Student dietitians discuss the importance of good nutrition and hydration
16 March marks the start of Nutrition and Hydration week!
Student Dietitians Catherine and Vasiliki have come together to highlight and promote the provision of nutrition and hydration for our patients.
In the UK, 3 million individuals are estimated to be malnourished or at risk of malnutrition. Prevention of malnutrition and dehydration can improve patient’s health and well-being as well as reducing hospital length of stay. With increasing financial pressures on the NHS, addressing preventative measures for malnutrition is an important area to focus on.
On Monday 16 March, there will be an information stand St’ Barts Hospital to provide some information advice on how those going through radiotherapy can optimise their nutrition and hydration and how our staff can best support patients.
Why is nutrition important for patients?
During periods of illness, patients are at higher risk of malnutrition because they may not be getting enough energy, protein or other nutrients to meet their nutritional requirements. This can be either due to burden of the disease, side effects of treatment or various other related complications that can affect appetite, food digestion and absorption. Malnutrition is best detected using the validated Malnutrition University Screening Tool (MUST) (Elia, 2003). This screening tool accounts for BMI, unplanned weight loss in the past 3 - 6 months, acute illness or no nutritional intake for more than 5 days. It is a quick and easy way of identifying at risk patients, e.g. those with a MUST score of 2+, who can then benefit from interventions such as dietary counselling, food fortification and oral nutritional supplements.
Treating Malnutrition - Oral Nutritional Supplements
If a patients’ energy and protein needs cannot be met through food alone and a patient scores 2 or more on the MUST screening tool, oral nutritional supplements (ONS) can be considered. The aim of ONS is to increase the energy and/or protein intake of the diet to ultimately optimise their nutritional status. ONS are available in many different forms to suit a wide range of needs and preferences. Below is a table outlining some of the different types available to patients in the Trust. Their use should be constantly monitored and reviewed to ensure they are appropriate for the patients’ needs.
|
Type |
Examples |
Rationale for use |
|
Milk-based type |
Fresubin Energy, Fresubin 2kcal, Fresubin 3.2kcal |
Nutritious and available in a wide range of flavours to suit patient taste. Fibre options available too. |
|
Juice type |
Fresubin Jucy |
Fat free and an alternative for patients that do not enjoy milk based drinks |
|
High protein |
Fresubin Protein Energy |
For patients with higher protein requirements e.g. in cancer patients |
|
High energy powders |
Calshake |
For patients that can tolerate higher volumes, ideally to be made with ~200ml blue top whole milk to provide both energy and protein |
|
Low volume but high energy (shots) |
Fresubin 5kcal, |
For patients with little appetite but high energy requirements |
|
Semi-solid type |
Fresubin 2kcal Crème |
Provide a mousse like texture that is smooth but semi-solid for patients |
Conclusion
In summary, all in-patients should be screened for malnutrition using the MUST tool. For patients who are malnourished or at risk of malnutrition, nutritional support can be considered to optimise clinical outcomes and shorten hospital stay.