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. (C) 2021 Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism.