Energy and protein intake adequacy in geriatric rehabilitation inpatients: A descriptive cohort study

Background: Indirect calorimetry (IC) provides an accurate measure of energy expenditure, which informs energy requirements. Achieving energy and protein requirements is fundamental in nutrition care. This study aims to determine if the energy requirements informed by IC and estimated protein requirements are met in geriatric rehabilitation inpatients receiving dietitian-led individualized nutrition care. Methods: Geriatric rehabilitation inpatients referred to dietitians were included. Resting metabolic rate was measured using IC at inclusion in the study and within 48 h before discharge. Food intake was assessed using plate waste observation. The patient's energy requirement was calculated using the resting metabolic rate and physical activity factor and adjusted for the weight goal. Protein requirements were estimated by the dietitian. The energy and protein intake adequacy was calculated as a percentage of the individual requirement and defined “adequate” if ≥100%. Results: Fifty-three patients were included (mean age, 84.3 [standard deviation, 8.44] years; 22 [41.5%] women). The median energy and protein intake adequacy was 101.7% (interquartile range [IQR], 76.4–112.9) and 87.6% (IQR, 71.9–122.2) at the start of the nutrition care (n = 53) and 99.9% (IQR, 63.9–113.8) and 80.1% (IQR, 65.1–99.6) at discharge (n = 29), respectively. Only 15 of 53 (28.3%) patients at the start of nutition care and 6 of 29 (20.7%) patients at discharge achieved both energy and protein intake adequacy. Conclusions: Energy requirements were met, but the protein requirements were not met in geriatric rehabilitation inpatients receiving nutrition care. However, less than one-third of patients achieved both energy and protein intake adequacy.