BMJ  2006;332:1334-1335 (3 June), doi:10.1136/bmj.332.7553.1334-d

Letter

Benefits of family mealtimes for nursing home residents

Protecting mealtimes may similarly benefit elderly inpatients

EDITOR—The study by Nijs et al of Dutch elderly nursing home residents showed that improving the ambience at mealtimes prevents a decline in body weight.¹ A decline in nutritional status during hospital stay may be the result not only of illness but also of problems with feeding and catering policies, such as poor environment, lack of help with eating, and interruption of meals by procedures and ward rounds.² Another reason is limited time available to eat each meal in the hospital.³

In the United Kingdom protecting mealtimes is an imaginative solution to improve nutrition of hospital patients in the better hospital food programme of the Department of Health. We conducted a pilot study in two medical wards for elderly patients at Castle Hill Hospital in West Yorkshire to check the effect of protected mealtimes in elderly hospital patients. The intervention was protection for an hour during lunchtime and evening mealtimes. It was an open study with four months interval between control (17 patients) and intervention (22 patients).

We found that protecting mealtimes helped in preventing weight loss (0.19 kg/week compared with 0.25 kg/week) and reduction in hand grip strength (0.53 kg v0.60 kg). Mid-arm circumference increased with mealtime protection (0.03 cm/week), whereas a reduction (0.02 cm/week) occurred in the control group (P = 0.056). Interestingly, we did not find protecting mealtimes to improve the food intake (calories: 1121/day v 1275/day; protein: 44 g/day v 50 g/day).

Similar studies showed equivocal results in the past among elderly hospital patients as mentioned by Milne et al.⁴ As the protection of mealtimes has consequences for medical care an equivalence trial would be worth while.

Pontefract General Infirmary, Pontefract WF8 1PL abhaylopa{at}yahoo.co.uk

Hull and East Yorkshire Hospitals NHS Trust, Hull HU3 2JZ

Department of Biostatistics, University of Leeds, Leeds LS2 9LN

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Competing interests: None declared.

References

1. Nijs KAND, de Graaf C, Kok FJ, Staveren WA. Effect of family style mealtimes on quality of life, physical performance, and body weight of nursing home residents: cluster randomised controlled trial. BMJ 2006;332: 1180-4. (20 May.)[Abstract/Free Full Text]
2. Allison S. Institutional feeding of the elderly. Curr Opin Clin Nutr Metab Care 2002;5: 31-4.[Medline]
3. Sydner YM, Fjellstrom C. Food provision and the meal situation in elderly care-outcomes in different social contexts. J Hum Nutr Dietet 2005;18: 45-52.[Medline]
4. Milne AC, Avenell A, Potter J. Improved food intake in frail older people. BMJ 2006; 1166. (20 May.)

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Relevant Article

Effect of family style mealtimes on quality of life, physical performance, and body weight of nursing home residents: cluster randomised controlled trial

Kristel A N D Nijs, Cees de Graaf, Frans J Kok, and Wija A van Staveren
BMJ 2006 332: 1180-1184. [Abstract] [Full Text] [PDF]