The Association of Inflammation with Food Intake in Older Hospitalized Patients

Maryam Pourhassan, S. Böttger, G. Janssen, L. Sieske, R. Wirth

An acute inflammatory process may play a role in inhibiting appetite and food intake particularly in acutely ill older individuals. However, there is a lack of knowledge on the effect of inflammation on food intake in humans. In this study, we sought to investigate the association of C-reactive protein (CRP), as an inflammatory marker, with food intake in acutely ill older hospitalized patients. This cross-sectional study investigated older participants who were consecutively admitted to a geriatric acute care ward. Food intake during previous week was measured according to the Nutritional Risk Screening (NRS-2002) and patients were grouped into two categories as intake ≥75% and <75% of requirements. Disease severity and mobility were measured based on the NRS-2002 and Mini Nutritional Assessment Short Form (MNA-SF), respectively. Serum CRP was analyzed according to standard procedures. Of 177 older participants (mean age 83.1 ± 6.5 y, BMI range of 14.7-43.6 kg/m2; 116 females), 67 (38.0%) had moderate to severe inflammation (CRP>3.0 mg/dl). In addition, 109 (62.0%) patients had intake <75% of requirements during previous week, in which 34 (31.0%) and 54 (50.0%) demonstrated mild and moderate to severe inflammation, respectively. Furthermore, there were significant differences in CRP levels between intake ≥75% and <75% of requirements (P<0.001). In a logistic regression analysis, CRP level (odds ratio; OR, 1.14; P=0.006), disease severity (OR, 2.94; P=0.022), mobility (OR, 0.44; P=0.005) and BMI (OR, 0.89; P=0.003) were the major independent predictors of low food intake. Our findings confirm a close association between food intake and inflammation in older hospitalized patients. In addition, CRP level and disease severity together were the most important independent predictors associated with food intake in these patients.