Evaluation of the relative validity of food record charts (FRCs) used within the hospital setting to estimate energy and protein intakes.

Abstract

Objectives: To determine the relative validity of two semi-quantitative food record charts (FRCs) to estimate patients' energy and protein intakes. Design, setting & participants: A pilot service evaluation of twenty seven patients in adult acute care wards in an NHS hospital, Scotland UK. Measurements: Weighed plate-wastage was undertaken to measure dietary intakes of patients being monitored using FRCs on two adult acute wards. Both FRCs listed food items typically served at each meal along-with an indication of portion size on a Likert scale. All items consumed over 12 hours (three meals and two snacks) were weighed prior to provision and all left-over items were weighed once eating had terminated to determine amounts consumed. Estimated energy and protein intakes from both methods were determined and compared using 95% limits of agreement. Results: FRCs on both wards underestimated energy and protein intakes (mean bias (95% CI): Ward A, n=12; -219 (-1170, 732) kcal; -five (-50, 40) gram and Ward B, n=15; -437 (-1403, 529) kcal, -18 (-57, 21) gram). All 12 FRCs on ward A and 13 out of 15 records on ward B were incomplete due to omissions of whole meals or omissions of particular foods and drinks throughout the day. Details of 'portion eaten' were frequently omitted from the completed FRCs on both wards. Discrepancies existed between food items documented on FRCs to those observed and weighed. Conclusions: Further development of FRCs and training of staff is needed to ensure appropriate completion and thus accurate estimation of patients' intakes to better inform nutritional care.