Medical nutrition therapy and simple interventions can improve intake in patients who eat poorly in hospital

The Australasian Nutrition Care Day Survey (ANCDS) reported two-in-five patients in Australian and New Zealand hospitals consume ≤50% of the offered food. The ANCDS found a significant association between poor food intake and increased in-hospital mortality after controlling for confounders (nutritional status, age, disease type and severity)1. Evidence for the effectiveness of medical nutrition therapy (MNT) in hospital patients eating poorly is lacking. An exploratory study was conducted in respiratory, neurology and orthopaedic wards of an Australian hospital. At baseline, 24-hour food intake (0%, 25%, 50%, 75%, 100% of offered meals) was evaluated for patients hospitalised for ≥2 days and not under dietetic review. Patients consuming ≤50% of offered meals due to nutrition-impact symptoms were referred to ward dietitians for MNT with food intake re-evaluated on day-7. 184 patients were observed over four weeks. Sixty-two patients (34%) consumed ≤50% of the offered meals. Simple interventions (feeding/menu assistance, diet texture modifications) improved intake to ≥75% in 30 patients who did not require further MNT. Of the 32 patients referred for MNT, baseline and day-7 data were available for 20 patients (68±17years, 65% females, BMI: 22±5kg/m2, median energy, protein intake: 2250kJ, 25g respectively). On day-7, 17 participants (85%) demonstrated significantly higher consumption (4300kJ, 53g; p<0.01). Three participants demonstrated no improvement due to ongoing nutrition-impact symptoms. “Percentage food intake” was a quick tool to identify patients in whom simple interventions could enhance intake. MNT was associated with improved dietary intake in hospital patients. Further research is needed to establish a causal relationship.

Estranged bodies and Vietnamese identities

In this paper I will explore both the regulation of migrant bodies as well as the lived experience of migrant embodiment in order to develop an analysis of the body as a vortex of meaning in the displacement process. By examining the way in which the bodies of Vietnamese immigrants are simultaneously object and agent, I will indicate how the relations between migrants and the wider society are felt and sensed through the bodily experiences of Vietnamese people. The dynamic between how Vietnamese bodies are represented and how they are experienced reveals the body to be a predominant marker of difference from both within and without, the mediator between experience and signification. I will indicate how the dominant media construction of Vietnamese bodies as defiled has sustained forms of exclusion and distancing which have influenced the way that Vietnamese bodies are lived. I thus explore the means through which the body has particular salience when attempting to understand the nature of migrant identities in Australia.