Inflammation impairs nutritional intake in hospitalized older adults

In acutely ill, hospitalized older patients, inflammation may lead to low food intake, reports a recent study. Serum levels of C-reactive protein (CRP) above 3.0 mg/dL may help in identifying these patients.

The study included 377 patients (mean age 82.2 years, 64 percent women) admitted to a geriatric acute care ward. Inflammation was measured using CRP levels, and patients were grouped according to the following ranges: 0.0–0.99, 1.00–1.99, 2.0–2.99, 3.0–4.99, 5.0–9.99, and ≥10.0 mg/dL.

The Nutritional Risk Screening tool, along with the plate diagram method, was used to evaluate nutritional intake. Participants were also grouped according to diet quality: intake of >75 percent, 50–75 percent, and ≤50 percent of requirements.

Median CRP concentrations varied across different food intake levels. For instance, those who consumed <50 percent of the requirements showed significantly higher CRP than comparators who ate >75 percent of requirements (2.3 vs 0.7 mg/dL; p<0.001).

Moreover, the proportion of patients with intake <50 percent of requirements progressively grew across increasing categories of CRP levels, from 19 percent at CRP 2.0–2.99 mg/dL to a peak of 28 percent at CRP 3.0–4.99 mg/dL (p=0.062).

Of note, the researchers found that a serum CRP level of 3.0 mg/dL seemed to be an acceptable threshold for determining lowered food intake among participants. For instance, the proportion of patients with intake <50 percent of the requirement was significantly higher in the CRP class <3 vs ≥3 mg/dL (18 percent vs 30 percent; p=0.017).

Meanwhile, the proportion with intake ≥75 percent of the requirements was substantially higher in the CRP group 3.0–4.99 vs <3.0 mg/dL (77 percent vs 44 percent; p=0.057).