Acute postoperative dietary intake in older adult hip fracture patients: An exploratory three-day weighed food diary observational study

Abstract

BackgroundOlder adults recovering from hip fracture surgery are at risk from poor outcomes that can impede dietary intake, delay recovery and exacerbate comorbidities. Adequate nutrition is critical to recovery in this group, yet acute postoperative intake is poorly understood. Measuring resting energy expenditure (REE) can inform optimal nutritional strategies.AimsThe primary aim of this observational study was to explore whether acute dietary intake of older adult hip fracture patients met individual REE needs and secondary aims were to explore patterns between REE and hospital length of stay, comorbidity and postoperative complications.MethodsA weighed food diary was used from postoperative day zero to three inclusive. All meals served were weighed before and after service. Snacks and oral nutritional supplementation were recorded. The study was registered with ClinicalTrials.gov (NCT06451679).SummaryTwenty-one participants were recruited; complete data were available for fourteen. Only one participant (male) met REE requirements. Lower intake on postoperative day one was observed alongside a longer length of stay. Oral nutritional supplement compliance was 11.9%. Additionally, 62.0% of participants would not meet REE based on standard hospital meal provision. This study provides preliminary insights regarding the energy intake of older adult hip fracture patients during acute postoperative recovery. The patterns observed suggest frequent underachievement of energy needs and highlight potential focuses for targeted education to support early postoperative nutrition. Given the small sample size, these patterns should be interpreted with caution.