Effect of a Preoperative Home‐Delivered, Protein‐Rich Meal Service to Improve Protein Intake in Surgical Patients: A Randomized Controlled Trial

IJmker-Hemink, Vera; Wanten, Geert; Nes, Lindsey C. F. de; Berg, M.G.A. van den

doi:10.1002/jpen.2015

Cited by 9 publications

(11 citation statements)

References 35 publications

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“…The repartition of surgical procedures in the 25 studies was as follows: abdominal (11/24, 639 patients), thoracic (3/24, 277 patients), urologic (4/24, 272 patients), vascular (2/24, 177 patients) and orthopaedic (2/24, 51 patients). Three studies included different types of surgery (654 patients) 44 , 61 , 64 . The case mix was as follows: abdominal and urologic (432 patients), neurosurgery and abdominal (96 patients), urologic, abdominal, gynaecological and orthopaedic (126 patients).…”

Section: Resultsmentioning

confidence: 99%

Impact of preoperative uni- or multimodal prehabilitation on postoperative morbidity: meta-analysis

Cambriel,

Choisy,

Hedou

et al. 2023

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Background Postoperative complications occur in up to 43% of patients after surgery, resulting in increased morbidity and economic burden. Prehabilitation has the potential to increase patients’ preoperative health status and thereby improve postoperative outcomes. However, reported results of prehabilitation are contradictory. The objective of this systematic review is to evaluate the effects of prehabilitation on postoperative outcomes (postoperative complications, hospital length of stay, pain at postoperative day 1) in patients undergoing elective surgery. Methods The authors performed a systematic review and meta-analysis of RCTs published between January 2006 and June 2023 comparing prehabilitation programmes lasting ≥14 days to ‘standard of care’ (SOC) and reporting postoperative complications according to the Clavien–Dindo classification. Database searches were conducted in PubMed, CINAHL, EMBASE, PsycINFO. The primary outcome examined was the effect of uni- or multimodal prehabilitation on 30-day complications. Secondary outcomes were length of ICU and hospital stay (LOS) and reported pain scores. Results Twenty-five studies (including 2090 patients randomized in a 1:1 ratio) met the inclusion criteria. Average methodological study quality was moderate. There was no difference between prehabilitation and SOC groups in regard to occurrence of postoperative complications (OR = 1.02, 95% c.i. 0.93 to 1.13; P = 0.10; I2 = 34%), total hospital LOS (−0.13 days; 95% c.i. −0.56 to 0.28; P = 0.53; I2 = 21%) or reported postoperative pain. The ICU LOS was significantly shorter in the prehabilitation group (−0.57 days; 95% c.i. −1.10 to −0.04; P = 0.03; I2 = 46%). Separate comparison of uni- and multimodal prehabilitation showed no difference for either intervention. Conclusion Prehabilitation reduces ICU LOS compared with SOC in elective surgery patients but has no effect on overall complication rates or total LOS, regardless of modality. Prehabilitation programs need standardization and specific targeting of those patients most likely to benefit.

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Section: Resultsmentioning

confidence: 99%

Impact of preoperative uni- or multimodal prehabilitation on postoperative morbidity: meta-analysis

Cambriel,

Choisy,

Hedou

et al. 2023

BJS Open

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“…This was a post-hoc analysis of a randomized controlled trial (RCT), which was conducted at two hospitals in the Netherlands (ClinicalTrials.gov NCT03488511) [21]. The Medical Ethics Committee of the Radboudumc indicated that no formal approval was required for this study (2016-3043) (clinicaltrials.gov: NCT03488511).…”

Section: Study Population and Designmentioning

confidence: 99%

“…Participants received the high frequency protein-rich meal service at home in the pre-operative setting for three weeks. This meal service consisted of six small, protein-rich dishes per day, including a morning snack (shakes: 5-10 g protein), lunch (salads and soups: 7-25 g protein), afternoon snack (5-19 g protein), dinner (hot meal and dessert: 16-39 g protein) developed by Radboudumc and a caterer (Supplementary Table S1) [21]. Data on energy and protein content of the meals was provided in the original publication [21].…”

