The nutritional impact of 7 versus 21 home-delivered medically tailored meals in patients with heart failure and malnutrition risk: a random order crossover feeding trial (MEDIMEALS)
Abstract Background Heart failure (HF) is frequently associated with malnutrition or malnutrition risk. The delivery of medically tailored meals (MTM) to the homes of patients with HF and malnutrition risk or malnutrition after hospital discharge holds promise for improving outcomes. However, the nu...
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2025-03-01
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| Series: | BMC Nutrition |
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| Online Access: | https://doi.org/10.1186/s40795-025-01036-y |
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| author | Charlene Compher Jule Anne Henstenburg Marianne Aloupis Amy Sun Ryan Quinn Elizabeth Emery Jovina Thomas Adrian Glass Crafford Daniel R. Schwartz |
| author_facet | Charlene Compher Jule Anne Henstenburg Marianne Aloupis Amy Sun Ryan Quinn Elizabeth Emery Jovina Thomas Adrian Glass Crafford Daniel R. Schwartz |
| author_sort | Charlene Compher |
| collection | DOAJ |
| description | Abstract Background Heart failure (HF) is frequently associated with malnutrition or malnutrition risk. The delivery of medically tailored meals (MTM) to the homes of patients with HF and malnutrition risk or malnutrition after hospital discharge holds promise for improving outcomes. However, the number of MTM needed to provide benefit is not established. Methods A random order crossover study was designed to compare the delivery of 7 versus 21 MTM for four weeks each to patients discharged from the hospital with HF and malnutrition risk. Telephone surveys were conducted at baseline, 30, and 60 days post-discharge to evaluate change in malnutrition risk, American Heart Association (AHA) diet goals, sarcopenia risk, and 30-day readmissions. Results Forty-six patients were enrolled. Patients had reduced odds of having malnutrition risk relative to the baseline score at one and two months (OR 0.18, 95% CI 0.04–0.74 and OR 0.21, 95% CI 0.05–0.99, respectively). The AHA diet score improved over time from baseline by 0.73 ± 0.22 units at one month (p = 0.0014), and by 0.48 ± 0.23 units at two months (p = 0.0430), regardless of the number of MTM provided. Sarcopenia risk improved over time (p = 0.01), decreasing by 0.43 ± 0.2 units by one (p = 0.03) and 0.59 ± 0.21 units by two months (p = 0.007) regardless of the number of MTM provided. Readmissions by 30 days were not significantly different based on the number of MTM provided (9% for 21 MTM vs 12.5% for 7 MTM), but well below national data at 23%. Conclusion The provision of at least seven MTM per week in the early window after hospital discharge to patients with HF and malnutrition or malnutrition risk is a promising strategy to improve malnutrition and sarcopenia risk and diet adherence, while keeping readmissions below national averages. Trial registration Clinicaltrials.gov NCT06142903, registered 11/23/2023. |
| format | Article |
| id | doaj-art-17b37bb06e8d4a2eab0111caf04eeae5 |
| institution | DOAJ |
| issn | 2055-0928 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nutrition |
| spelling | doaj-art-17b37bb06e8d4a2eab0111caf04eeae52025-08-20T02:51:23ZengBMCBMC Nutrition2055-09282025-03-0111111110.1186/s40795-025-01036-yThe nutritional impact of 7 versus 21 home-delivered medically tailored meals in patients with heart failure and malnutrition risk: a random order crossover feeding trial (MEDIMEALS)Charlene Compher0Jule Anne Henstenburg1Marianne Aloupis2Amy Sun3Ryan Quinn4Elizabeth Emery5Jovina Thomas6Adrian Glass Crafford7Daniel R. Schwartz8School of Nursing, University of PennsylvaniaMetropolitan Area Neighborhood Nutrition Alliance (MANNA)Hospital of the University of PennsylvaniaHospital of the University of PennsylvaniaSchool of Nursing, University of PennsylvaniaSchool of Nursing, University of PennsylvaniaSchool