Social Dining at The Royal Free Hospital - Effects on Calorie Intake in Elderly Inpatients

Social Dining at The Royal Free Hospital - Effects on Calorie Intake in Elderly Inpatients

Introduction: Malnutrition and reduced oral intake are common among older inpatients and contribute to delayed healing, sarcopenia and prolonged hospital stay. Social dining has been shown to improve mealtime engagement and nutritional intake through factors including longer mealtimes, modelling of behaviour, social interaction and improved mood.

Aim: To evaluate whether participation in a social dining (SD) lunch increases calorie intake compared with bedside lunch.

Methods: Social dining sessions are held weekly on two Health Services for Elderly People (HSEP) wards. A Dietitian estimated calorie intake from food record charts for the social dining meal and the following day's bedside lunch. Inclusion criteria were: (1) inpatient on HSEP ward, (2) suitable to attend social dining, and (3) remained an inpatient the following day. Forty paired observations were collected from 36 patients over 8 weeks. Participants had a mean age of 87 years (range 80–97), 56% were female, with a mean Clinical Frailty Score of 5 (mildly frail) and mean MUST score of 0.8 (1= medium risk of malnutrition).

Results: Mean calorie intake was higher during social dining than bedside dining (604 vs 533 kcal), an average increase of 71 kcal (13%). However, the difference was not statistically significant (paired t-test, p = 0.140). Considerable variation in calorie intake was observed, which may reflect day-to-day changes in clinical status, cognition, fatigue and mobility, all of which can impact oral intake regardless of dining environment. 

Conclusion: Social dining was associated with a higher mean calorie intake than bedside dining, although the difference was not statistically significant. The observed increase of 71 kcal may still be clinically relevant for frail older inpatients; if social dining could be sustained over multiple meals, it may have clinically meaningful nutritional benefits.