Maintenance Notice

Due to necessary scheduled maintenance, the JMIR Publications website will be unavailable from Wednesday, July 01, 2020 at 8:00 PM to 10:00 PM EST. We apologize in advance for any inconvenience this may cause you.

Who will be affected?


Currently submitted to: JMIR Research Protocols

Date Submitted: Sep 5, 2020
Open Peer Review Period: Sep 5, 2020 - Oct 31, 2020
(currently open for review)

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Evaluation of nutritional status, food intake and food waste costs in ‎hospitalized patients, considering relevant causes and finding possible ‎solutions: Protocol of a mixed-method study

  • Maryam Amini; 
  • Bahareh Nikooyeh; 
  • Delaram Ghodsi; 
  • Parisa Torabi; 
  • Tirang Reza Neyestani; 



Hospitalization may seriously affect patients’ nutritional status and may ‎occasionally be accompanied by malnutrition development or aggravation. Food intake is ‎often altered during hospitalization, which is tightly connected to malnutrition. On the other ‎hand, a huge amount of plate food wasted by patients, in addition to its health consequences, ‎has enormous economic and environmental expenses for governments and societies.


This ‎investigation aims firstly to assess the nutritional status of the patients hospitalized in general ‎wards and secondly to evaluate the quantity and financial burden of patients’ food waste ‎along with its possible nutritional outcomes.‎


A mixed-method study is performed in three general hospitals in Tehran. Adult ‎inpatients with eligibility criteria are recruited to the study from medical and surgical ‎wards. Anthropometric and demographic data are collected and energy and protein intakes ‎are extracted from a 24-hour food recall. Plate food wastes of eligible patients are weighed ‎in breakfast, lunch, and snacks during one day. Then, the economic cost of food waste is ‎calculated for each meal, patient, and ward. Nutritional status is determined through the ‎following methods: 1. Subjective criteria (Mini Nutritional Assessment and Subjective ‎Global Assessment tools) for malnutrition; 2. Measuring serum albumin, pre-albumin and ‎total protein for protein status; 3. Measuring serum retinol and 25-hydroxycalciferol assay ‎to assess certain micronutrient status (vitamins A and D); and 4. Examination of serum β-‎carotene, total antioxidant capacity, malondialdehyde, and highly sensitive C-reactive ‎protein to determine oxidative stress and inflammatory status. Also, a qualitative study is ‎conducted to evaluate the possible reasons for wasting food in these hospitals.‎




This study will provide appropriate data regarding the health and economic burden ‎of food waste in studied hospitals. These data are especially useful to healthcare authorities ‎and policymakers for planning efficient solutions to decrease food waste and to improve ‎patients' nutritional status. ‎


Please cite as:

Amini M, Nikooyeh B, Ghodsi D, Torabi P, Neyestani TR

Evaluation of nutritional status, food intake and food waste costs in ‎hospitalized patients, considering relevant causes and finding possible ‎solutions: Protocol of a mixed-method study

JMIR Preprints. 05/09/2020:24138

DOI: 10.2196/preprints.24138


Download PDF

Request queued. Please wait while the file is being generated. It may take some time.

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.