Abstract

Background: 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). Methods: 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. Results: 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. Conclusion: 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.

Original languageEnglish
JournalNutrition in Clinical Practice
DOIs
Publication statusE-pub ahead of print - 13 Aug 2019

Cite this

@article{39752f796fa1498ebd513323c7c12198,
title = "Validity of the “Rate-a-Plate” Method to Estimate Energy and Protein Intake in Acutely Ill, Hospitalized Patients",
abstract = "Background: 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). Methods: 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. Results: 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. Conclusion: 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.",
keywords = "adult, dietary intake monitoring tool, nutrition assessment, validity",
author = "Dekker, {Ingeborg M.} and Langius, {Jacqueline A.E.} and Stephanie Stelten and {de Vet}, {Henrica C.W.} and Kruizenga, {Hinke M.} and {de van der Schueren}, {Marian A.E.}",
note = "{\circledC} 2019 The Authors. Nutrition in Clinical Practice published by Wiley Periodicals, Inc. on behalf of American Society for Parenteral and Enteral Nutrition.",
year = "2019",
month = "8",
day = "13",
doi = "10.1002/ncp.10389",
language = "English",
journal = "Nutrition in Clinical Practice",
issn = "0884-5336",
publisher = "SAGE Publications Ltd",

}

TY - JOUR

T1 - Validity of the “Rate-a-Plate” Method to Estimate Energy and Protein Intake in Acutely Ill, Hospitalized Patients

AU - Dekker, Ingeborg M.

AU - Langius, Jacqueline A.E.

AU - Stelten, Stephanie

AU - de Vet, Henrica C.W.

AU - Kruizenga, Hinke M.

AU - de van der Schueren, Marian A.E.

N1 - © 2019 The Authors. Nutrition in Clinical Practice published by Wiley Periodicals, Inc. on behalf of American Society for Parenteral and Enteral Nutrition.

PY - 2019/8/13

Y1 - 2019/8/13

N2 - Background: 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). Methods: 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. Results: 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. Conclusion: 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.

AB - Background: 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). Methods: 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. Results: 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. Conclusion: 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.

KW - adult

KW - dietary intake monitoring tool

KW - nutrition assessment

KW - validity

UR - http://www.scopus.com/inward/record.url?scp=85070671175&partnerID=8YFLogxK

U2 - 10.1002/ncp.10389

DO - 10.1002/ncp.10389

M3 - Article

JO - Nutrition in Clinical Practice

JF - Nutrition in Clinical Practice

SN - 0884-5336

ER -