Restrictive diets in older malnourished cardiac inpatients: A cross-sectional study.

Aim: Restrictive diets are commonly prescribed to cardiac patients for therapeutic and preventative reasons. However, these are often contraindicated for malnourished, older patients. The present study aimed to explore dietary behaviours of malnourished older cardiac inpatients and identify sources of nutritional information.

Methods: A cross-sectional study was conducted over 4 months in a cardiology ward. Data on inpatients' habitual dietary behaviour, duration and reasons for dietary practices, and sources of nutrition advice were obtained during a dietetic assessment. From the reported reasons for dietary practices, diets were categorised by the treating dietitian into 'clinically indicated' (CI) or 'not clinically indicated' (NCI) diets.

Results: Sixty-seven malnourished patients were included, with mean age 76.6 ± 8.3 years and BMI 19.5 ± 6.2 kg/m . Twenty-six (38.8%) reported at least one dietary restriction, 14 (20.9%) were on a high energy-high protein diet prior to hospitalisation and 27 (40.3%) were on nonrestrictive diets. Five (19.2%) restrictive diets were assessed as CI at the time of admission, while 21 (80.8%) were NCI diets. CI diets were mostly recommended by dietitians (n = 15, 78.9%). Recommendations for NCI restrictive diets came mainly from 'Other' sources (n = 10, 55.6%) including the internet, friends and family.

Conclusions: Restrictive diets are common among malnourished cardiac inpatients with the majority no longer clinically indicated. It is important for dietitians to explore current dietary practices of malnourished older inpatients on admission. Inpatients following NCI diets may require additional time for education around nutritional priorities.