Special to the News: Nutrition Needs Must be Heeded

Dear Dr. Meinig:

Can anything be done to get hospitals to do something about the food they feed to their patients? My father recently had a trIple bypass artery transplant.
His first meal after surgery was spaghetti and meatballs and it was cold when it came to him. I have told about his shameful experience to perhaps a hundred people and each one recounted one or more equally dreadful stories about the meals they and others have received in hospitals.
I don’t know that you can do anything about it but I thought airing the public’s dissatisfaction might stir up some public action. – P.T.

 

Dear P.T.:

Your complaint about the poor nutritional care our people receive in hospitals isn’t an idle one.

It has been backed up by over 100 scientific articles that have appeared in such highly accepted publications as the American Journal of Clinical Nutrition, the Annals of Surgery, the British Medical Journal, Cancer Research, the Journal of the American Medical Association, the Journal of Trauma, the Lancet, the New England Journal of Medicine and others.

All these reports, along with some new ones, were summarized by Smith and Celice Smith, M.S., RD. Director of Clinical Dietetics, Children’s Memorial Medical Center, Chicago, and compiled into a publication called “Superior Nutritional Care Cuts Hospital Cost.”

They found between 29 to 82 percent of the patients who were admitted to a wide assortment of hospitals in urban, city, poor and affluent areas, had displayed frank evidence of malnutrition when only two nutritional parameters were Investigated.

The two factors studied were the patients’ protein status and total calorie intake. Fully 57 percent of these high risk trials that were surveyed screened patients’ nutritional status. Such simple recordings as height and weight were not found on 82 percent of patient charts, even though weight loss can be a significant indicator of a patient’s progress.

Further complicating that situation is the failure of many hospitals to have the special scales needed to weigh bed patients.

Other simple but important factors also missing from charts are whether patients eat all their meals and how much food they leave on their trays. While poor eating may result in dissatisfaction with what is served, other health conditions may be the cause of the discontent.

It is obvious to almost everyone except hospitals that the healing of sick or surgical Individuals will not progress well if the amount of their food intake is inadequate or if it is of poor quality and deficient in nutrients.

The Smiths learned that 95 percent of patients didn’t receive nutritional support until late in their hospitalization or only after they developed complications.

Of those that were found to be well nourished on admittance, 75 percent deteriorated if hospitalized two weeks or longer.

The positive side of all this is that patients who were in hospitals that provided the benefits of nutritional care developed fewer complications, had shorter hospital stays, faster wound healing, faster recovery. and reduced death rates. It would seem that in the publishing of such data we might expect a quick reversal of present do-nothing policies of hospitals.

Our health into their routines that when they hear the word “nutrition” their thoughts immediately envision increased costs.

Their first tendency in reducing high overhead expenditures is to cut food costs, never realizing the result is patient malnutrition and consequently the need for more extensive, costly treatment and care.

The big surprise and outstanding discovery of all the various investigations was the incredible amount of money saved by the hospitals that introduced just the two simple methods of nutritional intervention mentioned above.

It is easy to see why the Smiths’ 100-page publication of statistical data concentrated on informing hospitals how their costs could be materially cut by nutritional intervention. However, in view of the widespread implications about the role of nutrition to health, it was a shock to find so little mention of the important healing benefits that patients receive when their diets are improved, not to mention the monetary savings they receive.

Equally incredible was the absence of any discussion about the other well documented factors involved in achieving healing, such as vitamin C and zinc, plus the common need in deficiency and body stress situations for the other vitamins, minerals and digestive enzymes.

You would think the cost savings provided by better nutritional care would prompt insurance companies and the government’s Medicare division to rise up and insist upon the necessary changes. However, it probably is going to take the complaints of the public to secure the needed action.

If your hospital or insurance company would like full information on the implications and extent of these studies, they should write to Nutritional Care Management Institute, Philip E. Smith, Executive Director. 6033 N. Sheridan Road 6E, Chicago, IL 60660.