Visiting a hospital patient? Take fruit not flowers

Press, 22 November 1980, Page 10

Visiting a hospital patient? Take fruit not flowers

Does good food contribute to recovery from illness? Before the mid-1930s no medical' treatments were curative. - . •

Some operations were life-saving, ■ and this was the great age of heroic and dramatic surgery.

Because of the relative lack of success of most medicines of that era, in some countries such as Germany and France, great emphasis was placed on curative dietary regimes. The 19305, 1940 s and 1950 s saw the resurgence of the European spa with emphasis on hydro or water therapy and a variety of specialised diet therapies. In the last two decades

the dramatic upsurge in many powerful and effective pharmaceutical agents has led to a lessening in curative surgery and a steady swing towards repair and. replacement. Because of the rapid effectiveness of many modern treatments, there was in the 1950 s and 1960 s relatively less concentration on dietary regimes. Side effects from many powerful drugs have however now led to a growing interest in the specialised services offered by well trained dietitians. We in New Zealand are fortunate to have a very efficient, well-trained, and well regulated dietetic profession.

the food services of New Zealand hopsitals are efficiently managed and run by hospital dietitians, some of whom have specialised in managerial functions. Other dietitians may specialise in therapeutic dietetics, and offer family doctors and hospital spe-

cialists a wide range of help. This may vary from food allergy treatments to specific amino-acid diets for children. But what of the ordinary patient in a hospital ward? Are the diets of such ward patients designed for therapeutic value?

Are New Zealand studies being carried out to see how good these diets may be? The answers are somewhat like the gopd news - bad news story. Because of one of the highest rates of obesity in the world New Zealand hospitals certainly have a disproportionate number of overweight persons admitted ’ ith obesity-re-lated disorders. So, a high percentage of ward patients often increases the therapeutic dietetic work load by requiring an .individualised weight reduction diet. These patients undoubtedly benefit. For some time overseas

nutritional studies have shown vitamin and mineral deficiency states amongst older patients in nursing homes and in long-stay hospitals. Recently a doctor and his group of co-workers from the Department of Nutritional Sciences in the University of Alabama surprised nutritionalists and dietitians by showing that no less than 75 per cent of 134 consecutive patients admitted to an acute general medical service developed a worsened nutritional state during their stay than when initially admitted.

The Weinsier study measured the levels in blood of such substances as Vitamin C, Serum albumin, Vitamin A precursors and other good measures of nutrition.

They showed that the longer a patient remained in hospital the worse his or her nutritional state. It was also of great interest that more initially malnourished patients died when they were paired with those who had relatively good nutritional .states on admission.

We have only unofficial and unreported pilot studies in New Zealand ' which do show some deficiencies in Vitamin C status in longstay patients in our general medical wards.

This may. however, be due to the almost universally poor dental apparatus of the elderly New Zealander admitted to hsopital. Only

comprehensive studies will tell the whole story. What you can positively do? If you have your own close relatives in hospital you may supplement the hospital diet with fresh fruit.

With a cost squeeze on hospitals, good fruit supplements for all patients are not possible. Visiting relatives could peeling organs, cutting up peeling organes, cutting up apples, make sure to retain the skins, and preparing other fruits so that these pieces can then be fed slowIv to their hospitalised relatives.

Other supplements such as a-few raw oysters, a liver sandwich, pieces of celery, carrots and tomatoes are useful if the patient feels well enough to eat these and the nursing staff agree. In less ill patients supplements of dried fruit, raisins, and nuts are nutritionally more valuable than chocolate or sweets.

As the Weinsier study concludes, and this probably appropriate also for us in New Zealand: “It remains to be see if these findings of increasing malnutrition and worsening mortality with longer hospital stays can be altered by nutritional intervention.”

We know very little of the nutritional state of many of our hospital patients, but we can act on the reasonable hypothesis that some such supplements could be tried out here in New Zealand.