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Technology and health care for the elderly medical research studies

Focus on strategic priorities that have significant social impact.

SIG 2014F-08

More-2-Eat: Nutrition care pathway and optimized protein supplementation for malnourished elderly patients

This study will demonstrate the importance and impact of investing in food and nutrition care for the recovery of patients. Also, patients can anticipate improved nutrition care in hospitals that implement these best practices.

Possible Research Results

Anticipated findingsLearnings on how to implement this pathway are diverse and will assist other hospitals in Canada with improving their care practices. As a result of implementation of improved nutrition care practices, it is anticipated that patients will be more satisfied with the food they are offered, eat more food and have fewer barriers to food intake while in hospital. It is anticipated that over time this will improve the recovery of patients and their quality of life.

Impact of findingsSuccessful implementation and resource requirements for improving nutrition care practices will demonstrate to clinical practitioners that it is feasible to make positive changes that positively impact patient care. This study will demonstrate the importance and impact of investing in food and nutrition care for the recovery of frail elderly patients. Patients can anticipate improved nutrition care in hospitals that implement these best practices.

Publications, presentations and webinars

About the Project

Almost half of adult patients admitted to Canadian hospitals, and specifically medical and surgical care, are malnourished. This malnutrition develops in the community as a result of social and disease factors. Malnutrition, regardless of its cause, extends the length of the hospital stay and results in readmission if not resolved.

However, an evidence-based best practices algorithm to improve the nutrition care processes has been developed. This algorithm promotes prevention, detection and treatment of malnutrition, as well as improved transitions to the community after hospitalization.

Although designed to be feasible, this best practice algorithm needs to be tested to determine if and how it can be implemented and if patient reported outcomes improve as a result of these improved practices.

More-2-Eat is focused on implementing this best practice algorithm in five hospitals (one medical unit each) in four provinces to understand the process of implementation, resource requirements and if it improves patient reported outcomes such as food intake and barriers to intake while in hospital.

A sub study lead by Dr. Adam Rahman is focused on determining the feasibility of protein supplementation during and post hospitalization in frail, malnourished elderly. Specifically this study will determine recruitment methods, feasibility of measures for function, body composition and strength, as well as compliance with the high protein supplement. Results of this study will be used to develop a large multi-site trial.

For more details on the project rationale and objectives, click here.

Project Team

Principal Investigators:

Heather Keller, PhD, RD, FDC -- University of Waterloo/Schlegel-UW Research Institute for Aging

Adam Rahman, MD -- University of Western Ontario


Carlota Basualdo-Hammond, MSc, MPH, RD -- Alberta Health Services

Jack Bell, PhD, APD -- Metro North Hospital and Health Service, Queensland, Australia

Paule Bernier, PDt, MSc -- Ordre professional des diététistes du Québec (OPDQ)

Lori Curtis, PhD -- University of Waterloo

Pauline Douglas, BSc, PgCHEP, MBA, MIHM, FHEA, FBDA, RD -- UK Need for Nutrition Education/Innovation Programme

Joel Dubin, PhD -- University of Waterloo

Donald Duerksen, MD -- University of Manitoba

Leah Gramlich, MD, FRCPC -- University of Alberta/Alberta Health Services

Daren Heyland -- Queen's University

Manon Laporte, RD -- Vitalité Health Network Clinical Nutrition Department

Barbara Liu, MD, FRCPC -- Regional Geriatric Program of Toronto

Marko Mrkobrada, MD, FRCPC -- University of Western Ontario

Sumantra Ray, MBBS, PGCertMedEd, DipNutr, MPH, MD -- UK Need for Nutrition Education/Innovation Programme

Knowledge Users and Partners:

Linda Dietrich, MEd, RD -- Dietitians of Canada

Sarah Robbins, MD, MSc, FRCPC -- Canadian Nutrition Society/Canadian Malnutrition Task Force

Heather Truber -- Canadian Society of Nutrition Management

Abbot Laboratories

Néstle Health Science

Regional Geriatric Program of Toronto

UK Need for Nutrition Education/Innovation Programme (NNEdPro)

Project Contact: Heather Keller --

SIG 2014F-08

Key words: nutrition; malnutrition; hospitals; community; elderly; improvement; care pathway; best practices