Effects of protein-enriched familiair foods and drinks on protein intake and physical recovery of older patients during 12 weeks in transmural context: the randomized controlled cater with care trial

Rationale: Hospitalized older adults are recommended to consume 1.2-1.5 g of protein per kg body weight per day (g/kg/d) to improve recovery. The aim of this trial was to study the effectiveness of supplementing a hospital and home menu with protein-enriched familiar foods and drinks in reaching a protein intake of 1,2-1,5 g/kg/d and in improving physical recovery during 12 weeks after hospital stay in older patients. Methods: This randomized controlled trial followed 75 patients of ≥65 years (76.8±6.9 years) during and after hospitalization. During hospitalization subjects received either a standard energy and protein-rich menu (control) or a menu supplemented with protein-enriched products (intervention). During the 12-week home phase, subjects in the intervention group received the protein-enriched familiar foods and drinks, while the control group received regular non-enriched foods and drinks. Effects on protein intake and Short Physical Performance Battery (SPPB), gait speed, chair rise, leg extension, hand grip, nutritional status (MNA), independence (ADL), and body weight were analysed with linear mixed models. Results: The intervention group had a higher protein intake compared to the control group (P<0.01): 112±34 g/d (1.5±0.6 g/kg/d) compared to 78±18 g per day (1.0±0.4 g/kg/d). Energy intake did not differ (P=0.070). None of the physical recovery outcomes showed a significant group effect, or interaction of group x time effect. Time effects (P<0.05) were found for SPPB, gait speed, chair rise, body weight and MNA. Conclusion: Protein-enriched familiar foods and drinks successfully increased protein intake, but did not improve physical recovery in a 12 week period.