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Validity of the "Rate-a-Plate" Method to Estimate Energy and Protein Intake in Acutely Ill, Hospitalized Patients.

Authors
  • Dekker, Ingeborg M1
  • Langius, Jacqueline A E1, 2
  • Stelten, Stephanie1, 3
  • de Vet, Henrica C W4
  • Kruizenga, Hinke M1, 5
  • de van der Schueren, Marian A E1, 5, 6
  • 1 Department of Nutrition and Dietetics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. , (Netherlands)
  • 2 Department of Nutrition and Dietetics, Faculty of Health, Nutrition and Sport, The Hague University of Applied Sciences, The Hague, the Netherlands. , (Netherlands)
  • 3 Department of Epidemiology & Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. , (Netherlands)
  • 4 Department of Epidemiology & Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands. , (Netherlands)
  • 5 Dutch Malnutrition Steering Group, Amsterdam, the Netherlands. , (Netherlands)
  • 6 Department of Nutrition and Health, Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, the Netherlands. , (Netherlands)
Type
Published Article
Journal
Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition
Publication Date
Oct 01, 2020
Volume
35
Issue
5
Pages
959–966
Identifiers
DOI: 10.1002/ncp.10389
PMID: 31407826
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Prevalence of malnutrition in hospitals has been reported around 20% and increases during hospitalization. The "Rate-a-Plate" method has been developed to monitor dietary intake and identify patients whose nutrition status deteriorates during hospitalization, but has not yet been validated. The objective was to study the validity and reliability of the method (phase 1) and redesign and revalidate a revised version (phase 2). Detailed food records provided a reference method. A priori difference of >20% in energy or protein between the reference and the "Rate-a-Plate" method was determined as clinically relevant. Intraclass correlation coefficients were used to determine the reliability. In phase 1, 24 patients were included with a total 67 test days. In phase 2, 14 patients were included, 28 test days. In phase 1, the "Rate-a-Plate" method underestimated intake by 422 kcal (29%, ICC 0.349, 95% CI 304-541) and 5.7 g protein (10%, ICC 0.511, 95% CI 0.0-11.5). Underestimation was found in 65% and 23% for energy and protein intake, respectively. Underestimation was higher when patients had higher intake. In phase 2, underestimation was 109 kcal (7%, ICC 0.788, 95% CI -273 to 56) and 3.7 g protein (6%, ICC 0.905, 95% CI -8.4 to 1.0). In 32% and 21% of the cases, energy and protein intake were underestimated. The revised version of the "Rate-a-Plate" method is a valid method to monitor energy and protein intake of hospitalized patients and can be filled out by nutrition assistants. A larger validation study is required. © 2019 The Authors. Nutrition in Clinical Practice published by Wiley Periodicals, Inc. on behalf of American Society for Parenteral and Enteral Nutrition.

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