Protein and energy intake improved by in-between meals: An intervention study in hospitalized patients

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Background/aim: Disease related malnutrition is a major problem in hospitals. Malnutrition in hospitalized patients is caused by many factors. Among these factors are decreased appetite and early satiety, and reaching nutritional requirements in nutritional risk patients is a challenge when using ordinary energy and protein dense food. The aim of this study was to examine if total protein and energy intake in medical and surgical patients at nutritional risk could be improved by protein fortified and energy rich in-between meals. Methods: An assortment of fortified in-between meals including 10 g of protein was developed based on patient preferences and served in the Departments of Lung Medicine and Abdominal Surgery for a period of three months. Nutrition intake was recorded before and after intervention. Results: Food intake records were collected from a total of 92 patients, (46 before and 46 after intervention). The total amount of protein intake per in-between meal was increased from 2,6 g to 10,3 g. Total daily protein intake increased from 49% to 88% (p < 0.00) and total energy intake from 74% to 109% (p < 0.00) of requirements. Conclusion: Protein and energy intake for surgical and medical patients at in-between meals as well as total daily intake increased significantly. Recommended average level for individually measured requirements was reached.

Original languageEnglish
JournalClinical Nutrition ESPEN
Pages (from-to)113-118
Number of pages6
Publication statusPublished - 1 Apr 2019


  • Protein and energy intake
  • hospitalized patients
  • intervention study
  • Patients
  • Energy-protein malnutrition
  • Food fortification
  • Protein fortification
  • Product development
  • Hospital meals
  • In-between meals


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