Assessment of nutritional status of hospitalized patients including their food intake and evaluation of food waste, its causes and consequences in some selected Tehran hospitals: a cross-sectional study protocol

Background: Hospitalization may seriously affect patients’ nutritional status and may occasionally be accompanied by malnutrition development or aggravation. Food intake is often altered during hospitalization, which is tightly connected to malnutrition. On the other hand, a huge amount of plate food wasted by patients, in addition to its health consequences, has enormous economic and environmental expenses for governments and societies. This investigation aims firstly to assess nutritional status of the patients hospitalized in general wards and secondly to evaluate the quantity and financial burden of patients’ food waste along with its possible nutritional outcomes.Methods: A cross-sectional study is performed on 171 adult inpatients with eligibility criteria from medical and surgical wards of three general hospitals in Tehran. Nutritional status of patients is evaluated through the following methods: 1. Assessment of malnutrition using subjective criteria (Mini Nutritional Assessment and Subjective Global Assessment tools); 2. Assessment of protein status using determination of serum albumin, pre-albumin and total protein; and 3. Assessment of certain micronutrient status notably vitamins A and D using serum retinol and 25-hydroxycalciferol assay. Also, oxidative stress and inflammatory status are evaluated using examination of serum β-carotene, total antioxidant capacity, malondialdehyde and highly sensitive C-reactive protein. Anthropometric and demographic data are collected and energy and protein intakes are extracted from a 24-hour food recall. Plate food wastes for selected patients are weighed in breakfast, lunch and snacks for one day. Then, economic cost of food waste is calculated for each meal, patient and ward. Finally, the possible reasons for wasting food in these hospitals will be evaluated through conducting a qualitative study.Discussion: Findings of this study will provide appropriate data regarding health and economic burden of food waste in studied hospitals. These data are especially useful to healthcare authorities and policy makers for planning efficient solutions to decrease food waste and to improve patients' nutritional status.