of Nursing, University of PennsylvaniaMetropolitan Area Neighborhood Nutrition Alliance (MANNA)Clinical Medicine (Cardiovascular Medicine), Perelman University of Pennsylvania School of MedicineAbstract Background Heart failure (HF) is frequently associated with malnutrition or malnutrition risk. The delivery of medically tailored meals (MTM) to the homes of patients with HF and malnutrition risk or malnutrition after hospital discharge holds promise for improving outcomes. However, the number of MTM needed to provide benefit is not established. Methods A random order crossover study was designed to compare the delivery of 7 versus 21 MTM for four weeks each to patients discharged from the hospital with HF and malnutrition risk. Telephone surveys were conducted at baseline, 30, and 60 days post-discharge to evaluate change in malnutrition risk, American Heart Association (AHA) diet goals, sarcopenia risk, and 30-day readmissions. Results Forty-six patients were enrolled. Patients had reduced odds of having malnutrition risk relative to the baseline score at one and two months (OR 0.18, 95% CI 0.04–0.74 and OR 0.21, 95% CI 0.05–0.99, respectively). The AHA diet score improved over time from baseline by 0.73 ± 0.22 units at one month (p = 0.0014), and by 0.48 ± 0.23 units at two months (p = 0.0430), regardless of the number of MTM provided. Sarcopenia risk improved over time (p = 0.01), decreasing by 0.43 ± 0.2 units by one (p = 0.03) and 0.59 ± 0.21 units by two months (p = 0.007) regardless of the number of MTM provided. Readmissions by 30 days were not significantly different based on the number of MTM provided (9% for 21 MTM vs 12.5% for 7 MTM), but well below national data at 23%. Conclusion The provision of at least seven MTM per week in the early window after hospital discharge to patients with HF and malnutrition or malnutrition risk is a promising strategy to improve malnutrition and sarcopenia risk and diet adherence, while keeping readmissions below national averages. Trial registration Clinicaltrials.gov NCT06142903, registered 11/23/2023.https://doi.org/10.1186/s40795-025-01036-yHeart failureMedically tailored mealsMalnutrition riskMSTSARC-F |
| spellingShingle | Charlene Compher Jule Anne Henstenburg Marianne Aloupis Amy Sun Ryan Quinn Elizabeth Emery Jovina Thomas Adrian Glass Crafford Daniel R. Schwartz The nutritional impact of 7 versus 21 home-delivered medically tailored meals in patients with heart failure and malnutrition risk: a random order crossover feeding trial (MEDIMEALS) BMC Nutrition Heart failure Medically tailored meals Malnutrition risk MST SARC-F |
| title | The nutritional impact of 7 versus 21 home-delivered medically tailored meals in patients with heart failure and malnutrition risk: a random order crossover feeding trial (MEDIMEALS) |
| title_full | The nutritional impact of 7 versus 21 home-delivered medically tailored meals in patients with heart failure and malnutrition risk: a random order crossover feeding trial (MEDIMEALS) |
| title_fullStr | The nutritional impact of 7 versus 21 home-delivered medically tailored meals in patients with heart failure and malnutrition risk: a random order crossover feeding trial (MEDIMEALS) |
| title_full_unstemmed | The nutritional impact of 7 versus 21 home-delivered medically tailored meals in patients with heart failure and malnutrition risk: a random order crossover feeding trial (MEDIMEALS) |
| title_short | The nutritional impact of 7 versus 21 home-delivered medically tailored meals in patients with heart failure and malnutrition risk: a random order crossover feeding trial (MEDIMEALS) |
| title_sort | nutritional impact of 7 versus 21 home delivered medically tailored meals in patients with heart failure and malnutrition risk a random order crossover feeding trial medimeals |
| topic | Heart failure Medically tailored meals Malnutrition risk MST SARC-F |
| url | https://doi.org/10.1186/s40795-025-01036-y |
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