Individualised dietary counselling for nutritionally at‐risk older patients following discharge from acute hospital to home: a systematic review and meta‐analysis
Abstract
Background Many older patients are undernourished after hospitalisation. Undernutrition impacts negatively on physical function and the ability of older patients to perform activities of daily living at home after discharge from acute hospital. The present study aimed to evaluate the evidence for an effect of individualised dietary counselling following discharge from acute hospital to home on physical function, and, second, on readmissions, mortality, nutritional status, nutritional intake and quality of life (QoL), in nutritionally at-risk older patients. Methods A systematic review of randomised controlled trials was conducted. The overall quality of the evidence was assessed according to Grading of Recommendations Assessment, Development and Evaluation system (GRADE) criteria. Results Four randomised controlled trials (n = 729) were included. Overall, the evidence was of moderate quality. Dietitians provided counselling in all studies. Meta-analyses showed a significant increase in energy intake [mean difference (MD) = 1.10 MJ day(-1), 95% confidence interval (CI) = 0.66-1.54, P Conclusions Individualised dietary counselling by dietitians following discharge from acute hospital to home improved BW, as well as energy and protein intake, in older nutritionally at-risk patients, although without clearly improving physical function. The effect of this strategy on physical function and other relevant clinical outcomes warrants further investigation.
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Systematic reviews found evidence for improved body weight and nutritional status in older patients after discharge either with individualized nutritional support or intervention with ONS.
“Systematic reviews found evidence for improved body weight and nutritional status in older patients after discharge either with individualized nutritional support [113] or intervention with ONS [114].”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [113]
One guideline and one systematic literature review were found which examined the effectiveness of individualized nutritional counseling in older persons with malnutrition or at risk of malnutrition.
“One guideline (99) and one SLR (100) were found which examined the effectiveness of individualized nutritional counseling in older persons with malnutrition or at risk of malnutrition.”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [100]
Meta-analysis found positive effects of individualized dietary counseling on body weight, energy, and protein intake but no effect on handgrip strength or mortality compared to brief dietary advice or no intervention.
“Meta-analysis found positive effects on BW, energy, and protein intake but no effect on handgrip strength or mortality compared to brief dietary advice or no intervention (100).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [100]
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References 35 · Cited by 71
- Authors
- Munk, T., Tolstrup, U., Beck, A. M., Holst, M., Rasmussen, H. H., Hovhannisyan, K., & Thomsen, T.
- Affiliations
- Herlev Hospital (DK)
- Mondelez Danmark Brøndby Denmark
- Aalborg University Hospital (DK)
- Copenhagen University Hospital (DK)
- Corresponding author
- Munk, T.
- Venue
- Journal of Human Nutrition and Dietetics
- Publisher
- Wiley
- Published
- 2015-03-18
- Volume
- 29
- Issue
- 2
- Pages
- 196-208
- ISSN
- 0952-3871 (ISSN-L)
- 1365-277X
- OpenAlex
- W2034046229
- Cited by
- 71
- References
- 35
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 3 · 2023: 7 · 2022: 5 · 2021: 13 · 2020: 9 · 2019: 7 · 2018: 10 · 2017: 6 · 2016: 3
- FWCI
- 0.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Human Nutrition and Dietetics (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- VBN Forskningsportal (Aalborg Universitet) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Health Professions › Health Information Management › Dietetics, Nutrition, and Education
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Keywords
- older adults, post-hospital discharge, malnutrition, nutritional risk, dietitians, energy intake, protein intake, body weight, physical function, grip strength, mortality, hospital readmission, quality of life
- MeSH terms
- Activities of Daily Living, Aged, Body Weight, Energy Intake, Counseling, Dietary Proteins, Humans, Nutritional Status, Patient Discharge, Quality of Life, Risk Factors, Nutrition Assessment, Randomized Controlled Trials as Topic, Hand Strength, Malnutrition, Nutritionists
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