Validation of a plate diagram sheet for estimation of energy and protein intake in hospitalized patients

Background & aims: Validation of simple methods for estimating energy and protein intakes in hospital wards are rarely reported in the literature. The aim was to validate a plate diagram sheet for estimation of energy and protein intakes of patients by comparison with weighed food records. Methods: Subjects were inpatients at the Cardio Thoracic ward, Landspitali National University Hospital, Reykjavik, Iceland (N = 73). The ward personnel used a plate diagram sheet to record the proportion (0%, 25%, 50%, 100%) of meals consumed by each subjects, for three days. Weighed food records where used as a reference method. Results: On average the plate diagram sheet overestimated energy intake by 45 kcal/day (1119 +/- 353 kcal/day versus 1074 +/- 360 kcal/day, p = 0.008). Estimation of protein intake was not significantly different between the two methods (50.2 +/- 16.4 g/day versus 48.7 +/- 17.7 g/day, p = 0.123). By analysing only the meals where <= 50% of the served meals were consumed, according to the plate diagram recording, a slight underestimation was observed. Conclusion: A plate diagram sheet can be used to estimate energy and protein intakes with fair accuracy in hospitalized patients, especially at the group level. Importantly, the plate diagram sheet did not overestimate intakes in patients with a low food intake. (C) 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.