Dietary assessment methods for measurement of oral intake in acute care and critically ill hospitalized patients: a scoping review

Quantification of oral intake within the hospital setting is required to guide nutrition care. Multiple dietary assessment methods are available, yet details regarding their application in the acute care setting are scarce. This scoping review, conducted in accordance with JBI methodology, describes dietary assessment methods used to measure oral intake in acute and critical care hospital patients. The search was run across four databases to identify primary research conducted in adult acute or critical care from 1st January 2000-15th March 2023 which quantified oral diet with any dietary assessment method. In total, 155 articles were included, predominantly from the acute care setting (n=153, 99%). Studies were mainly single-center (n=138, 88%) and of observational design (n=135, 87%). Estimated plate waste (n=59, 38%) and food records (n=42, 27%) were the most frequent assessment methods with energy and protein the main nutrients quantified (n=81, 52%). Validation was completed in 23 (15%) studies, with the majority of these using a reference method reliant on estimation (n=17, 74%). A quarter of studies (n=39) quantified completion (either as complete versus incomplete or degree of completeness) and four studies (2.5%) explored factors influencing completion. Findings indicate a lack of high-quality evidence to guide selection and application of existing dietary assessment methods to quantify oral intake with a particular absence of evidence in the critical care setting. Further validation of existing tools and identification of factors influencing completion is needed to guide the optimal approach to quantification of oral intake in both research and clinical contexts.