Nutritional status of patients in a long-stay hospital for people with mental handicap

Objective. To investigate the general nutritional status of patients in Ale xandra Hospital, Cape Town, and to determine whether dietary copper deficie ncy was causing anaemia in hospital patients. Design. Descriptive and cross-sectional analytical studies. Setting. A long-stay hospital for people with mental handicap. Subjects. Information was obtained from the total hospital population. In a ddition, groups of 15 patients were selected from each of two specific ward s, one with active and the other inactive patients. To determine whether co pper deficiency was causing anaemia, a sample of 30 patients, divided into three groups (a hypochromic microcytic,a normochromic anaemic and a non-ana emic group) was studied. Main outcome measures. Body mass indices (BMI) and daily dietary intakes we re compared with Recommended Daily Allowance (RDA) values. Serum copper and serum caeruloplasmin levels were used to detect possible copper deficiency . Results: A considerable number of:patients were found to be underweight (32 % of males and 26% of females had BMIs < 20). A smaller number were obese ( 6% of males and 17% of females had BMIs > 30). Poor nutrition was more comm on in severely handicapped patients and those with acquired causes of their mental handicap. Subjects with Down syndrome were generally well nourished and occasionally obese. Poor dietary intakes of biotin, pantothenic acid, vitamin D and copper were encountered. The serum copper and caeruloplasmin values were found to be within normal limits. Patients with hypochromic, mi crocytic anaemia had higher serum Copper and caeruloplasmin levels than tho se with normochromic anaemia and the control group. Conclusions. A number of nutritional problems among the inpatient populatio n were found. Many were undernourished, while a smaller number of patients were overweight. In both the active and inactive wards macronutrient intake s were generally within-normal Limits. However, some micronutrient nutritio nal deficiencies were encountered. We were unable to establish that dietary copper deficiency was the cause of anaemia in our patients. Elevated serum copper and caeruloplasmin levels found in hypochromic, microcytic patients were thought to result from the existence of low-grade infection, associat ed with elevation of the acute-pi-case protein, caeruloplasmin.