk | Assessment by Mini Nutritional Assessment-Short Form, it has the three classifications: 0-7 points: malnourished; 8 -11 points: at risk of malnutrition; or 12-14 points: well-nourished | one day (first day of assessment) | 
| Dietary prescription of hospitalized elderly | to evaluate the number of hospitalized elderly who remained with salt and sugar restriction in the diet, according to medical prescription | three days | 
| Questionnaire on previous knowledge of protein source foods and sarcopenia | The questionnaire has 9 questions related to knowledge of protein source foods and their importance on health and impact when consumption is not adequate. The last question is about physical activity, to assess how many patients follow the World Health Organization's recommendation. Was evaluated how many patients answered the questions correctly and how many practiced physical activity | one day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Sarcopenia, Nutritional Supplements, Malnutrition, Hospitalized Patients, Elderly, Patient-Centered Care, Food Intake, Protein