Eat what you want and when you want. Effect of a free choice menu on the energy and protein intake of geriatric medical patients

BACKGROUND: Geriatric medical patients are often at nutritional risk when admitted to hospital. More flexible meal service concepts may prove successful in improving nutritional intake.

AIM: To evaluate whether the Free Choice Menu (FCM), a new room service resembling meal service concept, improves energy and protein intake in a population of geriatric medical patients compared with the traditional concept of serving meals from a trolley with a fixed menu (trolley).

METHODS: Data were collected consecutive in a geriatric ward at Slagelse Hospital (Denmark) before (autumn 2018; n = 98) and after (autumn 2020; n = 52) implementing the Free Choice Menu. Weighed dietary intake was recorded for three full days for each patient.

RESULTS: Energy and protein intake did not differ significantly when comparing the two meal service concepts (trolley: 6124 kJ; 52.6 g and FCM: 5923 kJ; 47.1 g) over three days. The FCM concept showed however a significantly higher energy and protein intake for the dinner (relative to the other meals), whereas a higher percentage of protein and energy intake was covered by oral nutritional supplements in the trolley concept. The majority of the participants met the recommendations for energy intake, while only a minority met the recommendations for protein intake. Plate waste was significantly lower (p = 0.0005) at the lunch meal for the FCM concept (15.6%) compared with the trolley concept (26.1%).

CONCLUSION: When implementing a FCM, energy and protein intake was maintained and patients received more energy and protein from the dinner and less from oral nutritional supplements. However, the introduction of a free choice of meals concept did not in itself ensure nutritional intake in geriatric medical patients.