Individualized Nutritional Intervention During and After Hospitalization: The Nutrition Intervention Study Clinical Trial
Abstract
Objectives To test the hypothesis that individualized nutritional treatment during and after discharge from acute hospitalization will reduce mortality and improve nutritional outcomes. Design Randomized, controlled trial. Setting Internal medicine departments. Participants Two hundred fifty-nine hospitalized adults aged 65 and older at nutritional risk were recruited and randomized according to hospitalization ward into one intervention and two control groups during hospitalization. Intervention Group 1 (intervention group) received individualized nutritional treatment from a dietitian in the hospital and three home visits after discharge. Group 2 received one meeting with a dietitian in the hospital. Group 3 received standard care. Groups 2 and 3 were combined into a single group that served as the control group in the analysis. Measurements Mortality, health status, nutritional outcomes, blood tests, cognition, emotional, and functional parameters were assessed at baseline and after 6 months. All participants were contacted monthly. Results The overall dropout rate was 25.8%. After 6 months, rise in Mini Nutritional Assessment score, adjusted for education and hospitalization ward, was significantly higher in the intervention group than in the control groups (3.01 ± 2.65 vs 1.81 ± 2.97, P =.004) mainly on the subjective assessment part (0.34 ± 0.86 vs. -0.04 ± 0.87, P=.004). The only laboratory parameter for which a difference was observed between the groups was albumin; 9…
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In a study by Feldblum et al., continued nutritional support in malnourished patients aged >65 years resulted in a significantly higher change in mean MNA score compared to the combined control groups (3.01±2.65 vs 1.81±2.97, p=0.004).
“showed that continued nutritional support in malnourished patients aged !65 years resulted in a significantly higher change in mean MNA score, compared to the combined group 2 and 3 (3.01 ± 2.65 in the IG vs. 1.81 ± 2.97 in the CG, p ¼ 0.004)”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [116]
In the study by Feldblum et al., patients >65 years who received individualized nutritional support during hospitalization and for six months after discharge had a significantly lower mortality rate (3.8%) than the control group (11.6%, p=0.03) at month 6.
“In the study by Feldblum et al., the IG patients (>65 years) who received individualized nutritional support from a dietitian during hospitalization and for six month after discharge (three home visits after discharge) exhibited a significantly lower mortality rate (3.8%) than the CG (vs.11.6%, p ¼ 0.03) at month 6”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [116]
Readmission rates were significantly reduced after six months of nutritional intervention in several trials but not all.
“it was significantly reduced after six months of nutritional intervention in several trials (level of evidence: 1-) [116] (level of evidence: 1þ) [130] (level of evidence: 1þþ) [126] but not all (level of evidence: 1þ) [125].”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [116]
Feldblum et al. extended an individualized nutritional intervention in older internal medical patients to six months after hospitalization and reported an improved Mini Nutritional Assessment score and reduced mortality in the intervention compared to the control group.
“Feldblum et al. (47) extended an individualized nutritional intervention in older internal medical patients to six months after hospitalization and reported an improved Mini Nutritional Assessment (MNA) score and reduced mortality in the intervention compared to the control group”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [47]
In Feldblum et al., there were no intervention effects on energy or protein intake, body weight, and functional measures.
“however, no intervention effects on energy or protein intake, BW, and functional measures.”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [47]
A second RCT explored an individualized nutritional intervention in 259 hospitalized older patients and found no changes in GDS scores at six months.
“A second RCT explored an individualized nutritional intervention in 259 hospitalized older patients and found no changes in GDS scores at six months (47), the number of those with depression is not stated.”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [47]
Two trials have considered the effect of nutrition intervention on depressive symptoms in older hospitalized patients.
“Two trials have considered the effect of nutrition intervention on depressive symptoms in older hospitalized patients.”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [47]
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- Authors
- Feldblum, I., German, L., Castel, H., Harman‐Boehm, I., & Shahar, D. R.
- Affiliations
- Ben-Gurion University of the Negev (IL)
- ORCID
- Shahar, Danit R.
- Venue
- Journal of the American Geriatrics Society
- Publisher
- Wiley
- Published
- 2010-11-18
- Volume
- 59
- Issue
- 1
- Pages
- 10-17
- ISSN
- 0002-8614 (ISSN-L)
- 1532-5415
- OpenAlex
- W1505520352
- Cited by
- 127
- References
- 35
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 3 · 2023: 3 · 2022: 14 · 2021: 10 · 2020: 5 · 2019: 6 · 2018: 17 · 2017: 12 · 2016: 10 · 2015: 8 · 2014: 6 · 2013: 15 · 2012: 9
- FWCI
- 5.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Geriatrics Society (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Health Professions › Health Information Management › Dietetics, Nutrition, and Education
- Keywords
- hospitalized older adults, nutritional risk, dietitian consultation, mortality, nutritional status, Mini Nutritional Assessment, serum albumin, hospital discharge, internal medicine
- MeSH terms
- Activities of Daily Living, Aftercare, Aged, Female, Food Service, Hospital, Hospitalization, Humans, Israel, Male, Nutritional Status, Survival Analysis, Malnutrition
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