Section: Nutritional Interventionmentioning

confidence: 99%

“…Moreover, protein intake was improved at all meal times compared to a traditional three meals a day service but the minimal threshold of 20 g was only achieved at dinner [20]. Following the rising trend of out-of-hospital care, this high frequency protein-rich meal service was implemented at home for patients awaiting surgery resulting in a higher protein intake and a higher percentage of patients achieving their individual protein requirements (35% vs. 14%) [21]. Extending this high frequency hospital meal service to an out-of-hospital setting and thus prolonging the exposure period to adequate protein intake at home might be beneficial for the recovery after surgery.…”

Section: Introductionmentioning

confidence: 99%

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High Frequency Protein-Rich Meal Service to Promote Protein Distribution to Stimulate Muscle Function in Preoperative Patients

et al. 2021

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Apart from meeting daily protein requirements, an even distribution of protein consumption is proposed instrumental to optimizing protein muscle synthesis and preserving muscle mass. We assessed whether a high frequency protein-rich meal service for three weeks contributes to an even daily protein distribution and a higher muscle function in pre-operative patients. This study was a post-hoc analysis of a randomized controlled trial (RCT) in 102 patients. The intervention comprised six protein-rich dishes per day. Daily protein distribution was evaluated by a three-day food diary and muscle function by handgrip strength before and after the intervention. Protein intake was significantly higher in the intervention group at the in-between meals in the morning (7 ± 2 grams (g) vs. 2 ± 3 g, p < 0.05) and afternoon (8 ± 3 g vs. 2 ± 3 g, p < 0.05). Participants who consumed 20 g protein for at least two meals had a significantly higher handgrip strength compared to participants who did not. A high frequency protein-rich meal service is an effective strategy to optimize an even protein distribution across meals throughout the day. Home-delivered meal services can be optimized by offering more protein-rich options such as dairy or protein supplementation at breakfast, lunch and prior to sleep for a better protein distribution.

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“…To date, research of meal delivery has generally been heterogenous in population, duration, and outcome, focusing predominantly on providing meals to vulnerable groups such as older adults ( 12 , 13 ), people experiencing food insecurity ( 14 ), those at risk for hospital readmissions or procedure complications ( 15 , 16 ), and those with multiple chronic conditions or complex comorbidities ( 17 , 18 ). Few research studies have explored meal delivery as a strategy for implementing healthy eating habits to improve outcomes for people with type 2 diabetes.…”

mentioning

confidence: 99%

Improved Time in Range During 28 Days of Meal Delivery for People With Type 2 Diabetes

et al. 2022

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Objective Nutrition therapy is a cornerstone of care for people with type 2 diabetes, yet starting new, healthy eating behaviors and sustaining them can be challenging. This decentralized, single-arm study assessed the impact of 28 days of home-delivered, pre-portioned meals (three meals per day) on continuous glucose monitoring (CGM)-derived glycemic control and quality of life. Research design and methods We enrolled 154 people with type 2 diabetes from across the United States. All participants were enrolled in a digital-first type 2 diabetes care center of excellence and had a time in range (TIR) <70% or a glucose management index (GMI) >7%. A total of 102 participants received another set of meals for a household member. Forty-four participants were excluded from CGM-based analysis because of sparse data in the baseline or intervention period. Results From the baseline through the intervention period, average TIR improved by 6.8% (95% CI 4.0–9.7, P <0.001), average GMI improved by 0.21% (95% CI 0.11–0.32, P <0.001), and participants’ odds of achieving ≥70% TIR increased (odds ratio 2.55 [95% CI 0.93–7.80, P = 0.051]). Although average TIR increased rapidly upon initiation of meal delivery, it regressed when the delivery period ended. Conclusion Home-delivered meals were associated with modest TIR and GMI improvements, but only in the short term. More research is needed to determine whether the effects of nutrition therapy can be extended by providing ongoing meal delivery or additional support such as behavioral intervention.

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Effect of a Preoperative Home‐Delivered, Protein‐Rich Meal Service to Improve Protein Intake in Surgical Patients: A Randomized Controlled Trial

Cited by 9 publications

References 35 publications

Impact of preoperative uni- or multimodal prehabilitation on postoperative morbidity: meta-analysis

Impact of preoperative uni- or multimodal prehabilitation on postoperative morbidity: meta-analysis

High Frequency Protein-Rich Meal Service to Promote Protein Distribution to Stimulate Muscle Function in Preoperative Patients

Improved Time in Range During 28 Days of Meal Delivery for People With Type 2 Diabetes

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